Patient Engagement and their Healthcare Literacy Levels

Document Type:Thesis

Subject Area:Nursing

Document 1

Healing Process 9 Nurses Overestimation of Patient Health Literacy 10 a. Quality and Safety 10 b. Financial 15 c. Hospital Discharge 17 Health literacy 19 a. Three Sequential Levels: 19 Functional literacy 19 Interactive literacy 21 Critical literacy 22 b. The health literacy progress helps patients monitor their living style and health progressively. Studies indicate that patients prefer leaving a decision that touches on medical history to their doctors or health physician (Vancheri, 2011). Most of the patients prefer sharing their medical information with the physician and allow them make critical decision about their health. The idea behind this ideology is that most of the patient ignore the fact that they can also contribute better to their health decision. The patients take doctors as people in possession of expertise in all field and from any single shallow explanation about health they are able to assist accordingly.

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It is clear that high levels of literacy enable people to play an active role in decision making especially those anchored on medical grounds (Papalois and Theodosopoulou, 2018). It is assumed that patients who show critical literacy skills are able to presumably take on their medical journey, apply their expertise understand what the medical officer says then make a concrete decision without involving other stakeholders (Papalois and Theodosopoulou,2018). According to studies patients with low literacy, desires do not actively participate in the medical decision-making process (Vancheri, 2011). However, most of the studies conducted concentrated on the functioning health literacy basic skills such as reading and ignored the broad concept that involves much more on health literacy program. Overall purpose of the project The purpose of the project is to ascertain the patient’s literacy levels and the impact on their future health.

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The purpose of the research is to reflect on patients’ needs in terms of medical literacy. To fully exhaust on the problem statement on patient’s literacy and engagement the study will focus on patient care process which will exhaustively cover the following a. Patient-centered care b. Patient satisfaction c. Healing process d. The care providers can gauge the positive impact of the engagement and generally they are their motivation to healing (Huisman, Morales, van Hoof & Kort, (2012) Functional literacy- It is the ability as an individual to use his or her basic skills to maneuver through health-related materials (Mitchell & Begoray, 2010) Interactive literacy- It depicts advanced cognition skills and ability of an individual to collaborate with others in a social environment (Mitchell & Begoray, 2010).

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Critical literacy- It is the ability to make health decisions that are informed in the contest of the day-to-day life, whether at home, workplace, the community, and the health care system. It rests on the first two skill levels, which enables an individual to handle various health-related issues (Mitchell & Begoray, 2010). Organizational Health Literacy- This is an effort taken by a healthcare organization to transform service and care delivery to make it easier for patients and medical practitioners to navigate through information, understand, and use it to improve health of their patients (Farmanova, Bonneville, & Bouchard, 2018). Problem overview Research shows patients who are engaged in their health care attain better outcomes, decreased healthcare expenses, and are happy with their care (Hibbard, Greene, & Overton, 2013).

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a. Patient-Centered Care: This is a type of care that focuses on three factors. The first one is ensuring that the needs of patients come first (Southwick, 2013). Patients need to be encouraged to share with the health care providers on their preferences, needs, and values, in relation to healthcare since it will form the basis in development of the care plan. Care needs to be customized per individual client and ensuring that it meets their cultural beliefs. The health provide should also answer any questions asked by the clients effectively using a language that is easy to understand. The patients should be given all the time they require to self-express their needs and concerns freely. Communication between the provider and the patient should be centered on the needs of the patient.

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Opportunities should be offered to the patient for them to come up with preferred treatment regimen, and the healthcare team members should discuss with the patient the advantages and disadvantages of each treatment option. Shared decision making should be shared to ensure the client feels that their preference and values are taken into consideration (Evariant, 2018). It is based on the value patients get from a medical center when they go for treatment. It is also based on effective use of medical tools for treatment, and the process used to deliver healthcare services to a patient (Ofili, 2014). The patient satisfaction is also rooted on their communication with providers and access to health data they might need. Research has shown that some patients like to view their medical records and access of their patient portal.

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To ensure patient satisfaction, there is need of the health care providers to take into consideration the cultural background of the patient to ensure they are fully satisfied with the kind of medical care experience they receive. Healing Process This is the process of patient’s body recovering its normal functionality following an illness. Patient engagement can affect the duration of all aspects in the patient heath care process. This includes all stages, from diagnosis, to the care plan. Patient compliance with the care plan, and their levels of satisfaction. Through patient engagement, there is improves health care outcomes for both the patients and the care providers. Additionally, overestimation of literacy levels contributes to the poor health outcomes of the patients.

