TRIMESTER - Rotunda Library Newsletter June 2013 | Page 5

5 Volume 6 Issue 2 June 2013 Health Literacy Approaching the Challenges of Health Literacy H ealth literacy is an important issue in Ireland today. The International Adult Literacy Survey, conducted by the Organisation for Economic Co-operation & Development in 1997, found that over 50% of Irish adults are affected in some way by literacy difficulties such as problems with reading, writing and numbers. The results of the 2007 Irish Health Literacy Research, sponsored by MSD and NALA, revealed the following: • • • • One in five Irish people are not fully confident that they understand all the information they receive from their healthcare professional (doctor, nurse or pharmacist). 43 percent of people would only sometimes ask their healthcare professional to clarify the information if they did not understand something they had said. One in 10 people have taken the wrong dose of medication because they didn’t understand instructions. Two thirds of people have difficulty understanding signs and directions in Irish hospitals. Fullam, J., and Doyle, G., (2009) Poor Literacy Poses Risk for Patients Irish Medical Times, December 18th 2009, pp. 34 Albert, C., and Davia, M. A., (2011) Education is a key determinant of health in Europe: a comparative analysis of 11 countries Health Promotion International, 26 (2): pp. 163 - 70 www.healthliteracy.ie/what-is-health-literacy/health-literacy-in-ireland/ NALA has developed the following ‘top tips’ for health professionals to follow when communicating with patients: • • • Avoid medical jargon – use plain English instead Use images or visual aids where possible Use the ‘teach back method’ – ask the patient to repeat what you have told them in their own words to make sure they understand www.healthliteracy.ie/health-sector-worker/ Sahm, L. J., et al., (2012) Prevalence of limited health literacy among Irish adults. Journal of Health Communication, vol 17 Suppl 3: pp. 100 - 8 Marshall, S., et al., (2012) Health literacy in Ireland: reading between the lines Perspectives in Public Health, vol 132 (01): pp. 31 - 38 The authors conducted 2 health literacy investigations in Cork, Ireland. Study 1 was undertaken in 5 community pharmacies and the outpatient department of 2 urban hospitals and assessed patients' health literacy skills using the Rapid Estimate of Adult Literacy in Medicine (REALM) and the Newest Vital Sign (NVS). Study 2 took place in 1 outpatient department and evaluated health literacy using the REALM and the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA). The authors collected data relating to age, gender, ethnicity, and educational level achieved. All subjects were asked items relating to their ability to use health-specific materials. A total of 1,759 people (61.2% female) completed either Study 1 (n = 1,339) or Study 2 (n = 420). Limited health literacy ranged from 18.4% (REALM) and 57.2% (NVS) in Study 1, and 21.9% (REALM) and 14.1% (S-TOFHLA) in Study 2 and was associated with increased age and lower educational attainment across all three tools (p < .001). Patients with limited health literacy were significantly more likely to report problems with using health materials received from a doctor or pharmacist. At minimum, 1 in 7 Irish adults were found to have limited health literacy, which may affect their ability to promote, protect, and manage health. As in the United States and in the United Kingdom, improving health literacy should be a public health objective for Ireland. Health literacy may be defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. While health literacy has become a vibrant area of international research, Ireland has lagged behind and to date few data exist. This article summarises the research that has been carried out in Ireland, highlighting key findings and recommendations. With several new initiatives in place such as the Crystal Clear health literac y Awards, it is expected that Ireland will lag behind in this field no longer. Inadequate health literacy is at epidemic levels in Ireland and is fast becoming recognised as a national issue. Simplification of the healthcare system, in its entirety is required but the much needed financial investment will only be made after original research, demonstrating successful intervention has been conducted. With a trend worldwide towards personalised medicine, this theme should be extended to include tailor-made personalised healthcare information. An investment in health literacy will ultimately increase a patient's self-esteem, compliance, capacity to self-manage and most importantly patient outcomes and safety.