Level of Health Literacy in the US - Research Paper Example

Literature Review for Nursing Research Ambika Chacko Western Governors 10 13 Task 2 Problem ment The level of health literacy among patients is a major concern to various health professionals because of the impacts that it has on the medication processes. Low literacy levels among patients affects the patient’s ability to handle different medical instructions given to them by the nurses and this has major impacts on their recovery process. The nurses are also affected adversely as they have to redefine and refine their instructions to suit the level of understanding of the patients. The physician may have coined this leads to increased cases of alteration of the original medical instruction as. The increased lawsuit cases against healthcare institutions charged with malpractices is attributed to patient’s inability to process and comprehend medical information from nurses (Nutbeam, 2000). This problem therefore affects the administration of nursing facilities as it does the nurses and the patients due to the financial commitments they have to make during these lawsuits. Health literacy among patients is thus a problem whose impacts affect a wide group of individuals with impacts that can cost a life, affect the image of a facility or even break the career of a nursing professional. Based on the impacts of this problem, the formulation of solutions and methods of improving the literacy levels of patients should be developed promptly. The complexity of health issues continue to rise and this makes it significant to create methods of providing prompt solutions to the problem to help mitigate the impacts that it has in the nursing profession and the entire health profession (Scheckel, Emery and Nosek, 2010). Symptoms of problem Health literacy has no direct correlation with educational literacy as many may believe and this has resulted into lack of development of proper methods of addressing the problem. Understanding medical terms and instructions require a medical background, which is only available among the health workers. To help cushion nurses from taking responsibility for health related errors committed by patients, there is increased need to evaluate ways of improving health literacy among the general population. This will also help reduce the number of lawsuits against health facilities for mistakes committed because of low literacy levels of the patients, a situation that the hospital administration may lack proper ability to solve (Baker, 2006). There is a lot of evidence to illustrate the grave consequences of low health literacy levels among residents of the United States and how this affects the general nursing profession. The lack of limited health vocabulary among patients compounded by facile use of medical terms by nursing professionals is responsible for increased health illiteracy and complications. A number of empirical evidence available in the country demonstrates the impacts of health literacy level on improved patient’s care. In the early 80s, patients in the United States who were diagnosed with asthma were given instructions to take theophylline regularly and to ensure diligence in following appointments as made by the nurses (Baker et al., 2002). According to Gormley-Fleming and Campbell (2011) the theophllyne prescription given to the patients were written scientifically and thus required a certain level of literacy for the patients to understand. The level of patient literacy at this time was attributed to the increased development of theophylline resistance among the general population attributed to lack of clear adherence to the instructions. Today, patients are given instructions to monitor their own disease using a peak flow meter, while making selections and correct use of appropriate inhalers. Further instructions may require the patients to augment the therapies with oral doses of steroid to help exuberate their asthma. Understanding this kind of instructions require advanced literacy levels among patients as any single omissions done has dire consequences on the health of the patients. Literature search In conducting the research on the available peer and scholarly reviewed articles on this topic, the development of strong key words to guide my search is necessary. A number of articles have been written to explain the impact of health literacy levels on the United States lifestyle and how a gap in the understanding of medical directions has dire consequences. The evaluation of the impacts of the current literacy gap has also been researched to help convince health policy makers in the country on the need for intensive health literacy education in the country (Gormley-Fleming and Campbell, 2011). Keyword searches For the purpose of this research, specific keywords were used that influenced the results of my research on various journals and peer reviewed article sites. ‘Health literacy’ was the first keyword that I used to enable gain general knowledge on what the term mean and confines of health literacy within the nursing fraternity. ‘Health literacy and nursing’ is the second keyword that enabled me to access scientific publications made on this topic in relation to the nursing discipline and how the different levels of health