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Health literacy affects the health of individuals in that they are most likely to have poor self-reported health and health status, and difficulty managing their own health and well-being. Additionally, these patients are 1. to 3 times most like to have a poor health outcome as they will not get to make informed choices on the care plan. On discharge such patients have higher chances of re-admission as they will not be aware of the care plan, the medication regime, the precautions to take, and self-management. Therefore, there are patient concerns that arise on whether the information offered was adequately communicated or even availed to the patients and if they understood what was said to allow for appropriate follow-up. At times, the nurses overestimate the literacy levels of the patient and this jeopardizes their safety.

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The most major safety issue that is linked to limited health literacy is the risk that the patient might commit medication errors and they will not take the proper dosing as advised. Low literacy level is also at times linked to a poorer understanding of the names of prescribed drugs, the indications for the medicines, instructions, and adherence to the right treatment regimens (Wolf & Cooper, 2009). Studies have shown that about half of the adults fail to properly understand the instructions given on the prescription drugs such as the common auxiliary warnings like for external use only and do not chew, swallow whole, and common dosing schedules such as take three tablets by mouth once daily, that hold vital information needed for effective use and support safety (Shannon, 2017) When the nurses overestimate the patient literacy level, the patients have inadequate information and yet they are required to perform self-care activities.

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Additionally, due to poor communication, the physician might fail to understand the patient and their cultural environment within which they are supposed to receive information (The Joint Commission, 2007). The misunderstanding between the nurses and other health practitioners and the consumer can be influenced by communication, language used, and the culture. The leaders in all health care organizations need to ensure that they create and hold unto a culture that ensures safety and quality. They can do this by making sure they are the steward fir communication and aware of any health literacy issues in the organization. They organization needs to be increasingly aware of their target community such as the language they use to self-express, ethnic groups, and their health literacy skills levels.

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Lastly the health interventions and communications need to be based on the audience. During the encounter with the healthcare, there is need for enhanced use of communication techniques that will ensure the patient fully understands such as plain language, give at most 2-3 points per time, encouraging the patients to question, use of models and drawings. Moreover, universal precaution should be followed like use of plain language and probing the client further to understand them better. According to The Joint Commission (2007), communication should be centered on the patient disease management should be aimed at reducing errors and improving health outcome, consents should use simple language, decision-making should be done alongside patients, and patient should be made the safety advocates. In the transition phase, communication should be standardized, where more information is given on their condition, test results, follow-ups, and diagnose (The Joint Commission, 2007).

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Lastly, there is need to increase the production of patient-centered education programs and materials to create more support for the growth of informed of patients who are more informed. b. Financial There exist a close linkage between the patients’ health literacy levels and health outcome and extensive utilization of the healthcare resources. About 90 million adults have low health literacy skills and this limits their ability to read, comprehend the instructions given on the medicine bottles and prescriptions, giving informed consent, appointment slips, insurance firms, and other educational materials (Hartley & Horne, 2006). These poor health literacy skills have great economic consequences among the patients, their families, and the nation in general. The patients have to incur costs of readmission while healthcare facilities have to incur space costs related to housing the readmitted patients (Johnson, 2014).

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These increased share of the health cost not only affects the patients with low literacy levels, but also their families, the healthcare providers, and the financers that share this burden with the patients such as the government, employers, and insurance services such as Medicaid and Medicare (MacLeod et al, 2017). For instance, health literacy problems cost the US healthcare system between $106 and $238 billion every year yet it can prevented through health literacy. This amount represents between 7% and 17% of all individual health care expenditures, and amount that is similar to insuring the existing more than 47 million individuals that are not cover in the US in 2006. c. Health literacy is often linked to increased risks of being hospitalized, increased rates of self-reported poor health status, low knowledge of one’s medical condition, poor medical plans, failure to adhere to stated medical plans, and poor self-care behavior all of which lengthen the stay of the patient in hospital (MacLeod et al.

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Most of the patients that stay longer in hospitals do not have clear understanding of their discharge instructions, and medications schedules and they are thus most likely to be re-admitted back to the hospital following their discharge. The patients are most likely to follow an erroneous treatment plan, such as use of a drug not on their discharge list, forgetting to take drugs at the required timing, forgetting to get a refill of their prescribed drugs, and cessation of drug use with no orders from the doctors. Following discharge, these patients with reduced health literacy skills have inadequate knowledge on the medications they are supposed to continue using while at home (MacLeod et al. The patients are not aware of the purpose of the drugs, the reason they were taking them, or the number of times they are supposed to take them.

