The presentation will illustrate the importance of effective communication and health literacy during an orientation session with new stuff at the healthcare settings. It will elaborate on the definition of health literacy and will also illustrate the benefits of communication and health literacy on overall health and well being of the patient. Importance will be given on discussing the different health literacy frameworks. Furthermore, the discussion will also focus on elaborating on the direct benefits of the aforementioned topics.
Health literacy refers to the ability to read obtain understand and utilise necessary healthcare information with the aim of conducting appropriate health decisions or showing adherence to instructions that are needed for treatment. It is found to be dependent on a range of systemic and individual factors, such as, the communication skills of professionals and lay person, knowledge about a range of health topics, demands of the public health care systems, demands of the context or situation and the cultural background (Schulz & Nakamoto, 2013). It often focuses on numeracy skills, such as, calculating blood sugar levels or cholesterol levels, and understanding nutrition labels related to food supplements, and measuring medications.
Owing to the fact that health literacy is a major contributing factor to existing health disparities in the present scenario, it has become a method of increasing concern for all healthcare professionals. Health behaviour has significantly improved among person with low health literacy, with the implementation of various interventions such as illustration, simplifying information, using teach-back methods, avoiding jargons, and encouraging the patients to put forth their questions (Betancourt, Corbett, & Bondaryk, 2014). Health literacy is a responsibility shared by the individual, the healthcare systems and all physicians or practitioners. Research evidences have often shown that there is a need for the healthcare service providers to work in collaboration with their clients, or patients, with the aim of increasing health literacy, among the vulnerable and minority population. This would further facilitate identification of the major barriers that limits literacy in the target population (Sykes, Wills, Rowlands & Popple, 2013).
Unaddressed cultural differences that exist between the patients and the providers also contribute to low health literacy, by developing value conflicts, misunderstandings, and disparate concepts of illness. Hence, an effective collaboration of the care providers with their clients will contribute to disparity reduction, by identifying the existence of health profession culture, in addition to personal bias and assumption, utilising team resources for recognising diagnosing and addressing cultural differences and low health literacy. This can be put into effective practice while working with racial or ethnic minorities, patients suffering from mental health disorders or those belonging to low socioeconomic background (Omachi, Sarkar, Yelin, Blanc & Katz, 2013).
Several proponents of health literacy view have extended the concept to include certain aspects that are beyond medical context and individual competencies. The health literacy model proposed by Nutbeam differentiates between three typologies namely, functional health literacy, interactive health literacy and critical health literacy (Smith, Nutbeam & McCaffery, 2013). Functional health literacy refers to basic reading and writing skills, needed to function effectively in general situations. Interactive literacy refers to advanced literacy and cognitive skills, which in combination with social skills, can help to participate in daily situations and derive meanings by extracting information, through different forms of communication. This can be used or implemented in changing healthcare circumstances. On the other hand, critical health literacy includes more advanced cognitive skills that are critically applied for analysing information, and using it for exiting a greater control over healthcare situations, and essential life events (McCaffery et al., 2013).
Health literacy frameworks focus on formulating strategies that will build the capacity of such people, to understand the options that are available for making decisions related to health care. The frameworks also focus to build capacity within the healthcare environment for making it easy for the people to use the services which includes patients, carers, and family members. The health literacy framework formulated by the Sydney Local Health District, shows the commitment towards improving the literacy, by using a collaborative and coordinated approach. This approach often utilizes embedding health literacy in practices, system, and organisational policy. The framework encompasses delivery of clear, usable and focused health related information, with the use of effective interpersonal communication (NSW Government, 2016). Furthermore, it also illustrates importance of integrating health literacy in education. Hence, the framework that contains major attributes of health literacy includes an organisational commitment, accessible technology and educational infrastructure, augmented workforce, implemented practices and policies, and effective bidirectional communication (Haun, Valerio, McCormack, Sørensen & Paasche-Orlow, 2014). The existing frameworks also emphasize on being committed towards a cultural shift, for obtaining better health outcomes and reducing health cost.
Communication is incorporated in different parts of the existing health literacy framework. While some include communication as an essential component of health literacy, the others focus on importance of communication for enhancing oral literacy such as, speaking and listening skills. Communication has been identified as a factor that influences appropriate development of health literacy. Communication within providers and the patients involves an interaction, which acts as a mediator of the relation and improves health outcomes and good health literacy. Moreover, the quality and effectiveness of communication between a patient and the physician is integral for developing a healthy or good relationship, between health literacy and health outcome (Norgaard et al., 2015). Health communication often encompasses interpersonal or mass communication that focus on bringing about an improvement in health of the individuals and the community. Demonstration of appropriate skills in getting a sound understanding or applying relevant information regarding health issues are critical in this process and have substantial impacts on health outcome or health behaviour.
Health communication can contribute to different aspects of health promotion, and disease prevention, and is related to several domains. These domains often include relationship between health professionals and patients, exposure of an individual to health information, and adherence to clinical regimen and recommendations. In addition, the domains that focus on effective communication for improving health literacy among patients also focus on construction of campaigns and public health messages and dissemination of health risk information (O'hagan et al., 2014). Communication skills have also been identified imperative while working with patients who belong to diverse cultural backgrounds. Healthcare professionals have the primary responsibility of forming an effective partnership or collaboration with their clients, in order to improve their health outcomes, regardless of their racial on linguistic background.
