The Knowledge, Behaviors, and Attitudes of Beginning Baccalaureate Nursing Students Using Health Literacy Strategies

Monday, 30 October 2017

Marion Caroline Alida Dunkerley, EdD
College of Nursing, California Baptist University, Riverside, CA, USA

Purpose: The overall purpose of this mixed study was to investigate ways in which the implementation of health literacy instruction would affect how beginning baccalaureate student nurses respond to patients with low health literacy in terms of their knowledge, behavior, and attitudes toward low health literate patients.

Methods: A mixed study that involved pretest and posttest surveys of two cohorts of 40 each, focused teaching about the concept of health literacy to one cohort, and a standardized patient simulation of an interaction with a low health literacy patient was done. The modified Health Literacy Knowledge and Experience Survey (HL-KES) was used to assess the health literacy knowledge and attitudes of the students before and after a teaching intervention took place. A standardized patient scenario was then done with a randomly selected small group and nurse–patient interactions were measured qualitatively.

Results: Data revealed that there were gains in basic knowledge after the intervention. Students recognized that low health literate individuals may not admit they are low health literate and that written materials should be presented using simple language. They could not identify literacy as the highest predictor of low health literacy, nor could they describe tools used to assess low health literacy. There were some changes in behavior, including attempts to read material with the patient and the use of teach-back. There were no measurable changes in student attitudes toward low health literate patients.

Conclusion: It can be concluded that although there are small changes after one intervention, threading health literacy concepts throughout the curriculum would be a better way to ensure that nurses have the necessary knowledge and skills to be able to effectively communicate with all patients, particularly those with low health literacy, in order to equip and empower patients to make decisions about their own health. Further research in this area is suggested.