by Caroline De Brún, PhD, DipLIS
People of all ages, backgrounds, and education levels need health information, but often find it difficult to find and understand. Low literacy levels, in terms of reading, and being able to find, understand, and apply information, are a barrier to successful patient participation, and this is problematic, given the increasing recognition about the importance of engaging patients in the treatment decision-making process.
Health literacy and health information literacy are phrases that are becoming more widely used, sometimes interchangeably. However, there is a difference, and this post hopes to clarify the meaning of each.
Health literacy is the ability to understand instructions provided by health professionals. “In England, 42% of working-age adults are unable to understand and make use of everyday health information, rising to 61% when numeracy skills are also required for comprehension” (1), and “around one in five adults cannot read or understand simple instructions or labels such as those found on medicine bottles” (2, 3). The inability to read can result in patients taking medicines at the wrong times, not following dosages correctly, or not understanding instructions properly (4). For example, if the label on the prescription says “Take three tablets daily”, does this mean take three tablets at the same time or take one tablet three times a day? The quote in the box below, comes from a Facebook post written by a surgeon, and perfectly illustrates the consequences of misunderstanding medical instructions.
Health information literacy
Health information literacy, although often referred to as health literacy, has a more in-depth scope. It is not only about access to the Internet and online health information, but also about having the skills required by people to effectively recognise:
· what they need to know about their condition and treatment options,
· how to find that information, to fill those knowledge gaps,
· how to appraise the information to ensure it is good quality, and relevant to their personal context, and then
· how to use the information with their health professionals so that they can make an informed decision that suits their needs (5, 6).
Poor health information literacy can result in poorer health outcomes, unhealthy lifestyles, increased incidence of chronic conditions and mortality, greater use of emergency services, and increased hospital stays (1, 7-13).
Role of librarians
Maimonides, a Spanish philosopher said “Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.” This quote reflects the importance of health information literacy, because if you find the information for the patient, their query will be satisfied, but if you teach them to search and appraise, they will be able to make informed decisions throughout their care pathways.
Health information literacy is an area where librarians, from all sectors, whether medical, public or academic, are in a strong position to support. They already have the resources, skills, and processes in place (14). Librarians can signpost people to the best sources, and teach them to search, retrieve, and appraise what they find (15). Medical librarians have the skills associated with evidence-based practice, as it is embedded in their roles, their primary function being teaching health professionals how to find and appraise the evidence. They also have access to the
relevant information sources, while public and school librarians are a trusted source within their communities, and understand the local context. Working in partnership would improve access to good quality health information at a location accessible to local people, who most likely would not have access to medical libraries.
People benefit from having access to good quality health information because it enables them to make informed decisions and follow their treatment regimens more effectively and safely (16-18). Informed patients are more likely to comply with the treatment regime, resulting in improved health, and reduced length of stay, and hospital admissions. Since the average doctor’s visit in England lasts 8-10 minutes (19), patients need to be ready to ask the right questions. Helping patients to self-manage by improving their health information literacy skills will benefit both the patient and the health system (1, 20, 21). By improving access to clear, current, accurate, and understandable consumer health information, health inequalities can be reduced and patients will feel more empowered (1, 22).
Creating health information literacy support programmes and resources is a new area for medical, public, and school libraries to work and lead on together. Library communities would benefit, in terms of professional development, more efficient working practices, and demonstrating value to the community. Patients could see improved health outcomes and better quality of life, health, and wellbeing, while health services might see a reduction in health service utilisation.
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