Abstract
Functional Health Literacy (FHL) is the ability to retrieve, process and understand information in order to make appropriate decisions regarding self-care, defined by the World Health Organization as a social determinant of health. Its evaluation is important especially between patients with noncommunicable chronic diseases, given the need of permanent health care. This paper aims to evaluate the FHL in patients with chronic cardiovascular diseases and possible implications to the understanding of the disease and medical instructions and adherence to the measures proposed by health professionals. This is a cross-sectional and quantitative study with the application of tool S-TOFHLA and a structured questionnaire on 345 patients of a cardiovascular disease outpatient service in Juiz de Fora. Less than a half (49.3%) of the sample showed adequate FHL. Satisfactory FHL was associated with lower ageand higher schooling. Lower FHL evidenced that it can influence the impaired comprehension of the disease and medical instructions and the rare habit to question professionals. A high prevalence of inadequate FHL was identified in our sample and was associated with the impaired understanding of the disease and medical instructions, showing the need to streamline medical communication in this group.
Highlights
Barriers that commonly prevent effective communication are found in the doctor-patient relationship
This study evaluates FHL among patients with chronic cardiovascular diseases, as well as the possible implications for understanding the disease, the medical instructions and the implementation of pharmacological and non-pharmacological measures proposed by health professionals. This is a cross-sectional study, in which factor and outcome are measured concomitantly, and that estimates the prevalence of the outcome variable, which in this study corresponds to the level of Functional Health Literacy among chronic cardiovascular patients
For the educational variable (Table 5), we found that 81.85% of those interviewed with education higher than the fourth year of elementary school mentioned a clear understanding of their health situation and, in the lower schooling group, this percentage was significantly lower (62.7%), with p-value = 0.001 (POR = 0.375)
Summary
Barriers that commonly prevent effective communication are found in the doctor-patient relationship. Such hurdles stem from two poles: due to difficulties of health professionals in providing instructions in an adequate and clear language and patients’ incorrect or incomplete absorption of imparted orientations. Both factors significantly affect the development of health problems and adherence to the proposed medical measures. There are still considerable obstacles to the understanding of important medical recommendations to practice self-care due to a possibly impaired Functional Health Literacy (FHL) of the population[1]. The term “health literacy” was first addressed in 1974 by Simonds[4] and was only rewritten by the American Medical Association (AMA) in 1999 as “Functional Health Literacy”, recognizing it as a set of skills that encompass “reading, understanding and acting on health information”[5]
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