| Learning Objective #1: Identify the importance of health literacy assessment | |||
| Learning Objective #2: Identify relationships between health literacy and other variables |
Purpose: Patients with inadequate health literacy may constitute a vulnerable population because they may incur increased heath care costs and have difficulty understanding directions for medications, informed consent documents, and in-home regimens. The purpose of this study was to describe the health literacy of inpatient and outpatient medical-surgical patients, compare instruments used to measure health literacy levels, and examine the relationship between health literacy and demographic measures. This study was executed by university faculty, clinical nurse specialists, unit managers, and staff nurses partnering as a hospital nursing research committee.
Methods: Using a cross-sectional descriptive survey design, a convenience sample of 54 patients was obtained from a comprehensive Midwest hospital. The following data collection instruments were used: a demographic information questionnaire, Hollingshead 4 Factor Index of Social Status, Rapid Estimate of Adult Literacy in Medicine (REALM), Test of Functional Health Literacy in Adults (TOFHLA), and the Health Status Instrument.
Findings: REALM scores indicated that approximately 33% of the patients had literacy levels that were eighth grade and below. According to the TOFHLA, 23% of the sample had marginal or inadequate functional literacy. Nearly 30% of the sample reported a REALM score lower than reported education. Literacy was primarily related to education and socioeconomic status. In addition, the REALM score correlated with the total TOFHLA score at p=<.01.
Significance: These findings are significant to nursing because an understanding of patients' reading abilities is necessary in order to design hospital documents and teaching materials that are written at appropriate levels. Health literacy should be a component of patient assessment. Screening tools that are easy to administer and acceptable to patients are needed. From this small study, it appears that the REALM would be feasible in a clinical setting and would provide a better indication of literacy than self-report of grade completed.
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