BackgroundHypertension is a universal risk factor for cardiovascular morbidity and mortality in both the ageing and obese populations and patients must be literate in hypertension health issues to participate actively in the management of their disease. Little research has been done to investigate hypertension health literacy levels among South Africans.AimTo develop a Hypertension Heath Literacy Assessment Tool to establish patients’ comprehension of the health education they receive in primary healthcare (PHC) clinics in Tshwane, Gauteng, South Africa.SettingPHC clinics in Tshwane, Gauteng, South Africa.MethodsThe design was quantitative, descriptive and contextual in nature. The study population comprised health promoters who were experts in the field of health, documents containing hypertension health education content and individuals with hypertension. Participants were conveniently and purposefully selected. A modified Delphi technique was used to develop and validate the Hypertension Health Literacy Assessment Tool (HHLAT). To ensure validity and reliability of the HHLAT, the tool was administered to 195 participants concurrently with the Learning Ability Battery (LAB).ResultsThere was a strong positive (F = 76.0, p < 0.0001, R2 = 28.25%) correlation between the LAB and the HHLAT. The HHLAT indicated that only 37 (19%) of the patients with hypertension had poor hypertension health literacy levels.ConclusionThe HHLAT is a valid tool that can be used in busy PHC clinics as it takes less than two minutes to administer. This tool can inform the healthcare worker on the depth of hypertension health education to be given to the patient, empowering the patient and saving time in PHC facilities.

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Background: Hypertension is a global health burden affecting developed and developing countries, and South Africa is no exception.Aim: This article aims to highlight the language and content used in health education on hypertension in primary healthcare (PHC) by health promoters and in pamphlets.Methods: The study design was quantitative descriptive. The population comprised a purposive selected sample of 12 health promoters in 12 PHC clinics and 50 pamphlets relating to health education on hypertension. An audio recorder was used to record health education provided by health promoters. Quantitative content analysis and frequency distribution was used to analyse the data.Results: The health promoters used various South African languages mixed with English (code switching). Patients were taught about lifestyle modifications and encouraged to adhere to management therapy. The switching in language usage may affect the understanding of those who do not speak the local language and that may explain the reason for lack of hypertension-suited life modification required by health education.Conclusion: It is important that heath education on hypertension should be standardised so that the content of health education in clinic A is similar to that in clinic B. Information contained in pamphlets should be summarised and standardised to the content presented by health promoters.

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This special issue focuses upon public health nursing with women and children in the 21st century. There are 6 papers which address a range of topics illustrating some of the opportunities and challenges arising in this area of nursing work from Ireland, Norway, Finland, UK, Canada, and Brazil.Two papers (A. Clancy et al. and R. Bryars et al.) remind us of how public health nursing varies according to context and population. This is illustrated in a comparative sense in the paper by A. Clancy and colleagues which compares public health nursing models in Ireland and Norway. These two countries have many similarities from a geographic and demographic perspective. Both have similar sized populations, but economically there are vast differences between Ireland and Norway in relation to poverty; most notably, life expectancy is lower and inequalities are higher in Ireland. Nevertheless, both countries have a strong commitment to WHO reforms towards primary care, and public health nurses have been identified as key players in the delivery of primary care services, particularly primary prevention. Families with children living in areas of high deprivation face multiple health and social challenges and this high level of need impacts on the work of health practitioners working in such areas. The paper by R. Bryar and colleagues reports the use of a Delphi approach to identify priority areas for health visiting practice in an area of deprivation in the UK. This process identified a wide spectrum of health and social needs indicative of the level of deprivation in the area and pressures on families with children and is the first stage of a six-stage project which aims to develop a toolkit of resources for evidence-based practice in health visiting.Public health nursing is often focused on addressing the health needs of "at risk" or marginalized groups, and this is illustrated in different ways in 3 papers which address postnatal depression (K. Glavin and P. Leahy-Warren), child maltreatment (J. Inkilä and colleagues), and maternal substance abuse (N. Letourneau and colleagues). K. Glavin, and P. Leahy-Warren discuss the global prevalence of postnatal depression and how this serious health issue is specifically addressed in Ireland and Norway. They cite international research studies that clearly indicate the positive difference public health nurses make when screening and referring for postnatal depression. Although the health care systems are dramatically different between Ireland and Norway, both countries strive to offer universal services to all new mothers by public health nurses.Child maltreatment is a global problem and a multidimensional phenomenon occurring in all social classes. The paper by J. Inkilä and colleagues depicts interprofessional collaboration associated with the detection of and early intervention in child maltreatment taking place in the family in Finland. The results provide basic knowledge of interprofessional collaboration associated with child maltreatment between the agencies involved in the ...