Introduction:
Respiratory self-care imposes significant demands on individuals with chronic respiratory diseases, requiring them to acquire, comprehend, and implement complex treatment regimens. As chronic diseases become more prevalent and burdensome on both healthcare systems and patients, there is a growing recognition of the need to empower patients to manage their conditions actively. Patient-centered care models emphasize collaboration between patients and healthcare providers, valuing patient preferences and needs. While educating patients about their conditions is essential, simply providing knowledge may not be effective in encouraging active participation. Health literacy is crucial to empowering patients and improving disease management outcomes. Low health literacy has been linked to poorer health outcomes.
What Is Health Literacy?
Health literacy (HL) involves a person’s ability to understand, assess, communicate, evaluate, and utilize health-related information across verbal, digital, and print formats, forming the five-domain HL model. However, this model is rarely utilized in the literature due to the lack of specific measurement tools for each domain, limiting the understanding of HL’s impact on chronic airway disease management.
Strengthening HL has been shown to enhance resilience, improve health and well-being, and reduce healthcare costs, particularly in patients with asthma and COPD (chronic obstructive pulmonary disease), where enhanced HL skills can lead to better disease self-management, medication adherence, and inhaler use.
HL is not solely an individual attribute but emerges from the interaction between patients, healthcare professionals, and healthcare systems, implying that patient factors, HCP communication skills, and the provision of accessible information and services by the healthcare system influence it.
What Is the Importance of Health Literacy in Respiratory Care?
Health literacy is often overlooked but crucial in respiratory care, particularly for conditions like asthma and COPD, which strain healthcare resources globally. Empowering patients with these diseases to make informed decisions and self-manage requires high self-efficacy, achieved through understanding and applying health-related information. Providers can enhance patient engagement in disease management by improving HL skills, potentially leading to slowed disease progression and improved health outcomes. Despite recognizing low HL by respiratory organizations worldwide, most studies focus narrowly on patient capabilities rather than specific HL domains, limiting the understanding of its impact on disease outcomes. While some strategies to address low HL have shown promise, they predominantly focus on educational interventions and outcomes related to comprehension and disease knowledge. Although associations between HL and various outcomes in asthma and COPD patients have been observed, the mechanisms behind these associations remain unclear due to the lack of HL improvements on specific outcomes.
What Are the Factors to Be Considered in Health Literacy in Respiratory Care?
Addressing patient health literacy (HL) challenges in respiratory care requires recognizing and overcoming barriers that hinder patients with respiratory diseases and low HL from actively managing their conditions.
Factors to be considered in health literacy in respiratory care may include:
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Accessing Health Information and Services: Limited access to reliable information and services is a significant issue, particularly among disadvantaged individuals who have fewer primary care visits and may rely on unreliable sources for healthcare information. Specialty clinics often struggle to provide culturally sensitive care. To address this, healthcare systems must invest in diverse personnel and provide multilingual, easily understandable health information.
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Processing and Understanding Information and Instructions: Respiratory care providers often overestimate patients’ HL skills, leading to misunderstandings. Educational materials should be tailored to diverse patient needs and abilities, using plain language and interactive techniques like the teach-back approach. Patient input in material development can ensure content is appropriate and understandable.
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Appraising the Quality of Information and Care Services: Patients must assess health information's quality and credibility. Evaluation skills are understudied but crucial. Accurate measurement of these skills can help identify gaps between patients’ expectations and perceptions of care.
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Applying Information to Make Health-Related Decisions: While patients may know their condition, they may struggle to apply it in managing their disease. Patient-provider interactions should focus on facilitating behavior change, including personalized instructions and opportunities for patients to practice relevant actions with feedback. This approach empowers patients to develop the skills needed for effective self-management.
How Do Health Literacy and Patient Education Help in Respiratory Care?
Health literacy and psychological well-being are associated with and significant in individuals with respiratory diseases. Higher education also emerged as a significant predictor in several analyses. Additionally, factors such as a shorter duration of COPD, fewer co-existing diseases, non-smoking conditions, and living arrangements are also known to relate to health literacy in certain domains.
Psychological well-being is strongly linked to higher health literacy across various domains, reflecting personal experiences such as feeling understood and supported by healthcare providers, having sufficient information to manage health, actively engaging in health management, receiving social support, and navigating the healthcare system. It is noteworthy that psychological distress, commonly expressed as anxiety and depression, is prevalent among COPD patients and is closely related to the social and emotional aspects of HL.
Education plays a significant role in equipping individuals with the capacity for information processing and navigation. However, it is important to note that many people need to start using the internet, which is increasingly vital for accessing health information. This underscores the need for tailored interventions to address COPD patients' diverse needs and capabilities.
Cultural and social factors deeply influence accessing and comprehending health information and services. Culturally competent care systems acknowledge and respect patients’ health beliefs, language barriers, and cultural practices, ensuring equitable access to essential healthcare services for all community members.
To address these disparities, a three-level model was proposed as follows:
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Healthcare Provider Training and Empowerment: Respiratory clinics should train providers to understand and accommodate patients' diverse beliefs and needs, adapting communication styles and clinical practices accordingly. By enhancing provider communication skills and awareness of social determinants of health, healthcare professionals can act as change agents, fostering patient engagement and self-management. This approach, supported by ongoing education and training, has shown promise in improving patient outcomes and reducing disparities in care.
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Embracing Technological Advances for Enhanced Care: Respiratory care providers should leverage technology, such as telehealth, to overcome barriers to healthcare access, especially for patients in remote or rural areas. Telehealth offers opportunities for remote communication, health education, and collaboration between primary care physicians and specialists. While telehealth interventions have shown positive outcomes across various chronic diseases, their effectiveness in respiratory care requires further evaluation and implementation of tailored programs such as virtual pulmonary rehabilitation.
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Community Partnerships and Patient Engagement: Successful care models must establish partnerships with community stakeholders, including patients, community leaders, and opinion influencers. Through community engagement initiatives and participatory research, healthcare providers can gain insights into the unique challenges faced by patients and develop culturally relevant education material and support networks. These collaborations have proven effective in reducing patient isolation, improving coping mechanisms, and enhancing patient confidence in self-management.
By implementing these strategies, healthcare systems can enhance health literacy, promote cultural competence, and deliver more equitable, patient-centered respiratory care services.
Conclusion:
Health literacy plays a crucial role in patient education and respiratory care. By empowering patients with the knowledge and skills to understand and manage their respiratory conditions effectively, healthcare providers can improve treatment adherence, health outcomes, and overall quality of life. Culturally competent approaches to patient education and the integration of technology and community partnerships are essential for addressing disparities in health literacy and ensuring equitable access to respiratory care services.
