Literacy in health and the challenge of sharing medical decision

Authors

  • Américo Varela Assistente Graduado de Medicina Geral e Familiar. USF Monte de Caparica, ACES Almada-Seixal. Monte da Caparica, Portugal.

DOI:

https://doi.org/10.25758/set.1501

Keywords:

Shared decision, Health literacy, Health gains, Patient, Health professionals

Abstract

Some studies have shown the relationship between increased and more structured involvement of patients in clinical decision-making, the improvement of literacy in health, and the obtainment of health gains. However, the existence of misconceptions on the part of doctors and other health professionals may contribute to their low compliance regarding shared clinical decisions and discussion of treatment options, particularly with users with low levels of literacy. With this critical essay, we intend to clarify these misconceptions, by doing an in-depth reflection and analysis of communication’s key elements centered on patient–health literacy and shared decision. Relevant issues about literacy in health and shared decision were presented, on which critical content was developed. This development is the most extensive part of the essay. We transmitted the point of view of several authors and critical analysis, and we tried to illustrate these ideas with examples and research studies, thus validating the presented arguments and answering questions raised during the analysis. The final considerations of this critical essay stress that promoting increased user participation in clinical decision-making improves the level of health literacy, through patient-focused communication performed by qualified professionals taking into consideration social determinants, and health gains are obtained.

Downloads

Download data is not yet available.

References

Guzys D, Kenny A, Dickson-Swift V, Threlkeld G. A critical review of population health literacy assessment. BMC Public Health. 2015;15:215.

Ceron M. Habilidades de comunicação: abordagem centrada na pessoa [Internet]. S. Paulo: UNIFESP; 2010. Available from: http://www.unasus.unifesp.br/biblioteca_virtual/esf/2/unidades_conteudos/unidade24/unidade24.pdf

Loureiro LM, Mendes AM, Barroso TM, Santos JC, Oliveira RA, Ferreira RO. Literacia em saúde mental de adolescentes e jovens: conceitos e desafios [Mental health literacy of teenagers and youth: concepts and challenges]. Rev Enf Ref. 2012;III(6):157-66. Portuguese

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152(9):1423-33.

Peek ME, Wilson SC, Gorawara-Bhat R, Odoms-Young A, Quinn MT, Chin MH. Barriers and facilitators to shared decision-making among African-Americans with diabetes. J Gen Intern Med. 2009;24(10):1135-9.

Gravel K, Légaré F, Graham ID. Barriers and facilitators to implementing shared decision-making in clinical practice: a systematic review of health professionals' perceptions. Implement Sci. 2006;1:16.

Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361-7.

Naik AD, Street RL Jr, Castillo D, Abraham NS. Health literacy and decision making styles for complex antithrombotic therapy among older multimorbid adults. Patient Educ Couns. 2011;85(3):499-504.

Uldry E, Schäfer M, Saadi A, Rousson V, Demartines N. Patients' preferences on information and involvement in decision making for gastrointestinal surgery. World J Surg. 2013;37(9):2162-71.

Monteiro MM. A literacia em saúde [Dissertation]. Lisboa: Universidade Lusófona de Humanidades e Tecnologias; 2009.

Metz J, Patrício M, Peinado JM, Szekeres P. Medical skills: resource book for teachers. Budapest: Pécs Medical University; 1999. ISBN 9637178341

Gazzinelli MF. Educação em saúde: teoria, método e imaginação. Belo Horizonte: Universidade Federal de Minas Gerais; 2006. ISBN 9788570415257

Légaré F, Thompson-Leduc P. Twelve myths about shared decision making. Patient Educ Couns. 2014;96(3):281-6.

Santos O. O papel da literacia em saúde: capacitando a pessoa com excesso de peso para o controlo e redução da carga ponderal [Health literacy: empowering the person with overweight for the control and reduction of body weight]. Endocrinol Diabetes Obes. 2010;4(3):127-34. Portuguese

Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014;(1):CD001431.

