What Effects Does Health Literacy Have on Nursing Assessment?

Published: 2021-06-22
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Boston College
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The purpose of this phenomenon study was to examine health literacy awareness in nurses. The most appropriate methodology was qualitative study to examine the beliefs and influences that guide nurses views of health care management while working and studying in higher education, hospitals, and nursing homes.

PROBLEM STATEMENT: Nurses have a gap with health literacy in awareness, knowledge, and clinical recognition of low health literacy, skilled and practices to address low health literacy. In additional, nurses do not routinely use best practices for effective communication to health consumers with low health literacy. Because such little health literacy research has been conducted with or by nursing professionals, however, the profession knows little about how it interacts or influences the phenomenon.

PURPOSE STATEMENT: The purpose of this qualitative study is to explain awareness to nurses, clinical knowledge, skills and attitudes with the practice of health literacy. To describe nursing professionals knowledge and perceptions of the impact of limited health literacy on individual patients, their practice, and the health system. To explore nursing professionals perceptions of the effectiveness of, or barriers to, implementation of health literacy programs for patients at their places of practice.

However, thus far, no studies have been conducted to assess the knowledge of nursing professionals across educational preparation, role, or practice specialty, regarding nursing knowledge of health literacy, its impact on patient outcomes, or nursing use of resources to facilitate communication with individuals with low health literacy. Nursings perception of health literacy remains largely unexplored, yet, health promotion activities and patient education have always been independent and intrinsic components of nursing care (Mason, 2001).

Introduction: Patient education and effective communication are core elements of the nursing profession; therefore, awareness of a patient's (health literacy) HL is integral to patient care, safety, education, and counseling. In health care organizations, low HL is sometimes assessed by asking patients the questions, Do you have any limitations to learning? and What was the last grade completed?

Annotated Bibliography

Dickens, C., Lambert, B. L., Cromwell, T., & Piano, M. R. (2013). Nurse Overestimation of Patients' Health Literacy. Journal of Health Communication, 18 (Suppl 1), 62 69.http://doi.org/10.1080/10810730.2013.825670


From the journal article of Dickens et al. looked at the comparison of the patients' health literacy estimates using the measurement of Newest Vital Sign. All who did these estimates were the nurses. What facilitated this study to be undertaken is that patient education is crucial for effective communication. Effective communication and patient education are all part of core elements that aid the nursing profession in executing their nursing care to various patients. Thus, when the nurse's fraternity is cognizant of the extent of patient' level of literacy, it is deemed necessary for nurses to know up what level of patient counseling level to hike to, how to educate the patient, care for him or her and how to accord the patient safety. Research evidence indicates that training in HL is crucial and thus needed for nurses of inpatient. Some schools presently have integrated HL in their curriculum, most of these professional nurses didn't receive the above information. 2008 National Sample Survey conducted among Registered Nurses surveys, 70% of the nurses had beginning nursing education. This is greater than 14 years ago. The subject of HL was not offered in the curriculum of nursing at that time. The 2008 survey indicated that, 62.2% of the nurses being employed by hospitals. Other health care professionals should be included in HL training so all professionals impacting the patient experience can be involved. For this to occur, leadership within healthcare organizations need to make an investment and train their workforce to become health literate.


Participants of the study came from a total of sixty-five patients and 30 nurses. The results from this study indicated that most nurses incorrectly categorize most of the patients with having a low health literacy. Equally, an overestimate in most cases outnumbers the level of underestimates at a ratio of 6:1. Thus, the study reinforces all the previous evidence given that almost all the healthcare providers overestimate the health literacy of their patients. Hence, the nurse's overestimation of their patients; health literacy contributes heavily to the widespread of problems that are associated with hospital readmission rates and poor health outcomes. For decision making and information evaluation, more sophisticated interactive health literacy skills were required. Health promotion faces adverse external influences from critical health literacy skills. The model is repetitive revolving around ethnicity, community, and culture. The study shapes on current models by emphasizing the significance of SDH in the conversion of latest health knowledge into behaviors. The relevance of health literacy is to enable individuals to overcome health barriers.


We found that nurses overestimate the HL skills of their patients. This is an important target for professional development as such errors may contribute to the widespread problem of poor health outcomes and hospital readmission rates in patients with low HL. Hence, the nurse's overestimation of their patients; health literacy contributes heavily to the widespread of problems that are associated with hospital readmission rates and poor health outcomes. Schools of nursing and health care organizations need to undertake the task of educating their nurses about HL. This research will add some value to this study since the study will borrow heavily from the comparison of the patients' health literacy estimates using the measurement of Newest Vital Sign. The research findings from Dickens et al. are equally significant to this study. Hence, future research should be targeted at the nursing profession to mitigate the negative patient outcomes associated with low HL.

