Why considering “health literacy” level is important for Family Physicians?

Öz

Family physicians are challenged with complicated cases every day, on some occasions; these circumstances get more difficult as a result of lack of compliance or poor communication between the patients and health care providers. Today, it is know that health literacy level of the individuals affect how patients interact with their care provider and their compliance to the treatment.Low health literacy levels are not exclusive to a particular region on the globe; reports show that 30% of the European has inadequate literacy level, and 64.6% in Turkey have low or problematic health literacy. Family physicians have a crucial role in identifying patients with low health literacy level and improve it to adequate level. Even though the limited time, work overload are some possible barriers for family physicians, a number of easy-to-use methods are developed to overcome some of these problems in primary care. Red flags have been identified to help family physicians to quickly identify the patients with low health literacy level. After that, in order to provide better communication, following strategies can be used are use of plain language, teach-back, ask me three questions, chunk and check, visual aids & written materials. Increasing health literacy can improve the health and well-being of the population and can also decrease the necessary time with patients to solve problems and prevent unnecessary repetitive attendance to primary health care services. Aile hekimleri her gün karmaşık olgular ile karşılaşmakta olup, bazı durumlarda, hasta uyumsuzluğu veya hasta-hekim iletişim yetersizliği nedeniyle bu durum daha da zorlaşmaktadır. Bugün, sağlık okuryazarlığının hastaların hekimleri ile iletişimlerini ve tedaviye uyumlarını nasıl etkilediği bilinmektedir. Düşük sağlıkokuryazarlığı herhangi bir bölgeyle sınırlı olmamakla birlikte, raporlar Avrupa halkının %30’unun yetersiz seviyeye sahip olduğunu, Türk halkının da %64,6’sının düşük veya sınırlı sağlık okuryazarlığı düzeyine sahip olduğunu göstermektedir. Aile hekimler sağlık okuryazarlık düzeyi düşük hastaları belirlemede ve düşük düzeyleri yeterli sağlık okuryazarlık seviyesine taşımada önemli bir role sahiptir. Kısıtlı zaman ve yoğun iş yükü aile hekimleri için olası engeller olsa da bazı kullanımı kolay teknikler bu sorunların üstesinden gelmek üzere birinci basamak için geliştirilmiştir. Kırmızı bayrak işaretleri hekimlerin sağlık okuryazarlığı düşük hastaları hızlıca belirlemeleri için tanımlanmıştır. Bunun ardından, daha sağlıklı bir iletişim için, yalın dil kullanımı, öğrenileni geri anlatma metodu, bana üç soru sor yöntemi, bilgiyi ver ve kontrol et metodu ve görsel ve yazılı materyal kullanımı gibi stratejiler uygulanabilir. Sağlık okuryazarlığı toplumun sağlık ve iyilik halini geliştirdiği gibi, hastanın problemini çözmekiçin gereken süreyi kısaltıp, gereksiz tekrarlayan birinci basamak başvurularını da önleyebilir.

Anahtar Kelimeler

• health literacy,primary care,family medicine

Kaynakça

1. 1. Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13(1).
2. 2. Tanrıöver Durusu M, Yıldırım H, Ready Demiray F, Çakır B, Akalın E. Türkiye Sağlık Okuryazarlığı Araştırması. Sağlık ve Sosyal Hizmet Çalışanları Sendikası Sağlık-Sen Yayınları-25, Ankara. 2014:14-26.
3. 3. Nouri SS, Rudd RE. Health literacy in the “oral exchange”: An important element of patient–provider communication. Patient Education and Counseling. 2015;98(5):565-571.
4. 4. Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International. 2000;15(3):259-267.
5. 5. McNeil A, Arena R. The Evolution of Health Literacy and Communication: Introducing Health Harmonics. Progress in Cardiovascular Diseases. 2017;59(5):463-470.
6. 6. Ngoh LN. Health literacy: a barrier to pharmacist–patient communication and medication adherence. Journal of the American Pharmacists Association. 2009;49(5):e132-e149.
7. 7. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Annals of internal medicine. 2011;155(2):97-107.
8. 8. Al Sayah F, Majumdar SR, Williams B, Robertson S, Johnson JA. Health Literacy and Health Outcomes in Diabetes: A Systematic Review. J Gen Intern Med. 2013;28(3):444-452.

