Health literacy is defined as “the degree of which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions” (Institute of Medicine, 2004). In addition, WHO explains health literacy more completely as follows (Nutbeam, 2000): (1) “Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways, which promote and maintain good health.” (2) “Health literacy means more than being able to read pamphlets and successfully make appointments.”
Provided that nurses are part of the health care team, they are one of the key factors in improving the health literacy level of their patients. Without a proper emphasis on this topic, it may greatly affect the overall health status of patients – physically, mentally, and socially.
To improve health literacy among patients, nurses used different ways in order to effectively promote health. This may include: health teaching, planning nursing interventions, and others. It is very important that health promotion should be appropriately carried out in order to ensure that patients will not have any form of medical errors (ex. medication error).
Before deciding what form of health promotion nurses will use, they must know first the capacity of learning that their patients have. They have to determine their patient’s ability to read, understand, and if they can accomplish the right health care choices for themselves using the information that they have.
To be effective, we should take an extra effort in order to establish an effective communication with our patients. If we can do it, then it will not be hard for us to make them comply with the health teaching that we provide for them.
Now, let’s see how a nurse can promote health using the nursing process (assessing, diagnosing, planning, implementing, and evaluating):
The nurse will include the following key factors in assessing his patient:
- Health beliefs review (e.g. religion, culture, etc.)
- Health risk assessment (i.e. correlating the patient’s behavior towards acquiring diseases or illness: ex. age, race, sex)
- Lifestyle assessment (i.e. patient’s personal habits: e.g. nutritional practices, physical activity, smoking, drinking, etc.)
- Health history and physical examination (e.g. immunization history, nutritional assessment, etc.)
- Physical fitness assessment (i.e. body composition, cardiovascular endurance, respiratory endurance, muscle endurance, etc.)
The nursing diagnosis should be based on the gathered data by the nurse during the assessment. It is very important also to consider the age of the patient in analyzing these data. The following are some of the examples indicated under NANDA taxonomy
- Readiness for enhanced nutrition
- Readiness for enhanced self-concept
- Readiness for enhanced self-care
- Readiness for enhanced knowledge (specify)
During this phase, the nurse will not function as a counselor or an advisor but rather she will only act as a resource person (e.g. giving information when asked). The patient will be the one who will determine the length of time needed to accomplish it.
Pander et al. (2006, pp. 127-141) indicated several steps where both the nurse and the client should participate:
- Review and summarize data from the assessment.
- Reinforce the strengths and competencies of the client.
- Identify health goals and related behavior-change options.
- Identify behavioral or health outcomes.
- Develop behavior-change plans.
- Reiterate the benefits of change.
- Address environmental and interpersonal facilitators and barriers to change.
- Determine a time frame for implementation.
- Formalize commitment to the behavior-change plan.
In the implementation phase, it is where the interventions will be done. One of the basic things that a nurse can provide toward her patient is support. If the patient can establish enough support system, he will have the drive to continue moving on.
In the evaluation phase, the client and the nurse will both decide if they accomplished their desired outcome. It is also during this time where the patient will choose if he still wants to continue the plan or wished to stop it.