Whether Increasing Health Literacy Would Reduce Blood Pressure - Literature review Example

Literature review narrative Name: Institution: Literature Review Introduction Literacy is highly important in health care provision in general and it plays a big role in determining the success of the various health initiatives. According to (Stonbraker, Schnall & Larson, 2015) health literacy can be define as the patient level of understanding or have the capacity to obtain, process and have clear understanding of the various health services and information needed to make decision that help health care mission be successful. High blood is a serious health problem in the west and lack of proper health literacy has contributed heavily in complicating the fight against high blood pressure. When high blood pressure gets higher than 140/90mmHg it is regarded as hypertension and (Jackevicius, 2012) outline it as one of the most thriving cardiovascular anomalies. One of the recent World Health Organization reports indicate that approximately 970 million of the total world population suffers from hypertension. A breakdown of the figures reveals an even grave situation that keeps burgeoning out of hand with time. For instance, 330 and 640 million of the population of developed and developing nations are victims of elevated blood pressure respectively (WHO, 2013). It is on such grounds that the World Health Organization rates hypertension as a prominent cause of premature mortality across the globe. But the reason behind such figures is somewhat unexpected. According to (Seanny, 2010), medical non-compliance is the chief justification for the prevalence of high blood pressure. Several expeditions and studies in the past have made a credible link between regimen on-adherence and the increase in the cases of high blood pressure and other cardiovascular diseases. The non-adherence to medication is, however, a product of several factors, both physician and patient-based. Among the chief causative agents of medical non-compliance include low literacy, impeded access to the medications, financial constraints and cultural issues (Seanny, 2010). The following literature review aims at establishing whether increasing health literacy would reduce blood pressure in patients with hypertension. Health literacy, as a factor, gives distinct attention as (Lucy, 2010) observes that it is the major factor in medical non-compliance. At the same time health literacy is distinct from the normal literacy but generally entails problem solving, information seeking, decision making and other useful healthcare management issues. Health literacy Health literacy is a term used since 1974 to refer to cases where patients going through medical procedure luck basic understanding of the basic health processes and requirement desired to make appropriate health decision. Stonbraker, Schnall & Larson (2015) believes improvement in health literacy can help reduce health care cost, allow timely screening, enhance social conditions and reduce general healthcare risks. Various organizations such as department of health and human services and world health organization all indicate the importance of health literacy and the need for further research to highlight on relation of health literacy to healthcare in general and hypertension patient in particular. Heart related complications are very complex hence require adequate patient participation. According to (Moser et al., 2015) heart failure knowledge and requisite skills are important in achieving necessary self-care and in avoiding unnecessary hospitals admissions. Moser et al (2015) define health literacy as a degree or capacity to obtain, process and understand basic health care information that contribute to important medical decisions. The Magnitude of Health Illiteracy in Patients with Hypertension According to statistics World health Organization (2013) one out of five adults has a prolonged disability or illness. In the UK, for instance, a national study by the Health Department in 2013 found out that above a third of the population with poor health had Entry Level 3 literacy skills or below (Vernon and Rosenbaum, 2013). In that case, the low levels of literacy and numeracy had a strong association with socio-economic deprivation. It then follows that adults in the most deprived areas performed at a relatively lower level compared to those in the areas that were less deprived since information access is easier. Another study in the same area with similar research design established that educational attainment ranging from 15 to 16 years was strongly linked to cardiovascular diseases like hypertension. The UK case is a typical reflection of the global situation. A fifth of the world adults, according to (Lucy, 2010), lack the basic skills particularly the functional literacy and numeracy. As such, those who fall in this category and also suffer from hypertension would face challenges with reading medication labels, following the regimens and taking the medication. As a consequence, most people with high uncontrolled high blood pressure are likely to develop stroke. Here is a graphical