Health Literacy as Communicative Action-A Qualitative Study among Persons at Risk in the Context of Predictive and Preventive Medicine.

Laura Harzheim,Christiane Woopen,Saskia Jünger,Mariya Lorke

doi:10.3390/ijerph17051718

Abstract

Predictive and preventive medicine play an increasingly important role in public debates on health, providing cutting-edge technologies with the potential to measure and predict individual risks of getting ill. This leads to an ever-expanding definitional space between being “healthy” and being “ill”, challenging the individual’s everyday life, attitudes and perceptions towards the self and the process of health-related decision-making. “How do the condition of ‘being at risk’ and individual health literacy interrelate?” is the leading question of the current contribution. Drawing on empirical qualitative data, collected by means of narrative interviews with persons at risk in four clinical fields, a bottom-up ethnographic and health sciences perspective on health literacy (with an emphasis on critical health literacy) is employed. The findings will be embedded within theoretical approaches dealing with power relations and communication in healthcare encounters, particularly Habermas’ theory of communicative action. The core outcome of our study is a concept for an overarching model of health literacy in the context of health-related risk prediction across indications, based on empirical insights gained through interpretative analysis of the four clinical domains.

Highlights

Being confronted with a health risk entails the solicitation to deal with risk-related information.When conducting research on the phenomenon of being at risk, it is important to consider the evolving possibilities of predictive and preventive medicine, and their effects on individual needs with respect to information and support in decision-making processes
This qualitative study is part of the project Health Literacy of Persons at Risk – From Information to Action (RisKomp) which investigated the role of health literacy (HL) in persons with an increased risk of developing a disease in one of four exemplary clinical fields (Alzheimer’s dementia (AD), familial breast and ovarian cancer (FBOC), coronary heart disease (CHD) and psychosis (PSY))
We identified three central categories which refer to key situations of risk perception, the processing and understanding of disease risk, and risk-related agency of “persons at risk” (Figure 1)

Summary

Introduction

When conducting research on the phenomenon of being at risk, it is important to consider the evolving possibilities of predictive and preventive medicine, and their effects on individual needs with respect to information and support in decision-making processes. Communication between health care professionals and persons at risk is an essential element in this course. Technical innovations in the field of predictive and preventive medicine allow for early detection of individual risk factors concerning a constantly increasing number of diseases. This presents health professionals, patients and their relatives with new manifold challenges. From a patient’s perspective, to be confronted with a (suspected) increased risk of developing a certain illness does mean.

Methods

Results

Discussion

Conclusion