Literacy Concept In Health Care and Nursing How to Define Literate
For many years, there was no consensus on what it meant to be literate in American society. Traditionally, a literate person was loosely described as someone who possessed basic reading and writing abilities, such as the ability to sign their name or write a simple sentence. Over time, literacy became more commonly measured by performance on reading tests, which aimed to assess grade-level achievement. However, these methods are often imprecise, as they do not truly capture a person’s functional reading abilities. In practice, many researchers have found that the number of years of schooling a person has attended does not reliably predict their true reading skills (Chew et al., 2004; Doak et al., 1996).
In an attempt to better measure literacy, researchers and educators have begun to rely on standardized tests to evaluate the specific reading and writing abilities of individuals. These tests provide more detailed insights into how well someone can function in society using their literacy skills. Yet even this method has its limitations, as literacy is a complex, multifaceted ability that extends beyond simple reading and writing. For instance, someone may be able to read a sentence but struggle to understand its meaning or apply the information to real-world situations.
Literate in the United States
In the United States, literacy is most often defined as the ability to read and write in English. According to the 1992 National Adult Literacy Survey (NALS), the U.S. Department of Education defines literacy as “the ability to use printed and written information to function in society, achieve one’s goals, and develop one’s knowledge and potential” (National Center for Education Statistics, 1993, p. 6). This definition emphasizes the practical application of literacy, focusing on how individuals use their skills in everyday life.
NALS categorized literacy into three key areas:
- Prose Literacy: The ability to read and understand continuous texts such as books, magazines, and newspapers.
- Document Literacy: The ability to interpret documents such as insurance forms, consent forms, and other non-continuous texts.
- Quantitative Literacy: The ability to handle numbers and perform tasks such as calculating bills, managing finances, and understanding nutritional information.
This tripartite model provides a more comprehensive understanding of literacy in the U.S., recognizing that literacy is not just about reading and writing, but also about the ability to use written and printed information effectively.
Literate Definition by NAP
The National Assessment of Adult Literacy (NAP) takes this concept a step further by adding skills such as basic math, interpreting speech, and comprehending information into the definition of literacy. NAP also includes numeracy, which involves basic probability and numerical concepts (Baur, 2011). This approach acknowledges that literacy is not just about language skills, but also about the ability to process and use numbers effectively.
This expanded definition is particularly important in today’s society, where individuals need to navigate a range of tasks that require both language and numerical skills. For example, someone might need to read a medication label and calculate the correct dosage, or interpret a financial statement and make informed decisions about their health or finances.
Literate and Illiterate in Functional and Conventional Terms
In functional terms, low literacy—sometimes referred to as marginally literate or marginally illiterate—refers to the ability of adults to read, write, and comprehend information at a level between the fifth and eighth grades. Individuals with low literacy skills often struggle to use written information in their everyday lives. For example, they may have trouble reading a TV schedule, taking a telephone message, or filling out a simple application form (Doak et al., 1996).
Functional illiteracy is an even more severe limitation, where adults lack the basic skills necessary to perform everyday tasks. These individuals might be able to read simple words, but they struggle to understand the meaning or sequence of instructions. For example, someone who is functionally illiterate may be able to read the label on a can of soup that says “Pour soup into pan. Add one can of water. Heat until hot,” but they may not be able to follow these directions correctly.
Despite these challenges, it’s important to note that low literacy or illiteracy does not equate to low intelligence. Many individuals who are functionally illiterate may have average or even above-average intelligence but have not had the opportunity to develop their literacy skills.
Literacy Challenges in Health Care
Health literacy, a concept closely related to general literacy, refers to an individual’s ability to obtain, communicate, process, and understand basic health information and services. This ability is crucial for making informed health decisions, particularly in today’s complex healthcare environment. However, even individuals with strong literacy skills may struggle with health literacy due to the specialized language and technical information used in healthcare (McCray, 2005).
Several challenges contribute to low health literacy, including:
- Unfamiliarity with Medical Terms: Many individuals are not familiar with medical terminology or how their bodies function, which can make it difficult for them to understand health information.
- Numeracy Skills: Health literacy often involves interpreting numbers or risks, such as calculating the correct dosage of medication or understanding the likelihood of side effects.
- Emotional Stress: When diagnosed with a serious illness, people may feel scared or overwhelmed, which can impair their ability to process health information.
- Complex Self-Care Instructions: Many health conditions require patients to manage complicated treatment plans, including taking medications, following dietary restrictions, and performing self-care tasks.
- Health-Related Decisions: Patients are often asked to make important decisions based on technical health information, such as deciding whether to undergo a particular treatment or participate in a clinical trial.
Common and Health Literacy Concepts
The complexity of health literacy is compounded by the fact that it can change over time. A person’s health literacy level is influenced by various factors, including education, language, culture, and personal experiences with health and illness (Baker, 2006). For example, an individual may have strong general literacy skills but struggle with health literacy due to unfamiliarity with medical jargon or the stress of dealing with a health condition.
Health literacy is also influenced by the healthcare system itself. Some researchers have suggested that health literacy is not just about an individual’s skills but also about the characteristics of the healthcare system (Baker, 2006). For example, if health information is presented in a clear and culturally appropriate way, patients are more likely to understand and apply it. Conversely, if the information is confusing or irrelevant to the patient’s background, it may be difficult for them to comprehend and use it effectively.
Benefit of Literate Patients in Health Care and Nursing Education
Patients who are literate or health-literate have several advantages in the healthcare setting. For one, they are more likely to understand their diagnosis and treatment plan, which can lead to better health outcomes. Literate patients are also more likely to follow medical instructions correctly, whether it’s taking medications, following a diet, or managing a chronic condition.
In contrast, patients with low literacy or health literacy are at a higher risk for negative health outcomes. They may struggle to understand medical instructions, leading to medication errors or missed appointments. They are also less likely to use preventive services, such as vaccinations or cancer screenings, which can result in more serious health problems down the road (Berkman et al., 2011).
Nursing education plays a critical role in addressing these challenges by teaching nurses how to communicate effectively with patients of all literacy levels. Nurses can use a variety of strategies to improve health literacy, such as simplifying medical instructions, using visual aids, and ensuring that patients understand the information by asking them to explain it in their own words.
In conclusion, literacy and health literacy are vital for navigating modern society and the healthcare system. As the complexity of healthcare continues to grow, so does the need for individuals to have strong literacy and numeracy skills. Addressing the literacy needs of patients through clear communication and education can lead to better health outcomes and a more equitable healthcare system.