representation of the situation. (Source: www.wto.com) Besides stroke, hypertension patients are also susceptible to other cardiovascular diseases. The graph above shows the probable risk of stroke with respect to diastolic and systolic blood pressure. Jackevicius (2012) point out that strokes and heart attacks are in one way or the other related to blood pressure and happen above the normal range. In the world, it is estimated that approximately 50% of the adults living with hypertension are likely to suffer a stroke and other cardiovascular attacks. A huge percentage is, however, witnessed in the third world countries where the literacy is low and vice versa. On the overall, (Pignone and Lohr, 2014) explain that the figures are on the rise and unless an intervention is timely affected the situation may spin out of hand by 2030. Hypertension is responsible for annual deaths approximated at 7.1m and the number of adults suffering from high blood pressure has also already at 972million and is predicted that by 2020 60% of the people will be facing issues related to high blood pressure. Though most people believe in the internet information aspect, a good percentage of such information sources cannot be trusted. However, low health literacy level can hinder information access and possibly lead to misinterpretation and that can be very dangerous (Sillence, Briggs, Fishwick & Harris, 2007). Factors that Contribute to Hypertension Several risk factors contribute to hypertension. The first one is age. Pignone and Lohr (2014) explain that the risk of hypertension grows with age. Additionally, in her 2010 study, Lucy (2010) found out that while men are highly at risk of high blood pressure at the age of 45, their female counterparts are highly exposed to the same after 65 years of age. Race has also been confirmed to have a link with hypertension. Vernon and Rosenbaum (2013) substantiated that the blacks are more vulnerable to high blood pressure and are likely to contact it at an earlier age compared to their white counterparts. Additionally, the disease is projected to follow the family history. Obesity and sedentary lifestyles also lead to high blood pressure (Lucy, 2010). However, this can be explained biologically. The more the one weighs, the more blood is required to supply oxygen to all their body tissues. Therefore the increased blood volume increase the pressure exerted on the arterial walls. In connection, sedentary lifestyles increase the risk of obesity and the ultimate increase in pressure (Jackevicius, 2012). Besides, the chemicals in tobacco put the smokers at a higher risk of suffering heart attacks and hypertension. Other factors that may lead to high blood pressure, according to (WHO, 2013) include excess sodium in the diet, insufficient potassium, alcoholism, stress and such chronic conditions as diabetes. Hypertension is therefore a lifestyle disease that needs day to day management of our lifestyle through getting enough exercise and consuming less fatty, less sugary and less salty food. The Link between Health Literacy and Hypertension Prior to the main discussion, it is worth noting that ‘low literacy’ is not a direct cause of hypertension, but a causative agent of non-capacitance which increases the risk of hypertension. Vernon and Rosenbaum (2013) explain that the term ‘health literacy’ connotes the capacity of individuals to acquire process and comprehend ordinary health information before making a decision. Thus, it is associated with both the functional and cognitive skills required for any health related decision. There is, thus, much more to health literacy than the ability to read a sentence or simply understand the written instructions. It also consists of the numeracy capabilities such that the patient can compute their glucose levels and accurately measure their medication. In hypertension, the numeracy skills are particularly important in that the disease may attack when the physician is absent, and the victim will be required to perform such activities. Pignone and Lohr (2014) postulate health literacy and the normal literacy differ in that one’s health literacy may be lower than their ordinary literacy. In his recent study, (Seanny, 2010) outlined the unique link between low health literacy and hypertension. Firstly, hypertensive patients with health illiteracy rely entirely on oral communication that they rarely get from the pharmacists. Substituting oral communication with written communication, therefore, impedes the patients’ ability to follow their regimen. As a repercussion, such patients are more exposed to the risks of hypertension. Even then, (Lucy, 2010) notes that the health-illiterate hypertensives face challenges in reading the physicians’ written information. Health illiteracy also hampers the patient’s ‘medical knowledge’ as (Jackevicius, 2012) states. Medication knowledge refers to the ability of the patient to contribute to their care for purposes of decision-making. Hypertension, among other heart diseases, requires immense participation from both the physician and the patient. In a case the patient does not make contributions due to lack of