A study of patient’s and the registered nurses role concerning essential and idiopathic hypertension with adult onset of diabetes. Part two

 
Background -

The aging populations in the U.S. with ‘Essential’ Hypertension are showing inadequate health literacy, plus its impact on patients with idiopathic chronic diseases such as type II, adult onset Diabetes Mellitus are makeable.
 

Objective -

To identify among patients with hypertension and/or with diabetes the relationship between their functional health literacy levels, and the role of the registered nurse as communicator and educator.

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Keywords: efficiency of care, health literacy, communicator, educator, assessment skills, clear with simplified language, and direct involvement.  

 
Health Literacy -  

The healthcare providers (e.g., registered nurses, nurse practitioners, and licensed vocational nurses), can enhance the effectiveness and efficiency of the care they provide by recognizing their patients’ health literacy.  Health literacy is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” [1] At its core, health literacy is about clear communication between the healthcare system and the patients; on an individual level, health literacy is about enabling patients in understanding their medical condition, and how to treat it. 

Over 90 million American adults cannot read complex text or have difficulty understanding complex instructions; this means over 90 million American adults, close to one-half of the US adult population have limited health care literacy. [2]

Chronic metabolic conditions such as ‘essential’ hypertension (i.e., HT) and diseases such as diabetes (i.e., DM) require patient education to achieve adequate control and prevent adverse health outcomes. Patients with HT may need to understand how to properly take multiple medications and modify their lifestyle (e.g., low salt diet, weight control, and/or exercise) to achieve adequate B/P (HbA₁с) control. The intricacies of the diabetic diet, insulin therapy, and home glucose level (A₁с) monitoring, place even greater educational requirements on the patients. As a healthcare provider, you are aware that patient education also plays a critical role in facilitating patients’ acceptance of their diagnosis and understanding behavioral changes required for active participation in treatment. [3]

Traditional patient education relies heavily on written material about disease processes, medical management, and self-care instruction guides. Despite the availability of extensive health-care education materials with relatively consistent content, many are written at too high a level for low literate patients to comprehend essential points. [4]ʹ[5] Today, patients with inadequate literacy may not benefit from such educational efforts. This may explain why some patient education programs have been unsuccessful. [6]ʹ[7]

This problem may be more common than many health-care providers realize; reading skills are deficient in 47% to 53% of adult US citizens according to the National Adult Literacy Survey. [8] The registered nurse first, must have a solid understanding of the relationship between literacy and knowledge of the chronic disorder and/or disease. Also, the functional health literacy of patients with diabetes or HT and relationship of patients’ literacy levels to knowledge of their chronic disease and markers of disease control. Understanding the role of functional health literacy in disease management along with patient education should enhance efforts to improve patients’ knowledge of their disease and adherence to treatment plans.

Current demographic trends make health literacy increasingly significant for today’s primary care providers (i.e., RN’s LVN/LPN’s, Nurse Practitioners), who treat older adults. Older individuals are more likely to develop chronic medical illnesses and functional limitations that may profoundly affect health literacy. For example, inadequate health literacy (i.e., essential HT and/or with DM), has been linked to increased prevalence of several chronic conditions (i.e., age-related sensory changes, vision, hearing loss, and cognitive impairment), to name a few. Also, problems with the use of preventive services and glycemic control in diabetes mellitus in older adults. [9] Other consequences can include errors in self-administration of medications. [10]

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