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An individual’s literacy levels will direct affect the ability of the person to act on their health information and also to take much better control of health as individuals, families and the society in general. The capability allows one to act appropriately regarding medical decisions for the health (Nubeam, 2000). Health literacy is significant for all individuals, because during our life span, we will need to discover, comprehend, and use health information and medical services (Centers for Disease Control and Prevention, 2016). a. Three Sequential Levels: Functional literacy It is the ability as an individual to use his or her basic skills to maneuver through health-related materials (Mitchell & Begoray, 2010). These patients are less likely to understand the diagnosis and treatment regimens, and their rate of appointment compliance will be low (Rask, Uusiautti & Määttä, 2014).

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Moreover, they will not be able to their medicines in the correct manner and they will also not get to adhere to the prescribed treatment regimens. These patients are most likely to have poor health outcomes and should be more engaged. The nurses need to improve the access of these patients with inadequate functional literacy to health information and enhance their ability to effectively use functional health literacy that is key for their empowerment. Functional numeracy is important as it allows the person to read consent forms, labels on medicines, and health care information, and to effectively comprehend the information that is given to them by nurses and other care providers such as physicians, and pharmacists and to follow the directions given to them through appropriate medication regimes, self-care adherence while at home, and ensuring that they promptly adhere to appointment schedules as advised (Rask, Uusiautti & Määttä, 2014).

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Interactive health literacy is more time oriented, and this means that people’s perceptions, knowledge and attitude. Poor interactive literacy difficulties means that individuals face difficulties when they try explaining their health problems or whenever they are holding a discussion on the health problems with health professionals. Individuals with limited interactive health literacy could have little experience in the health care system since to them, everything is new and it needs to be discovered. The relations with health care providers is hierarchical and at times unequal (Simon & Dong, 2014). This group of people may be reluctant to question the health care providers including nurses since they fear that they might waste their time, which they do not wish to. Individuals who are critically health literate, they tend to seek out for more information, take more control of their health situations, and thus will have a greater sense of control over their health.

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Good critical health literacy means that the individual is most likely to seek for more information for instance by checking the information on the internet, consulting friends and relatives, or even ensuring they have regular medical consultations and in the process, they also ensure that they always ascertain the reliability and value of each of these information channels as some could not be correct. Individuals with poor critical health literacy skills will most likely not be able to come up with own health care decisions based on the information and knowledge available as they lack skills needed to critically appraise and conduct an evaluation of the information (Simon & Dong, 2014). People with limited critical health literacy find it hard to make the right health decisions even those that are experienced.

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Situations that are viewed as stressful or difficult such as facing life-threatening conditions could make it difficult for them to make decision as that are rational. These include;- • The organizational strategic direction and policies, these include the mission statement, vision, training and development policies, and the consumer engagement policies of the organization • Health-related information which are the forms, healthcare directions and advice concerning medication, general healthcare information, therapies if any, referrals, the treatment plans to be followed, preventive therapy, exercise, or even diet. • The organizational information such as website information, recorder information on healthcare, directories for the patient to reach the hospital in case of emergencies, and recorded information. • Processes and systems for the patients to follow to reserve an appointment, get their test results, follow their plan of treatment, payment of care, attend referrals ,and any claims for insurance • The people and team that are working within the health care environment such as the nurses, doctors, managers, executives, administrators and all other staff.

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The healthcare managers need to review all these aspects of their healthcare organization to help check if there is need for improvement so that the systems, information, and services can be easily accessible to patients, and that they better understand the processes, and their conditions for better use. The health literacy environment at the health care needs to be improved for effective patient engagement. The organization should also be part of assessing success with the most vulnerable groups as part of their overall organizational performance measures. Some of the most vulnerable groups are the low health literacy groups (Brach et al. The health care organization can achieve this by conducting an audit of the health literacy environment as either a standalone audit or as part of the annual audit.

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They should also ensure that the quality & safety, and other improvement initiatives are a reflection of the health literacy principles and that they are evaluated to ensure they improve the health literacy environment. Lastly, the focus should be aligned on health literacy with other organizational priorities such as providing patient-centered care and reduction of health disparities. The organizations should also collaborate with members from the target communities in the designing and testing of any interventions that are to be implemented including the designing of the facilities, and general project redesign and evaluation. • The needs of the clients and the populations with arrange of the health literacy skills need to be met with no stigmatization. The organization should ensure that the communication and information is clear, linguistically and culturally appropriate for every client they anticipate to handle.