literacy among residents of the country impacts of the professionals. To enable to access specific publication on the health literacy levels in the country, the keyword ‘health literacy levels in the united states’ was used. This refined the articles received to specific publications made on this topic as far as the United States as a country is concerned. The keyword ‘impacts of health literacy on nursing’ will also guide my search to enable me acquire relevant publications on the impacts of this research problems to nurses and how it affects their daily work schedules (Sarker, Schillinger, and Fisher, 2006). Modification of keywords After using random keyword search, the search was modified with the keywords changed to ensure the optimization of the search. The keyword ‘health literacy and nursing’ was modified to ‘impacts of health literacy on nursing’ to enable the search to give results which are specifically targeted towards the impacts of adequate or inadequate health literacy on the nursing profession. The keyword ‘health literacy levels in the united states’ were also modified in order to optimize the results obtained and was thus changed to ‘impacts of low literacy levels in the united states, this keyword produced data on the literacy levels in the country and the impacts that such levels have on health care in the country. Most useful keywords The most useful keywords are those that produced search results that targeted the required group, demography and country. As a result, in this search, the keywords ‘health literacy’, ‘health literacy in the united states’, ‘impacts of health literacy on nursing’ and ‘impacts of health literacy on health care in the united states’ produced the most significant results which were beneficial for this study. According to the (Schillinger et al, 2002), report, low literacy levels are attributed to the development of health complications because of mistakes committed by patients out of ignorance. To enable me acquire enough publications on this aspect, the keyword ‘health complications and literacy levels will be used. This will refine my search to the level of complications, which have been reported because of low understanding of the medical instructions by nurses. A number of scholars have raised concern in their publications over the low level of health education in the country to try to raise awareness on its importance. Accessing such kind of information, which will guide my literature review section, requires the keyword ‘health education in the United States’. Finally, despite the much-publicized impacts of health literacy among the general population many residents are quite informed and possess adequate health education. In developing, a policy for rolling out health education for the general public, clear data that demonstrate the demographic level of literacy will be needed. The keyword ‘level of health literacy in the united states’ will be used to enable me access publications made on the current literacy levels in the country. To find this information, study and scholarly databases will be used due to the credibility of their publications and the authenticity of the information. Nursing reference centre, a scientific database resource centre hosted by EBSCO will be used. This site provides nurses with adequate resources and point of care materials on nursing skills and literature reviews on nursing research. The national nursing database will also assist in providing the necessary reference materials for this dissertation due to its evidence based regulatory excellence for doing research on patient safety and public protection. Most of the research articles available in this site are cantered on research done in the United States making it a viable source for collecting the necessary information. The gravity of health literacy in the United States is attributed to the high number of publications and research around this topic. As a result, a simple non-refined keyword search on this topic was able to generate enough research articles that were just sorted out to enable me remain with the relevant ones only. Nursing reference database also possesses articles written on other geographical locations that discusses the impacts of this topic on nursing and its effects to patients generally. Data evaluation SOURCES CREDIBILITY ACCURACY REASONABLE SUPPORTED Baker, 2006 The authors academic credentials are relevant to the information he has provided in the article The information provided in the publication is up to date and well researched hence accurate. In the nursing context, this reference material is reasonable Approved by CME credit and quoted in several academic journals Williams, et al., 2002 The author has relevant academic experience in this topic and area of nursing research Does not account for the significant changes in literacy data available in the country hence less accurate Lack visible bias hence more reasonable Supported and published in family medicine journal Sarker, Schillinger, and Fisher, 2005 The two authors are renowned health researchers and authors in the areas of nursing research Accurate as the information presented concur with other publications The publication is made to help mitigate the impacts of low literacy levels among US citizens Has