Abstract
OBJECTIVE: To analyze the scoring obtained by an instrument, which evaluates the ability to read and understand items in the health care setting, according to education and age. METHODS: The short version of the Test of Functional Health Literacy in Adults was administered to 312 healthy participants of different ages and years of schooling. The study was conducted between 2006 and 2007, in the city of São Paulo, Southeastern Brazil. The test includes actual materials such as pill bottles and appointment slips and measures reading comprehension, assessing the ability to read and correctly pronounce a list of words and understand both prose passages and numerical information. Pearson partial correlations and a multiple regression model were used to verify the association between its scores and education and age. RESULTS: The mean age of the sample was 47.3 years(sd=16.8) and the mean education was 9.7 years(sd=5; range: 1 - 17). A total of 32.4% of the sample showed literacy/numeracy deficits, scoring in the inadequate and marginal functional health literacy ranges. Among the elderly (65 years or older) this rate increased to 51.6%. There was a positive correlation between schooling and scores (r=0.74; p<0.01) and a negative correlation between age and the scores (r=-0.259; p<0.01). The correlation between the scores and age was not significant when the effects of education were held constant (rp=-0.031, p=0.584). A significant association (B=3.877, Beta =0.733; p<0.001) was found between schooling and scores. Age was not a significant predictor in this model (B=-0.035, Beta=-0.22; p=0.584). CONCLUSIONS: The short version of the Test of Functional Health Literacy in Adults was a suitable tool to assess health literacy in the study population. The high number of individuals classified as functional illiterates in this test highlights the importance of special assistance to help them properly understand directions for healthcare.
Highlights
Functional illiteracy can be understood as the inability to use printed and written information to function in society, to achieve goals and to develop knowledge and potential.[15]
The high number of individuals classified as functional illiterates in this test highlights the importance of special assistance to help them properly understand directions for healthcare
The Brazilian version of the S-Test of Functional Health Literacy in Adults (TOFHLA) was administered to 312 healthy participants
Summary
Functional illiteracy can be understood as the inability to use printed and written information to function in society, to achieve goals and to develop knowledge and potential.[15] Functional illiterates are likely to have significant difficulties with routine reading requirements, such as those in pill bottles, appointment slips, self-care instructions, and health education brochures.[8,12,13,22,24] This problem affects the health care system, because, by not managing health problems effectively, these individuals are prone to require more appointments and to have higher hospitalization rates, implying extra-costs for the system. Assessing and determining levels of functional literacy is very important in the health care system to develop different ways of conveying information to individuals with limited reading and written comprehension skills so as to assure that they can understand and carry out medical directions concerning their health treatments (e.g. medication intake and chronic disease management). Establishing levels of functional illiteracy and adjusting test scores according to this variable can result in better diagnostic accuracy of cognitive tests
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