Macabasco-O'Connell, Aurelia, and Eileen K Fry-Bowers. 2011. "Knowledge and perceptions of health literacy among nursing professionals." Journal Of Health Communication 16, no. 9: 295-307. CINAHL Plus with Full Text, EBSCOhost (accessed April 7, 2017).


The main tenacity of this study was to designate the practice, perceptions of low health patients' literacy and the nurses' knowledge of on their patients. This study was conducted using the cross-sectional method. Under cross-sectional, it embraced the descriptive study using web-based survey in the name of assessing the knowledge and nurses perception on the health literacy of their patients. Those who took part in the study include Registered Licensed Nurses from the state of California. The data used for analysis was descriptive statistics that described the general perceptions and knowledge of the professional from nursing department. On the patients' part, the qualitative textual analysis was conducted using a questionnaire response that requested all the participants to define their health literacy. According to 2003 National Adult Literacy Survey, a 36% Americans hold basic literacy skills and, as such, lack sufficient ability to read, comprehend, act on medical information, and interact with the health care system. This ability formally labeled health literacy,' comprises various skills beyond those of reading and writing, and includes numeracy, speaking and listening, and relies on cultural and conceptual knowledge. Importantly, low literacy in health seems to be firmly associated with low educational attainment, race, ethnicity, age, and English-speaking ability. Substantial evidence reveals that individuals with low health literacy possess imperfect knowledge of chronic conditions, lack ability to navigate an increasingly complex health care system have an increased risk of hospitalization and a greater risk of mortality when compared with those with higher levels of health literacy.


The data used for analysis was descriptive statistics which described the general perceptions and knowledge of the nursing professionals. On the patients' part, the qualitative textual analysis was conducted using a questionnaire response that requested all the participants to define their health literacy. Macabasco-O'Connell, Aurelia, and Eileen's study revealed that the nurses' professional role of understanding and their knowledge of patient health literacy impacts either negatively or positively on the patients' health outcome. They continue to assert that patients' perceptions and knowledge of health literacy's outcome role are limited. Health literacy was also reported to be a low priority among providers and organizations. Nursing plays an important part in the direct patient care and the delivery of health services. Educating nurses on health literacy and improving patient communication and understanding can improve clinical outcomes.


This article is significance to the study since it offers a background of sufficient information on the application of health literacy. At the same not, this article will serve well other researchers who would love to combine it with other relevant studies. Health literacy which is low is common. As the diversity of patients continue to rise within the health care setting, and at the same time complexity and demand of health tasks and information being scarce, the entertaining reduced capture of health literacy will be problematical in the long run. The study focuses on various level systems of health care that examine how patient health literacy in the family of patient population can be determined. Equally, the study will help in determining what programs are to be put in place that will be addressing the limited patient health literacy. Additionally, the study has to look at the roles of rapid health screening procedures and tools that help in assessing literacy in huge populations and how fair it is to determine which approach is operational in supporting quality care improvement. Furthermore, the systems of health care need to sustain and facilitate the continuity of education on health literacy among the healthcare providers and nurses. The nursing education ought to take account of a greater emphasis on incorporating health literacy of patients within the curriculum of the nursing school. Thus, nursing curriculum ought to include some concepts such as perceptions and knowledge of health literacy's outcome from Macabasco-O'Connell, Aurelia, and Eileen's study. But, concept borrowings will be limited to the impacts of understanding and knowledge of patient health literacy about the patients' health outcome. Future research is duty-bound to address educational approaches for nurses, and in what way is increasing understanding and knowledge of health literacy can help in advancing patient health outcomes.

Roundtable on Health Literacy; Board on Population Health and Public Health. Practice; Institute of Medicine. Implications of Health Literacy for Public Health: Workshop Summary. Washington (DC): National Academies Press (US); 2014 Sep 10. Appendix C, A Prescription Is Not Enough: Improving Public Health with Health Literacy. Available from: https://www.ncbi.nlm.nih.gov/books/NBK242434


The roundtable comprises of leaders from the government Foundation, academia, industry, representatives, and associations of consumer and patient interests who strive hard to improve and address the health literacy. For the roundtable partners achieve their core mission, they usually deliberate on various...

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