no support contacts of the writers Schillinger et al, 2002 Has credible evidence of quality control through review by peers in this area. It is published in peer reviewed journal Though published more than 10 years ago, the information is accurate as it provides detailed information on the health literacy levels then Widely cited due to the reasonability of the context The writers have no provided their details, journal published Baker et al., 2002 Credible due to its presence in referred journals of nursing Not updated to concur with current changes in the health sector that may have affected the data presented Viewpoint adequately advanced hence more reasonable Though highly credible, the writers fail to provide contact support Speros, 2005 Less credible due to poor visual presented and lack of enough information on the author’s academic achievements Date of publication and copyright information provided hence making it more accurate Highly cited in other research work due to reasonably Not sufficiently supported Carolan, 2007 Credible as the author possess vast experience in health literacy as a practicing nurse Less contradiction in the information provided with other reports Highly educative on the need to increase literacy levels and the impacts of the initiative No supporting information included Gormley-Fleming, and Campbell, 2011 Referred and published in peer-reviewed journals hence credible. Accurate as the site of retrieval is continually updated Highly recommended source Supported by additional details Annotated Bibliography Scheckel, M., Emery, N. and Nosek, C. (2010). Addressing health literacy: experience of undergraduate nursing students. Journal of clinical nursing, 19, 794-802. doi: 10.1111/j.1365-2702.2009.02991. In this article, the experience of undergraduate nursing students in providing patient learning education is documented. Nurses have made immense contribution in the process of improving the health literacy of patients as documented in this article. It seeks to teach students experiences of learning and providing patient education and clinical practice guidelines that will enable them understand the importance of health literacy. This reference provides the basis upon which nurses actions towards different practice situations relating to health literacy is founded. This article does not however explicate the students’ experiences of learning and providing patient education. Chang, L. (2011). Health literacy, self reported status and health promoting behaviors for adolescents in Taiwan. Journal of clinical nursing, 2, 190-196. doi: 10.1111/j.1365-2702.2009.03181.x. This study provides an analysis of the relationship that exists between health literacy, health status and health promoting behaviour. Limited health literacy is associated with poor health outcomes including low use of preventive services, inability to report health progress and lack of healthy behaviours in adults. Patients with moderate to high health literacy have a better chance of promoting personal health and increasing awareness of their health status. The article is intended for the Taiwanese population but has aspects that can be applied to the American general population. Huntington, A. et al. (2012). Nurses’ use of online health information in medical wards. Journal of advanced nursing, 68, 1349-1358. doi: 10.1111/j.1365-2648.2011.05845.x. This journal article evaluates the nurse’s access, use and evaluation of online health information in medical wards and this affects how they handle patients with different literacy levels. Online health information has been of benefit to patients with chronic health conditions to enable them support their health conditions. It helps strengthen the role played by online medical information in reducing the impacts of low health literacy among patients. However, it fails to document how these reduce the level of corporation among patients who fail to recognize and accept their diagnosis. Baker, D. (2006). The meaning and the measure of health literacy. Journal of internal medicine, 27, 878-883. doi:  10.1111/j.1525-1497.2006.00540.x. This manual provides the necessary health literacy skills that are necessary for a patient to understand his/her medical condition. It provides a manual that can be used by nurses to help gauge the literacy levels of patients before engaging them in complex health discussion. It also provides detailed information on how the patients may benefit from this information in improving their health literacy levels. This article provide a descriptive need for improving health literacy levels especially among patients suffering from chronic illnesses who may require to be able to administer self-care while at home. It however does not provide scientific data on the impacts of lack of enough health literacy especially to patients diagnosed with chronic health conditions. Williams, M., et al. (2002). The role of health literacy in patient-physician communication. Family medicine, 34, 383-38. This journal article reviews various researches on health literacy with the sole objective of examining its impacts on the patient-physician communication. According to this article, a number of research reviews exist on the level of health literacy in the United States but they have