Better, sooner, more convenient health care in Midlands

55. CommunityA focus on health literacyA focus on Health Literacy - self-management supportOur health care system places significant reading demands on patients. They must read andunderstand signs, registration forms, prescription bottles, home-glucose monitors, dischargeinstructions, health education materials, and appointment slips. For most health care providers,reading is so much a part of daily life that we think little about this and usually operate under theassumption that all patients can read adequately. Every office or clinic is filled with informationalbrochures for patients. The woman who is leaving the hospital with her newborn may be givenwritten instructions on how to clean the umbilical cord or check for a fever. Busy clinicians may giveprescriptions to patients with minimal explanation.A patient’s ability to be able to cope with this barrage of information is a concept known as healthliteracy, which is defined as the degree to which individuals have the capacity to obtain, process,and understand basic health information and health services needed to make appropriate healthdecisions. Effective health literacy begins in early childhood and continually builds on knowledgeand experience gained throughout the life span.The potential for negative health outcomes associated with low literacy, and particularly with lowhealth literacy, is not restricted to a small portion of the population. According to research in 2006,just under half (43%) of New Zealanders over the age of 16 do not possess the minimum healthliteracy skills required to read and understand medication and nutrition labels. In all of these cases,inadequate literacy skills can pose significant health and safety risks: improving the health literacyskills of New Zealander’s is therefore a critical issue.Research suggests that people with low health literacy:• Make more medication or treatment errors;• Are less able to follow treatments;• Lack the skills needed to negotiate the health care system;• Are at a higher risk for hospitalisation than people with adequate literacy skills.Delving further into the extent of health literacy, while a large percentage of adults are estimatedto have low health literacy, there are also a percentage of adults who have the skills and knowledgeto be literate but choose not to use them. Defined as ‘aliterate’ this group chooses not to read,prefer visual media (television or internet) to print media (newspapers or brochures). They approachlearning through trial and error and will avoid reading instructions (Eagle et. al.: 2005).Health literate patients will:Effectively manage their own healthShared decision-making is a key component of our Duty of Care, one of the components of theIntegrated Family Health Centre. Patient-centred care puts responsibility for important aspectsof self care and monitoring in patients’ hands. Shared decision-making requires that patients fullyunderstand their health problems and treatment options. This can be challenging for people whohave difficulties with reading, writing, numeracy, problem-solving and complicated oral information.Learning about health-related issues allows individuals to gain control over their own health byhelping them make educated decisions to improve their health outcomes. Attaining any controlover health outcomes requires the ability to find reliable and up-to-date health-related information,the ability to understand that information, and the ability to apply the information to specific life62