Patients’ and providers’ perceptions of the impact of health literacy on communication in pulmonary rehabilitation

Abstract

Chronic obstructive pulmonary disease (COPD) is the most prevalent form of chronic respiratory diseases worldwide. Pulmonary rehabilitation, including self-management education, highlights the importance of good patient-provider communication in establishing optimal care. There is a growing awareness of the potential impact of health literacy (HL) on the patients' access to and understanding of medical information. This study was designed to explore the patients' and health care professionals' (HCPs) perceptions of the role of HL in health communication.Semi-structured interviews and focus groups were conducted with 12 patients and 20 HCPs at a Pulmonary Rehabilitation Center in Metropolitan Toronto.Although the term health literacy was not familiar to many patients, the contribution of knowledge to patient well-being was consistently identified by patients and HCPs. Barriers to communication included provider time constraints and the use of medical jargon. For providers they also included patient characteristics, language, culture and awareness of health resources. Approaches that might improve communication incorporated family support, peer support, better print and visual teaching material and a trusting empathic patientprovider relationship.The findings provide an increased understanding of patients' and providers' perceptions of HL as a barrier to effective communication of medical information to patients with COPD as well as approaches that might improve this communication.

Can Patients With COPD Assimilate Disease-Specific Information During an Acute Exacerbation?

“…Alternatively, the modest improvements noted in some studies may be related to the patients' level of literacy. [21][22][23][24] Although our booklet used simple language, 53.3% of the patients in the intervention group had not completed high school and may have found the content difficult. Literacy carries a stigma and therefore patients may not have identified a lack of understanding of the material provided.…”

“…Literacy carries a stigma and therefore patients may not have identified a lack of understanding of the material provided. 22,23 Eighty-seven percent (n=13) of the patients reported that nothing was required to improve the program. Although the intervention group included a higher proportion of patients with a low level of education, the increase in BCKQ suggests that the intervention adequately targeted patients who may have had low health literacy.…”

Development of the Health Literacy Assessment Scale for Adolescents (HAS-A)

“…The existing body of work has documented a strong relationship between health literacy and health outcomes for adults, 1 and a growing number of studies have examined health literacy for parents, finding that low health literacy among parents leads to worse child health outcomes. 2 In particular, research has found that health literacy, including numeracy, can play an important role for communication in health care settings 3–6 ; people with lower health literacy skills often report greater issues with provider communication.…”

An insight into the perception of community pharmacists on health literacy

“…The study also highlights the perceived barriers towards HL and unlike other studies, time constraint was not regarded as the main obstacle in practicing and applying HL skills. This study identifies the ‘lack of knowledge’ and ‘lack of organizational resources as the major barriers to HL among the community pharmacists.…”

“…The concept of HL not only includes improving their level of literacy about diseases, medicines and self‐care but it starts at identifying the literacy needs or the areas that need to be addressed predominantly. Considering the definition of HL by WHO and the relevant literature, HL is the shared responsibility of healthcare providers as well as patients …”