understanding of the proceedings; they risk the repercussions (Hutchison, Warren-Findlow, Dulin, Tapp & Kuhn, 2011). Other effects of low health literacy with respect hypertension include reduced cognitive capacity. At unmonitored high levels of health illiteracy, the patient may feel uncared for and, therefore, will not have the motivation to follow the set regimens. Hypertension according to (Williams, Baker, Parker & Nurss, 1998) is a chronic disease which requires proper patient education to necessitate implementation control and prevention outcomes. Patient understanding is important in hypertension cases since it help improve patient understanding on how to take multiple medications and change lifestyle to suit regime that require intake of low salt diet, weight loss and BP control. The health care providers have even much harder task since most patients have insufficient knowledge needed to manage their own health. In the United States which is considered developed, around 50% of the adult citizen have insufficient knowledge to satisfactorily manage their health situation according to National adult literary survey. Williams, Baker, Parker & Nurss (1998) taking language consideration point out that 35.1% of English speaking students and 61.7% of Spanish speaking student’s experience health literacy problems. Moghaddami & Veghar (2013) carried out a research in the northern part of Iran in 2013 to assess the impact of literacy among the patient suffering from high blood pressure and how that affected the prevalence, awareness, treatment and control of such health problem. The study revealed a disturbing fact that indicated the awareness of such health problem among the illiterate was high unfortunately priority was not accorded to the prevention, detection, treatment and control. Williams, Baker, Parker & Nurss (1998) uses chronic disease health markers like levels of hemoglobin [Hb] A1c and blood pressure to determine the literacy or the patient understanding of daily self-care required to improved such health conditions. The patient understanding which is related to literacy level determine the chances of patient having knowledge regarding the disease in question and at the same time enhance chances of such as a patient adhering to the healthcare plan. Barriers to health literacy Health literacy is highly dependent on the health communication which continues to experience barriers such as cultural barrier and language barrier. Culture basically the values, beliefs and lifestyles that we learn, share and unknowingly transmit from generation to generation. Culture therefore influences our thinking, decision making and our actions. Nurses in more developed countries do their best to enlighten patients by making them learn the health requirement and teach them to be self-reliant. Health literacy cover areas like reading and writing skills, listening and speaking skills, numeracy skill and finally critical thinking, assessment and decision making stage. In 2003 National assessment of adult literacy (NAAL) carried a study on literacy disparities among the multicultural Americans from different background such as black, Hispanics and American Indians (Singleton & Krause, 2016). The cultural disparities contribute to other disparities such as racial and health need disparities. Nurses are at a better platform to provide necessary interconnection between the patient cultural background, diverse language and health literacy with an aim of improving the health outcomes among culturally diverse patients. However, Cultural position influences decision making which is important in health management and care. For example, familism and individualism will determine the patient priority during the health care provision. In familistic culture the family need take precedence over the individual need and in such culture the decision making and problem solving is done by the family as a whole. At the same time, the cultural perception may be linked to time orientations which determine a person’s world view. A person might focus on the past, present and future and the latter two are more applicable in health related issues which normally take the preventive approach. The United State culture is more futuristic hence put much emphasis on preventive approaches, new technology, progress and change. Language plays a huge part in complicating the struggle towards eliminating the low health literacy. Many patients have ended up taking overdose or under dose as a result of failure to follow instructions accorded perfectly due to either language misunderstanding or low health literacy. Communication is very important in medication and the practitioners and patients need to have a common understanding of the basic instruction that is followed at home during the treatment process (Aboumatar, Carson, Beach, Roter & Cooper, 2016). It is the policy of the most governments like United State to reduce hospital admittance and most patients are provided with the health provisions at the comfort of their homes. The process need better health literacy level as the patients are mostly alone and should be capable of following the