According to research evidences, effective communication between a patient and health care practitioner has shown significant effects in improving the overall satisfaction and contributing towards better or long-term health outcomes. The ease with which a patient understands the health information that is provided, also creates an impact on the health decisions that will be taken in future. Failure of the patient to understand the information that is being conveyed might increase the risk of not following the instructions properly, thereby increasing the likelihood of an adverse medical event. The most common problems that are faced in relation to ineffective communication in a healthcare setting includes poor manner or attitude, providing inadequate information, delivering misleading or incorrect information, and not accommodating the special needs of the patient (Aboumatar, Carson, Beach, Roter & Cooper, 2013). Communication in a healthcare setting is one of the most essential tools that help in providing great patient care and improve the overall patient satisfaction.
Hence, effective communication is imperative for addressing the poor health literacy that exists among most patients. With the aim of improving patient health literacy, and associated health outcomes, additional efforts must be taken to focus on integrating critical attributes of a collaboration and effective communication. This generally encompasses facilitating and open communication, shared responsibility, shared decision making and proper coordination. Patients usually demonstrate more confidence in healthcare professionals who communicate effectively that makes the former improve their health literacy skills. Communication, which involves exchanging or imparting information ideas or thoughts, with the use of writing, speaking or other medium such as, behavior or signals often, helps the patient to improve their numeracy skills and decision making skills (Green, Gonzaga, Cohen & Spagnoletti, 2014).
Low health literacy has been found to contribute to communication gap between physicians and clients. Moreover, patients with low health literacy often have less familiarity with certain medical vocabulary and concept which makes them hide their limited understanding, out of embarrassment. Patients immediately forget most of the relevant medical information that has been conveyed to them, if they have poor literacy skills. Hence, communication access a leading factor in preventing death, and disability, due to the fact that healthcare providers who engage in active listening, assess the preferences and demands of their patients and encourage their patients to talk, often report less complaints of adverse health outcomes (Nouri & Rudd, 2015). Thus, the most effective strategies that can be implemented to facilitate effective communication includes assessing the baseline understanding of the patients before providing them extensive health information, explaining medical terms, using simple language, effectively encouraging them to ask questions. and using an open-ended approach.
To conclude, health literacy is integral or critical to empowerment due to the fact that it improves the ability of all patients to access and use necessary healthcare information and also enhance their capability to use it in an effective manner. Thus, it can be stated that a combination of several skills that include writing, reading, speaking, listening, critical analysis, communication, and numeracy are imperative for demonstration of appropriate health literacy.
Aboumatar, H. J., Carson, K. A., Beach, M. C., Roter, D. L., & Cooper, L. A. (2013). The impact of health literacy on desire for participation in healthcare, medical visit communication, and patient reported outcomes among patients with hypertension. Journal of general internal medicine, 28(11), 1469-1476. https://doi.org/10.1007/s11606-013-2466-5
Betancourt, J. R., Corbett, J., & Bondaryk, M. R. (2014). Addressing disparities and achieving equity: cultural competence, ethics, and health-care transformation. Chest, 145(1), 143-148. https://doi.org/10.1378/chest.13-0634
Green, J. A., Gonzaga, A. M., Cohen, E. D., & Spagnoletti, C. L. (2014). Addressing health literacy through clear health communication: a training program for internal medicine residents. Patient education and counseling, 95(1), 76-82. https://doi.org/10.1016/j.pec.2014.01.004
Haun, J. N., Valerio, M. A., McCormack, L. A., Sørensen, K., & Paasche-Orlow, M. K. (2014). Health literacy measurement: an inventory and descriptive summary of 51 instruments. Journal of Health Communication, 19(sup2), 302-333. https://doi.org/10.1080/10810730.2014.936571
McCaffery, K. J., Holmes-Rovner, M., Smith, S. K., Rovner, D., Nutbeam, D., Clayman, M. L., ... & Sheridan, S. L. (2013). Addressing health literacy in patient decision aids. BMC medical informatics and decision making, 13(2), S10. https://doi.org/10.1186/1472-6947-13-S2-S10
Norgaard, O., Furstrand, D., Klokker, L., Karnoe, A., Batterham, R., Kayser, L., & Osborne, R. H. (2015). The e-health literacy framework: a conceptual framework for characterizing e-health users and their interaction with e-health systems. Knowledge Management & E-Learning: An International Journal (KM&EL), 7(4), 522-540. Retrieved from- https://cdrwww.who.int/global-coordination-mechanism/working-groups/elearn_hl.pdf
Nouri, S. S., & Rudd, R. E. (2015). Health literacy in the “oral exchange”: An important element of patient–provider communication. Patient education and counseling, 98(5), 565-571. https://doi.org/10.1016/j.pec.2014.12.002
NSW Government. (2016). Health Literacy Framework 2016 - 2020. Retrieved from https://www.slhd.nsw.gov.au/pdfs/SLHD_HLF.pdf.
O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., ... & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), 1344-1355. https://doi.org/10.1111/jan.12296
Omachi, T. A., Sarkar, U., Yelin, E. H., Blanc, P. D., & Katz, P. P. (2013). Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. Journal of general internal medicine, 28(1), 74-81. https://doi.org/10.1007/s11606-012-2177-3
Schulz, P. J., & Nakamoto, K. (2013). Health literacy and patient empowerment in health communication: the importance of separating conjoined twins. Patient education and counseling, 90(1), 4-11. https://doi.org/10.1016/j.pec.2012.09.006
Smith, S. K., Nutbeam, D., & McCaffery, K. J. (2013). Insights into the concept and measurement of health literacy from a study of shared decision-making in a low literacy population. Journal of health psychology, 18(8), 1011-1022. https://doi.org/10.1177/1359105312468192
Sykes, S., Wills, J., Rowlands, G., & Popple, K. (2013). Understanding critical health literacy: a concept analysis. BMC public health, 13(1), 150. https://doi.org/10.1186/1471-2458-13-150
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