Understanding Health Literacy Skills in Patients with Cardiovascular Disease and Diabetes

Abstract

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched the learning preferences and needs of the patients. A social ecological framework was used, which underscored the importance of understanding health literacy from multiple sources. Semistructured interviews were conducted on 19 healthcare professionals and 16 patients. Emergent key themes included: (a) social support plays an important role as a learning opportunity; (b) many patients get their information from internet searches; (c) instructional strategies should be personalized, interactive, social, and relevant; and (d) patients are self-directed learners. Linking of these themes led to the development of the health literacy instructional model, which is a 3-step approach, including an emotional support, behavioral approach, and instructional strategy. Social support was the common element in all 3 phases and was perceived to be key to developing health literacy skills, resulting in the key implication for social change. Recommendations are to consider social support in the development of health literacy instructional strategies.

Health Literacy of Patients Attending Cardiac Rehabilitation

“…An interviewee from this cluster also noted a lack of reliable, locally relevant websites, suggesting that this cluster may benefit from support to find reliable information sources. 42 Participants in cluster D reported lower trust in providers and limited skills to navigate the health system, potentially leading to frustration with providers and services. 40 Cluster E, with the lowest HL overall, is a group who requires ongoing support to find, understand, and use information to manage their condition in the long-term.…”

“…24 Instead, consideration could be given to asking brief questions such as "how comfortable do you feel talking to your doctor." 44 In addition, strategies to build HL should be routinely applied, 45 such as giving simple and personalized action-orientated information, 19,42 helping CR participants to build stable relationships with a trusted provider, 46,47 providing direction to reliable information sources, and offering opportunities for ongoing peer support. Importantly, given that we found most participants felt comfortable with health providers, CR practitioners are in a strong position to provide trustworthy and relevant information.…”

Perception and Evaluation of a Knowledge Transfer Concept in a Digital Health Application for Patients with Heart Failure: A Mixed Methods Study (Preprint)

“…Heart failure requires a high level of active patient involvement [5]. Self-monitoring of physiological parameters, medication intake, nutrition, and physical activity are crucial factors in preventing hospitalizations of patients [6,7].…”