Abstract
Background: Health literacy, a recently determined construct plays an important role in how individuals are able to manage their health. A useful approach for the assessment of health literacy is to measure the comprehension of available patient education materials (PEMs).Objective: We aimed at assessing the usefulness of PEMS available in Hungarian by testing comprehension of selected PEMs in different groups of users.Methods: Comprehension of patient education materials in the domain of healthcare was tested by selecting PEMs and creating questions based on their text in 3 dimensions of health literacy: understand, process/appraise, apply/use. Twenty questions were created that could be answered without pre-existing knowledge by reading the appropriate text taken from PEMs. Comprehension was examined in four groups: laypersons, non-professional healthcare workers, 1st year healthcare students, and 5th year medical students. Readability indices were calculated for the same texts to which questions were created.Results: Laypersons answered <50% of the PEMs-based questions correctly. Non-professional healthcare workers performed better with 57% of right answers but significantly worse than healthcare students or medical students. Those with at least high school qualification (maturity exam) showed significantly higher comprehension compared to those with lower educational attainment. Persons in good or very good health also had significantly better comprehension than those in less favorable health. All readability indices showed that comprehension of the tested PEMs required at least 10 years of schooling or more. Therefore, these PEMS are difficult to understand for persons with less than high school level of education.Conclusion: Rephrasing of the investigated patient educational materials would be recommended so that they better fit the educational attainment of the Hungarian population. Evaluation of the readability and comprehensibility of other PEMs also seems warranted.
Highlights
According to an early definition of the term, health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions [1]
Our study tested the comprehension of patient education materials in various occupational groups, among them nonprofessional health workers who are supposed to help lay people access and use health care services and understand health-related information
Overall comprehension of the investigated patient education materials (PEMs) among laypersons was around chance, that is, their comprehension was no different from selecting answers randomly, as opposed to answers based on the provided information
Summary
According to an early definition of the term, health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions [1]. A more recent definition of Sorensen and the HLS-EU Consortium [2] based on a systematic literature review proposed a more complex definition according to which health literacy “entails people’s knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during the life course.”. Health literacy is assessed at the individual or population level using one or more of the large numbers of validated instruments [3, 4]. A useful approach for the assessment of health literacy is to measure the comprehension of available patient education materials (PEMs)
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