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The feedback of the target population should be used to verify the understanding and the usefulness of the information given. The organization should also use channels and formats that are within the highest reach of the intended groups and individuals. The organization needs to incorporate techniques that make it easy for individuals to find information in the facilities such as through social service agencies, clinics, and departments, website, and other communication channels. Social media and website communication should adhere to best practices to ensure the patients using electronic materials, systems, and messages like patient portals easy for them to find, comprehend and use. If there is any telephone-based information that is communicated to the patients, like toll-free information lines and scheduling of appointments, the staff responsible should make sure that they use plain language when handling all the needs of the patients, and the general population (CDC, 2017).

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The healthcare organization should be designed in a way that there exist features that will act as a guidance to the patients for them to easily find their way around the organization. Additionally, symbols and easily understood language should be used on all the signage within the organization to give directions. The provider should be able to identify the high risk situations and develop plans to ensure that they safely communicate to clients concerning issues such as informed consent, referrals, end of life care, and the regimens they are supposed to follow for the prescribed medicine (CDC, 2017). The organization should put in place, processes to ensure that the people receive useful and clear communication when they are at their most vulnerable state, both physically and emotionally.

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During the planning for crises, emergencies, and any stressful transitions it is anticipated that the patients’ health literacy will be an issue and thus preparations should be made on the type of basic services and information that will be required to responds to the high-risk situation. • There should be clear communication on health coverage and the payments the client are expected to make to the organization The organization needs to ensure clear communication techniques to try and explain the choices of a patient among the health services, the cost of the preferred choice, and all other services. If the patient will be needed to fill in forms for them to receive services, the language used in the forms should be plain with information design technique that will make it easier for the patient to understand and correctly complete these forms (CDC, 2017).

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A. In Siegel, E. R.  Health literacy: New directions in research, theory and practice. Vancheri, C. Zarcadoolas, C.  Advancing health literacy: A framework for understanding and action. San Francisco, Calif: Jossey-Bass. Marks, R.  Health literacy and school-based health education. C: National Academies Press. Papalois, V. E. Theodosopoulou, M.  Optimizing health literacy for improved clinical practices. athenahealth. com/whitepapers/patient engagement-strategies Berwick, D. M. What ‘patient-centered’ should mean: confessions of an extremist.  Health affairs, 28(4), w555-w565. Keller, D. Hernandez, L. M. Baur, C. Dreyer, B. Retrieved from https://www. cdc. gov/healthliteracy/planact/steps/index. html Clancy, C. M. Journal of Health Communication 18(Supplement 1), 62-69. Doi: 10. Evriant. What is patient Engagement? Retrieved from https://www. evariant. Jeffress, D. Sofaer, S. Shaller, D. Prager, D.

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J. R. French, D. D. Campbell, R. R. H. Greene, J. Overton, V. Patients with lower activation associated with higher costs; delivery systems should know their patients’ ‘scores’.  Health affairs, 32(2), 216-222. Patient engagement.  Health affairs. Johnson, A. Health literacy, does it make a difference? The Australian Journal of Advanced Nursing, 31(3). Kaphingst, K. Effects of patient health literacy, patient engagement and a system-level health literacy attribute on patient-reported outcomes: a representative statewide survey.  BMC health services research, 14(1), 475. Kelly, A. Haidet, P. Physician overestimation of patient literacy: a potential source of health care disparities. Patient engagement in the process of planning and designing outpatient care improvements at the Veterans Administration Health‐care System: findings from an online expert panel. Health Expectations, 20(1), 130-145. DOI: 10.

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hex. Kripalani, S. Straus, S. E. Wodchis, W. P. Baker, G.  Journal of patient experience, 3(4), 119-130. MacLeod, S. Musich, S. Gulyas, S. Cheng, Y. A. Using health literacy guidelines to improve discharge education and the post-hospital transition: a quality improvement project.  Am J Med Qual: Off J Am Coll Med Qual, 29, 86. Mitchell, S. E. Rask, M. Uusiautti, S. Määttä, K. The fourth level of health literacy.  International quarterly of community health education, 34(1), 51-71. What “patient-centered” should mean: Confessions of an extremist. Promising Care: How We Can Rescue Health Care by Improving It, 123. The Joint Commission. Language differences as a barrier to quality and safety in health care: the Joint Commission perspective.  Retrieved from https://www.  Clinical nursing research, 25(5), 494 511. Weaver, N. L.

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Wray, R. J. Promoting Health Literacy to Prevent Hospital Readmissions: Necessary but not Sufficient. Wolf, M. Cooper Bailey, S. The role of health literacy in patient safety.  Perspectives on Safety.

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