9. 9. DeWalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and Health Outcomes. J Gen Intern Med. 2004;19(12):1228-1239.
10. 10. Batterham R, Hawkins M, Collins P, Buchbinder R, Osborne R. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 2016;132:3-12.
11. 11. Kickbusch I, Pelikan JM, Apfel F, Tsouros AD, World Health Organization, eds. Health Literacy: The Solid Facts. Copenhagen: World Health Organization Regional Office for Europe; 2013. Accessed January 5,2018.
12. 12. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Roundtable on Health Literacy. Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations Through the Use of Health Literacy and Community Engagement Strategies: Proceedings of a Workshop. Washington (DC): National Academies Press (US); 2017. http://www.ncbi.nlm.nih.gov/books/NBK464589/. Accessed May 3, 2018. 13. Simonds SK. Health Education as Social Policy. Health Education Monographs. 1974;2(1_suppl):1-10.
13. 14. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC public health. 2012;12(1):80.
14. 15. Kiechle ES, Bailey SC, Hedlund LA, Viera AJ, Sheridan SL. Different Measures, Different Outcomes? A Systematic Review of Performance-Based versus Self-Reported Measures of Health Literacy and Numeracy. J Gen Intern Med. 2015;30(10):1538-1546.
15. 16. O’Connor M, Casey L, Clough B. Measuring mental health literacy – a review of scale-based measures. Journal of Mental Health. 2014;23(4):197-204.
16. 17. Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Abdollahi M, Amini M, Eini-Zinab H. Developing and validating a scale to measure Food and Nutrition Literacy (FNLIT) in elementary school children in Iran. PLoS One. 2017;12(6).
17. 18. Chinn D, McCarthy C. All Aspects of Health Literacy Scale (AAHLS): Developing a tool to measure functional, communicative and critical health literacy in primary healthcare settings. Patient Education and Counseling. 2013;90(2):247-253.
18. 19. Rowlands G, Khazaezadeh N, Oteng-Ntim E, Seed P, Barr S, Weiss BD. Development and validation of a measure of health literacy in the UK: the newest vital sign. BMC Public Health. 2013;13:116.
19. 20. Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: A new instrument for measuring patients’ literacy skills. Journal of General Internal Medicine. 1995;10(10):537-541.
20. 21. Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP et al. Quick Assessment of Literacy in Primary Care: The Newest Vital Sign. Ann Fam Med. 2005;3(6):514-522.
21. 22. Batterham RW, Buchbinder R, Beauchamp A, Dodson S, Elsworth GR, Osborne RH. The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform. BMC public health. 2014;14(1):694.
22. 23. Abacigil F, Harlak H, Okyay P, Kiraz DE, Gursoy Turan S, Saruhan G et al. Validity and reliability of the Turkish version of the European Health Literacy Survey Questionnaire. Health promotion international. 2018:1-10.
23. 24. Bilgel N, Sarkut P, Bilgel H, Ozcakir A. Functional health literacy in a group of Turkish patients: A pilot study. Cogent Social Sciences. 2017;3(1):1287832.
24. 25. Ozdemir H, Alper Z, Uncu Y, Bilgel N. Health literacy among adults: a study from Turkey. Health education research. 2010;25(3):464-477.
25. 26. Brega A, Barnard J, Mabachi N, Weiss BD, DeWalt DA, Brach C et al. AHRQ health literacy universal precautions toolkit. Rockville, MD: Agency for Healthcare Research and Quality. 2015. Accessed March 15, 2018
26. 27. Taggart J, Williams A, Dennis S, Newall A, Shortus T, Zwar N et al. A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors. BMC Fam Pract. 2012;13:49.
27. 28. McGill B, Nutbeam D, Premkumar P. Improving health literacy in community populations: a review of progress. Health Promotion International. 2017;33(5):901-911.