instructions left behind by practitioners such as type of meal to avoid, type of meal to take, medication dosage, exercise routine and medication time. Therefore higher literacy level improves language understanding and enables effective communication between the practitioner and patient. Conclusion To sum up the review, (WHO, 2013) proposes that ameliorating the cognitive capacity, medication knowledge and mode of communication, as aspects of health literacy, is critical in reducing the risk of hypertension and other cardiovascular attacks. Thus, increasing health literacy among adults with hypertension will result in decreased cases of blood pressure and similar attacks. The chief reason for such a conclusion is the proven fact that increasing the health literacy motivates the clients to adhere to their drug prescriptions and follow the medical regimen which is normally complex and require improved level of understanding (McNaughton, Jacobson & Kripalani, 2014). The preceding literature review is of particular importance as it also proposes ways of combating the rising health illiteracy. By highlighting how the various modes of communication, for instance, are related to health literacy, various preventive measures can be drawn from such assumptions. Thus, the use of pictorial aids may come in handy for the illiterate hypertensive patients to ensure they absorb the medical instruction they are given. When a patient does not comprehend the instructions through oral or written communication, pictorially representing the information may increase the chances of the patient understanding the instructions given. According to the literature review, such a step will improve medical adherence and compliance to the regimen which is important in case the patient need to experience the desired health changes in time (Stonbraker, Schnall & Larson, 2015). The literature review also plays a major role in highlighting the magnitude of the health illiteracy crisis. Thus, medics and all the responsible experts of goodwill are called to action concerning the looming menace. Finally, all the steps outlined to increase literacy levels are aimed at eliminating the medical non-compliance that is the primary product of low health literacy. This is because compliance increases the rate of body response to medication and reduces the risk of overdose and under dose which normally can cause serious complications. References Aboumatar, H., Carson, K., Beach, M., Roter, D., & Cooper, L. (2016). The impact of health literacy on desire for participant in healthcare, medical visit communication, and patient reported outcomes among patients with hypertension. Society of General Internal Medicine, 28(11), 1469-76. Hutchison, J., Warren-Findlow, J., Dulin, M., Tapp, H., & Kuhn, L. (2011). The Association Between Health Literacy and Diet Adherence Among Primary Care Patients with Hypertension.Digitalscholarship.unlv.edu. Retrieved 8 March 2016, from http://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=1203&context=jhdrp Jackevicius, CA. (2012). ‘Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction.’ Circulation.117: 1028–1036 Lucy, N. (2010). Health Literacy: A barrier to pharmacist-patient communication and medication adherence. New York: Sage Publications. McNaughton, C., Jacobson, T., & Kripalani, S. (2014). Low literacy is associated with uncontrolled blood pressure in primary care patients with hypertension and heart disease. Patient Education And Counselling, 96(3), 165-170. Moghaddami, A., & Veghar, G. (2013). Impact of literacy on the prevalence, awareness, treatment and control of hypertension in adults in Golestan Province (northern Iran). Caspian Journal Of Internal Medicine, 4(1), 580. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762233/ Moser, D., Robinson, S., biddle, M., Pelter, M., Nesbit, T., & Southard, J. et al. (2015). Health Literacy predicts Morbidity and Mortality in Rural Patient with patient safety. Journal Of Cardiac Failure, 21(8), 12-45. Pignone, M. & Lohr, KN. (2014). ‘Interventions to improve health outcomes for patients with low literacy.’ The Journal General Medicine. 20:185-192. Seanny, M. (2010). Health Literacy and Medication Adherence. San Francisco: University of San Francisco Press. Singleton, K., & Krause, E. (2016). Understanding Cultural and Linguistic Barriers to Health Literacy. Medscape. Retrieved 7 March 2016, from http://www.medscape.com/viewarticle/717468 Stonbraker, S., Schnall, R., & Larson, E. (2015). Tools to measure health literacy among Spanish speakers: An integrative review of the literature. Patient Education And Counselling, 3(2), 33-44. Vernon, JA, & Rosenbaum, S. (2013). Low Health Literacy: Implication for National Health Policy.Retrieved December 13, 2015, fromhttp://www.iom.educ/project.asp:id=3827. Williams, M., Baker, D., Parker, R., & Nurss, J. (1998). Relationship of Functional Health Literacy to Patients' Knowledge of Their Chronic Disease. Arch Intern Med, 158(2), 166. http://dx.doi.org/10.1001/archinte.158.2.166 World Health Organization. (2013). Adherence to Long-term therapies: evidence for action. Geneva: WTO Publications. Read More