Nurses need to change how they think about health literacy, says nurse researcher

‘In public health we tend to tell people what to do,’ says Kristina Jenei, former nurse turned researcher who is working with the World Health Organization to support access to medicines and healthcare.

However, educating patients about their health is far more than simply telling them what is good for them. To improve health literacy, nurses need to learn how to teach, she has suggested in a paper published in the Lancet this week.

In the UK there is a ‘crisis’ in adult health literacy, with 43% of adults being unable to understand written health information according to the Health Education England.

And according to NHS England, patients with lower levels of health literacy experience significantly more negative outcomes across a number of indicators, are more likely have unhealthy lifestyles, and are less able to manage long term conditions.

However, Ms Jenei believes that nurses across primary care can do much more than nurses in hospitals to help boost patients’ understanding of their health.

Speaking to Nursing in Practice, she explained: ‘As a nurse you may see people coming in with diabetes, and we tell them to control their blood glucose, but it often doesn’t work. We need to think about why that type of education we’re giving them doesn’t work, and its likely because it’s disconnected from that person’s way of life.’

And, Ms Jenei says: ‘With the understanding that community services are severely underfunded and nurses are already doing so much, nurses in the community have more of an opportunity to do this than in acute care.

‘Asking open questions, practising empathy, trying to understand why the other person is the way they are; nurses are already really good at this. Having more of that open, non-judgemental conversation with patients can really get them to start critically thinking about why they act in the way they do in regard to their health.’

In the Lancet, Ms Jenei drew on the work of Brazilian philosopher and educator Paolo Freire to argue that healthcare professionals should view patients less as ’empty vessels waiting to be filled with knowledge’.

‘For me,’ Ms Jenei says, ‘health literacy is the ability to engage positively with risk in the world in order to live a healthy lifestyle. Its about being able to make good health decisions and being able to understand information and engage with it.’

For healthcare professionals, such as nurses, building up a patients health literacy is about engaging with the community and trying to understand why health problems persist.

Ms Jenei started her career in nursing in Canada, working with patients experiencing substance abuse, before moving to the UK for a PhD in health policy.

‘I felt at the time there was this sort of revolving door in acute care. I saw the same people over and over, but there were loads of services for people experiencing homelessness and addiction issues. Yet, every time they would come into the hospital we would discharge them with the same plan. There was a disconnect between what we were saying and the person.’