Health Literacy in the Context of Implant Care—Perspectives of (Prospective) Implant Wearers on Individual and Organisational Factors

Abstract

The continuous development of medical implants offers various benefits for persons with chronic conditions but also challenges an individual’s, and the healthcare system’s, ability to deal with technical innovation. Accessing and understanding new information, navigating healthcare, and appraising the role of the implant in body perceptions and everyday life requires health literacy (HL) of those affected as well as an HL-responsive healthcare system. The interconnectedness of these aspects to ethically relevant values such as health, dependence, responsibility and self-determination reinforces the need to address HL in implant care. Following a qualitative approach, we conducted group discussions and a diary study among wearers of a cochlear, glaucoma or cardiovascular implant (or their parents). Data were analysed using the documentary method and grounded theory. The data reveal the perceptions of implant wearers regarding the implant on (1) the ability to handle technical and ambiguous information; (2) dependence and responsibility within the healthcare system; and (3) the ethical aspects of HL. Knowing more about the experiences and values of implant wearers is highly beneficial to develop HL from an ethical perspective. Respective interventions need to initially address ethically relevant values in counselling processes and implant care.

Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices

“…Lastly, as shown by Huebner et al [ 23 ], health literacy development will be increasingly related to ethical aspects, such as the dependence on technology to make “good” health decisions or the extent of actual responsibility of health professions and healthcare systems to support individuals in becoming health literate. To understand how health literacy and ethics are interrelated, the authors assess implant wearers’ perspectives on responsibilities and challenges when accessing and applying information and advice about the integration of (implant) technology in everyday life, as well as how individual skills, as well as a healthcare system’s responsiveness, impacts the dependence on a technological device.…”

Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants – a scoping review

“…Here, health literacy (HL) could prove to be a beneficial factor for device management. Technology-related HL [ 131 ], as a ‘dimension upgrade’ on established models of HL and specification of digital HL, could serve as a contemporary add-on to this concept [ 18 ].…”

“…Yet, such safety standards must be maintained for impaired persons without the absolute necessity of an implant or even nudging them to decide for an implant, potentially leading to ethical conflicts. In implant care, safety refers to the feeling of security concerning implant functionality and therefore feeling safe in everyday life [ 18 ].…”

“…Thus culture, defined as “The shared, overt and covert understandings that constitute conventions and practices, and the ideas, symbols, and concrete artifacts that sustain conventions and practices, and make them meaningful.” (p. 1610) [ 38 ] also affects the evaluation and acceptance of medical implants. The decision for an implant may affect participation e.g., by being seen as part of or no longer/ belonging to certain cultures or groups [ 18 ].…”

“…A sustainable healthcare system “improves, maintains or restores health, while minimizing negative impacts on the environment and leveraging opportunities to restore and improve it, to the benefit of the health and well-being of current and future generations.” (p. IV) [ 42 ]. Implantation entails ongoing navigation of implant care and continuous (self)management of the disease and implant [ 18 ]. This demonstrates the importance of sustainable implant care, e.g.…”