failed to provide necessary steps that can be taken to help reduce the impacts of low literacy levels among patients. It provides recommendations on how to enhance patient-physician communication especially in situations where the patients lack adequate literacy on health matters. Schillinger, D. et al. (2002). Association of health literacy with diabetes outcomes. The journal of the American medical association, 288, 651-670. In this journal article, the world health organization provides a detailed report on the current health literacy levels in the entire Europe. Low literacy levels are common among the poor ethnic minorities, the elderly persons and patients with chronic conditions. According to WHO, health literacy level in major countries of the world have been neglected and this has contributed to lack of quality health care among patients. The report also relates these findings with other previous studies conducted in other countries on the literacy levels. It however fails to give direct date on the current prevailing health literacy condition and levels in the United States. Sarker, U., Schillinger, D. and Fisher, L. (2006). Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Journal of journal of diabetes, 29, 823-829. doi: 10.1177/014572170302900411. The findings of this journal report helps to evaluate the missing link between health literacy levels in the United States and its impacts in implementing different nursing policies. This paper seeks to highlight the impacts of literacy levels on diabetic patients especially those who are on self or home-based care. The ability of an individual to understand the basics of his or her condition while undergoing treatment is very important in home based care of diabetes. It provides a link between effective homes based diabetes management and the patient’s health literacy levels. The findings in this reports come from a study conducted in 2005 by the association of clinicians for the undeserved on different healthcare facilities across the country. Gormley-Fleming, L. and Campbell, A. (2011). Factors involved in young people’s decisions about Health care. Nursing, children and young people, 23, 19-22. In this journal, the relationship between the choices made by young people and their health literacy levels is determined. It also highlights the impacts that the parent’s literacy levels have on the health decisions made by youths. Health literacy among the youths can improve the level of health care among young patients and provides them with enough information to make independent decisions on their health. It does not however provide details on the literacy levels of youths in the country and hoe this has influenced their decisions. Carolan. M. (2007). Health literacy and the information needs and dilemmas of first time mothers of over 35 years. Journal of clinical nursing, 16, 1162-1172. This journal attempts to highlight the dilemmas that exist in handling first time mothers with low literacy levels and how this affects their health and that of their new-born. Data on the impacts of literacy levels on the United States’ first time mothers should however be provided to support this information (Sharker and Fischer, 2005). In addition, this journal provides an analysis of the concept of health literacy in an attempt to provide clarity on its meaning, reduce the existing ambiguities and promote consistencies in using this concept in nursing promotion and research. References Huntington, A. et al.(2012). Nurses’ use of online health information in medical wards. Journal of advanced nursing, 68, 1349-1358. doi: 10.1111/j.1365-2648.2011.05845.x. Baker, D. et al. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American journal of public health, 92, 435-441. Baker, D. (2006). The meaning and the measure of health literacy. Journal of internal medicine, 27, 878-883. doi: 10.1111/j.1525-1497.2006.00540.x. Speros, C. (2005). Health literacy: concept analysis. Journal of advanced nursing, 50, 633-640 Chang, L. (2011). Health literacy, self reported status and health promoting behaviors for adolescents in Taiwan. Journal of clinical nursing, 2, 190-196. doi: 10.1111/j.1365-2702.2009.03181.x. Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International. 15(3), 259-267. Gormley-Fleming, L. and Campbell, A. (2011). Factors involved in young people’s decisions about. Health care, nursing children and young people, 23, 19-22 Scheckel, M., Emery, N.and Nosek, C. (2010). Addressing health literacy: experience of undergraduate nursing students. Journal of clinical nursing, 19, 794-802. doi: 10.1111/j.1365-2702.2009.02991. Carolan, M. (2007). Health literacy and the information needs and dilemmas of first time mothers of over 35 years. Journal of clinical nursing, 16, 1162-1172. Williams, M., et al. (2002). The role of health literacy in patient-physician communication. Family medicine, 34, 383-38. Sarker, U., Schillinger, D. and Fisher, L. (2006). Is self efficacy associated with diabetes self-management across race/ethnicity and health literacy? Journal of journal of diabetes, 29, 823-829. doi: 10.1177/014572170302900411. Schillinger, D. et al. (2002). Association of health literacy with diabetes outcomes. The journal of the American medical association, 288, 651-670. Read More