Nursing and allied health professionals’ views about using health literacy screening tools and a universal precautions approach to communication with older adults: a qualitative study

Abstract

Purpose: Health literacy describes individuals’ abilities to access, understand and use health information. Lower health literacy is associated with poor health outcomes, is more common among older adults and impacts on the effectiveness of rehabilitation/self-management interventions. This research explored nursing and allied healthcare professionals’ views about identifying and responding to older adults’ health literacy needs.

Methods: Qualitative focus groups were conducted with a purposive sample of 22 UK nursing and AHPs working with older adults. Focus groups were audio-recorded, transcribed verbatim and analyzed using framework approach.

Results: Participants used a variety of practices to identify older patients’ health literacy levels, but primarily relied on subtle cues. Participants lacked knowledge and confidence in identifying and addressing health literacy needs. Participants expressed concerns about patient reactions and described practical barriers to using recommended health literacy strategies.

Conclusions: Participants recognized the importance of addressing patients’ health literacy needs, but do not routinely use health literacy strategies, lack confidence and have reservations about recommended health literacy strategies. This impacts on healthcare professionals’ abilities to support patients to self-manage and participate in rehabilitation. Health literacy education for health professionals should consider barriers to using health literacy strategies and be tailored to accommodate variation in teams and professions.

Implications for rehabilitation

• Rehabilitation professionals need to standardise their practice to health literacy, using strategies which can be easily integrated into routine practice.

• To meet older adults’ health literacy needs, rehabilitation professionals should use clear and accessible tailored communication, build trust, assess understanding and involve patients’ social networks.

• Rehabilitation professionals would benefit from further education regarding health literacy to build their knowledge/confidence and address their concerns about implementing health literacy strategies.

• Professional education regarding health literacy needs to accommodate variation between individuals and teams.

Keywords:

• Communication
• health literacy
• measurement
• universal precautions
• older adults
• healthcare professionals

Acknowledgements

The authors thank the Solent NHS Trust who funded this clinical academic doctoral fellowship, all the healthcare professionals who participated in this research study and those who assisted with note-taking during focus groups: Dr Annabel Rule, Chantel Ostler and Sian Kilmister. No external funding.

Disclosure statement

The authors report no conflicts of interest.