Health literacy has become one among the various concerns that the healthcare system considers as an integral part in the proper health care delivery. Numerous studies have already been able to illustrate the link between health literacy and patient care. Health literacy was found to influence patient care even to the chronic diseases.
A patient’s health outcome is dependent on his literacy regarding proper health care. Therefore a person who obtains sufficient health care information or education, his is less likely to suffer from extreme health problems and spend too much on health care delivery.
Health literacy links literacy skill level with the ability to understand health information and take control of one’s health. Obtaining a high level of health literacy however goes beyond the simple understanding of various health information and instructions but it is being able to make choices, influence events and successfully managing ones life (Chiovetti, 2006).
Health literacy is simply the capacity to obtain, process, and understand basic health information and services that are necessary in making health care decisions.
It may require medical knowledge, navigational skills, cultural competency, and initiative such that its prerequisite involves the basics of oral and written communication. Thus, a person with poor reading skills may also obtain poor health literacy (DeWalt & Pignone, 2005).
Health literacy is not determined by education alone but includes age, culture, socio-economic status, language, access to care and environment. “Anyone of any age or background can find it challenging to understand health information,” says Richard Carmona, the U.S.
Surgeon General. “However, some people are disproportionately more vulnerable to poor health literacy skills, including the elderly, people of color and those with low incomes.” (“Patient Care,” para 7)
Health literacy skills, which encompass the ability to process and understand basic information needed to make appropriate health decisions, are strongly associated with health-related outcomes.
Those with poor health literacy skills are less knowledgeable about health, receive less preventive care, have worse chronic illness control, and have higher emergency department and hospital utilization (Greene, Hibbar & Tusler, 2005).
Using the health care system requires patients to be health literate otherwise they will be faced with difficulties such as the ability to attend appointments because they were unable to register for health insurance or follow directions to the physician’s office.
They may also not be able to complete forms in the physician’s office that are necessary in diagnosis and treatment of the health problem that they may be consulting. Because they are ashamed of asking for assistance in filling out forms, they may leave with unanswered questions or sign documents which they have not understood.
When the appointment is over, patients do not know when to come back or follow up on the visit. Eventually, when things et worse, they would complain of their physician’s not helping them out in explaining and help them understand their medical condition in simple and understandable ways they could understand (Keenan & Safeer, 2005).
Health Literacy and Patient Care
Health literacy is considered as a national problem that needs appropriate attention and demand immediate action (Dreger & TRembeck, 2002).
As a result, the United States federal government had initiated its move in addressing this concern in the healthcare delivery system. Healthy People 2010 is the US federal government’s public health policy initiative that aims at improving health literacy (U.S. Department of Health and Human Services, 2000 as cited in Schwartzberg, 2002).
Scholars find it important to identify the relationship between health literacy and patient care since the outcomes of the healthcare that they provide them does not reflect the patient’s literacy but their ability to deliver proper care to them.
However the situation may seem odd, the role of the medical staffs in a healthcare delivery system involves providing the patients with adequate health information especially when patients have very low literacy level.
Literacy in itself is already found to be greatly affecting the health outcomes of patients such that patients with inadequate literacy – poor reading and writing skills – are prone to obtain poor health than those who can read and write (DeWalt & Pignone, 2005).
Almost all of health care directions involve words and numbers. Old instructions in patient care such as the directions in dosage medications and the like involve basic mathematical equations. If patients have very low levels of literacy, they may not be able to understand the medications and may not follow proper instructions that may even promote adverse effects on their health condition (Schwartzberg, 2002).
Most often, medical staffs assume that their patients can read and write accurately. However, according to the results of studies that were conducted regarding the literacy levels, there are 90 million Americans who have low literacy levels (Arnold, Davis, Jackson, Mayeaux, Murphy & Sentell, 1996; Dreger & Trembeck, 2002) that means fair to poor literacy (Keenan & Safeer, 2005).
This also shows that these people whose literacy skills are at one or two are at higher risk in obtaining adverse events when they encounter the reading challenges of the current health care system (Schwartzberg, 2002).
There are three dimensions of literacy involving patient education and care: a) prose literacy which is the ability to understand written news stories, poems and editorials; b) document literacy which is the ability to understand bus or train schedules, charts, maps, and graphs; and c) quantitative literacy which is the ability to use numbers, balance a checkbook, and understand fractions.
These three literacy dimensions are significant requirements in order for patients to understand most of the brochures and other written information that patients get every time they visit their health care provider.
It is necessary for the patients to be able to read and understand the basic things involved in the health care such as the food exchange list from a diabetic diet, thermometer reading, childhood immunization schedule compliance, and proper administration of various medications (Dreger & Trembeck, 2002).
Each patient encounter with health professionals and institutions involves an excess of paperwork such as insurance forms, intake and medical history questionnaires, informed consent documents, pre-procedure instructions, educational brochures, appointment slips, and prescriptions.
Physicians and nurses offer brief explanations and expect patients to read and re-read the materials they are given and then act appropriately (Schwartzberg, 2002).
The greatest burden of low health literacy is laid on patients who have prevalent chronic diseases and on patients who use the hospitals, medical and pharmaceutical care more often. They have higher risks for misunderstandings, medical errors, increased hospitalizations, and poor health outcomes (Schwartzberg, 2002).
Chronic illnesses such as multiple sclerosis rely on patients’ self management of the disease such that the rapid development in the healthcare system prevents them from staying for a long time in the hospital.
The responsibility of its care is now basically relied on the patient himself rather than the healthcare institutions. Thus, there is a need got MS patients to have sufficient knowledge and understanding of the disease and its management. They must be provided with sufficient information that involves its prognosis, symptom management, and complex treatment options.
These information are considered vital for their self-management, health maintenance and quality of life that is a part of their responsibility. Therefore, patients who have low literacy skills may not be able to understand these huge information that their physicians may provide them.
This inability will at the same time prevent them from acting on the information provided (Chiovetti, 2006).