Health literacy : the perceptions and experiences of primary healthcare nurses.

Abstract

The purpose of this research study was to identify the nurses' perceptions and experiences of health illiterate clients, their styles of teaching and learning adopted with these clients, together with recommendations that they thought would help enhance the education of such clients. A sample of eight (n=8) nurses working at the Medical Consultant Clinics within the 8 Health Centres around Malta were interviewed using semi-structured, face-to-face interviews which were tape-recorded. These were later transcribed and analyzed using qualitative thematic analysis. The concept of health literacy has never been studied on the Maltese Islands, nevertheless the study identified that nurses do have a certain awareness of difficult patients who seem unable to understand what is being told to them. In fact, findings from this study revealed that nurses have employed certain nursing interventions to enhance their patients' understanding. The skills and abilities to employ such interventions were acquired only through experience throughout their nursing career. The nurses (n=8) were confident that they found no problems in giving information to their patients. In fact, one common theme that emerged from the data collected was that, it is the patients who do not understand the information given to them. All nurses stated that several times, most patients go back to the clinic to verify certain difficulties. Nurses were not aware of established health literacy assessment tools which would help them identify and adjust their teaching according to a patient's specific educational and learning needs. Nurses agreed that it is absolutely crucial for patients to understand the information related to self-care. However, the data suggests that nurses may underestimate the close relationship between a patient's health literacy and the extent to which the patient would engage in effective self-care after being provided with the related information. In determining the strengths and limitations of the nurses' current practice in relation to health illiterate patients, the findings indicate the areas within the nurses' role that may be addressed through further educational and research opportunities.