Escoval A. Decisão partilhada em saúde. In Think Tank Capacitação do Cidadão em Saúde - A saúde que conta. Lisboa; 2013 May. Available from: http://www.apdh.pt/sites/apdh.pt/files/Abertura%20e%20Apresenta%C3%A7%C3%A3o%20do%20Sa%C3%BAde%20que%20Conta.pdf

Felipe GF. Educação para a saúde em grupo: olhar da enfermeida e do usuário hipertenso [Dissertation]. Ceará: Universidade Estadual do Ceará; 2011. Available from: http://www.uece.br/cmacclis/dmdocuments/gilvan_ferreira.pdf

Leng G. Shared decision making [Internet]. London: NICE; 2015. Available from: https://www.england.nhs.uk/wp-content/uploads/2015/11/4-nqb-160915.pdf

General Medical Council. Consent: patients and doctors making decisions together [Internet]. London: GMC; 2008. ISBN 9780901458315. Available from: http://www.gmc-uk.org/GMC_Consent_0513_Revised.pdf_52115235.pdf

Chewning B, Bylund CL, Shah B, Arora NK, Gueguen JA, Makoul G. Patient preferences for shared decisions: a systematic review. Patient Educ Couns. 2012;86(1):9-18.

Macedo AF, Azevedo MH. Relação médico-doente [Internet]. In: Oliveira CF, editor. Manual de ginecologia. Coimbra: Permanyer Portugal; 2011. p. 59-79. ISBN 978-972-733-254-0. Available from: http://www.fspog.com/fotos/editor2/cap_04.pdf

Kobylarz FA, Pomidor A, Heath JM. SPEAK: a mnemonic tool for addressing health literacy concerns in geriatric clinical encounters. Geriatrics. 2006;61(7):20-6.

Tarlov A. Social determinants of health: the sociobiological translation. In: Blane D, Brunner E, Wilkinson R, editors. Health and social organization: towards a health policy for the 21st century. London: Routledge; 1996. p. 71-93. ISBN 9780415130707

Loureiro I, Miranda N. Promover a saúde: dos fundamentos à acção. Coimbra: Almedina; 2010. ISBN 9789724043999

George F. Sobre determinantes da saúde. Lisboa: Direção-Geral da Saúde; 2011.

Sykes S, Wills J, Rowlands G, Popple K. Understanding critical health literacy: a concept analysis. BMC Public Health. 2013;13:150.

Hibbard JH, Greene J, Tusler M. Improving the outcomes of disease management by tailoring care to the patient's level of activation. Am J Manag Care. 2009;15(6):353-60.

Volandes AE, Ferguson LA, Davis AD, Hull NC, Green MJ, Chang Y, et al. Assessing end-of-life preferences for advanced dementia in rural patients using an educational video: a randomized controlled trial. J Palliat Med. 2011;14(2):169-77.

King JS, Eckman MH, Moulton BW. The potential of shared decision making to reduce health disparities. J Law Med Ethics. 2011;39 Suppl 1:30-3.

Gionfriddo MR, Leppin AL, Brito JP, LeBlanc A, Shah ND, Montori VM. Shared decision-making and comparative effectiveness research for patients with chronic conditions: an urgent synergy for better health. J Comp Eff Res. 2013;2(6):595-603.

Guadagnoli E, Ward P. Patient participation in decision-making. Soc Sci Med. 1998;47(3):329-39.

Peerson A, Saunders M. Health literacy revisited: what do we mean and why does it matter? Health Promot Int. 2009;24(3):285-96.

Lim HM, Kumiasanti KS. Shared decision making and effective physician-patient communication: the quintessence of patient-centered care. Int J Med Students. 2015;3(1):7-9.

Graffigna G, Barello S, Bonanomi A, Lozza E, Hibbard J. Measuring patient activation in Italy: translation, adaptation and validation of the Italian version of the patient activation measure 13 (PAM13-I). BMC Med Inform Decis Mak. 2015;15:109.

Published

2022-09-06

Issue

Section

Artigos

How to Cite

Literacy in health and the challenge of sharing medical decision. (2022). Saúde & Tecnologia, 16, 44-49. https://doi.org/10.25758/set.1501