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Health literacy has an impact on patient health outcomes and should be included in prelicensure nursing curricula to prepare
the next generation of nurses to provide care for patients with limited health literacy. Nursing curricula should go beyond
inclusion of patient teaching strategies. This article provides a systematic review of the current literature related to health
literacy in nursing education and identifies implications for nursing curricula.
H
ealth literacy has been found to be a stronger predic- patients with conditions such as high blood pressure, diabe-
tor of health status than socioeconomic status, age, tes, asthma, or HIV/AIDS who also have limited health literacy
and ethnic background.1 Health literacy is defined as skills have less knowledge of their illness and its management.5
the degree to which individuals have the capacity to obtain, Low literacy is more prevalent in people with fewer
process, and understand basic information and services needed years of education, those of certain racial or ethnic groups,
to make appropriate decisions regarding their health.2 It is the elderly, and individuals with lower cognitive ability.4 In
estimated that about half of American adults have difficulty addition, individuals with low health literacy are at increased
understanding and using health information, resulting in a risk of health disparities.6 Many health care professionals are
higher rate of hospitalization and use of emergency services unaware which of their patients have limited health literacy
among patients with limited health literacy. 2 Nearly 9 of or how to intervene appropriately.7 Furthermore, patients
10 adults have difficulty using the everyday health informa- with low health literacy may report a sense of shame about
tion that is routinely available in health care facilities, retail their skill level and may hide their reading or vocabulary dif-
outlets, media, and communities.3 ficulties to maintain their sense of dignity.5
Low literacy is associated with difficulty understanding Health literacy should be included in nursing curricula
written or verbal health care advice, adverse health outcomes, to adequately prepare students to provide care in the clinical
and negative effects on the health of individuals.4 An indi- setting.8 Although most curricula include information on the
viduals ability to function in the health care environment patient teaching process, they do not specifically address health
can be affected by low literacy, as well as patient-provider literacy.9 The significant impact of limited health literacy on
communication, and can lead to substandard health care.4 patient outcomes makes health literacy a critical topic area to
Individuals with limited health literacy skills are more likely be addressed in nursing education. This article reports on a
not to seek important preventive measures, such as mammo- systematic review of the current literature related to health
grams, Papanicolaou smears, and flu shots, and enter the literacy in nursing education programs.
health care system when they are sicker, compared with those
with adequate health literacy skills.5 Those with limited health Search of the Literature
literacy are more likely to have chronic conditions and are Methods and Search Parameters
less able to effectively manage them. Studies have found that The aim of the systematic review was to review the litera-
ture that identified health literacy in nursing education.
Author Affiliation: Associate Professor, College of Nursing, University The electronic databases reviewed for the systematic review
of Oklahoma Health Sciences Center. of the literature included CINAHL Complete, MEDLINE
The author declares no conflicts of interest. (OVID), Health Source: Nursing/Academic Edition, Google
Correspondence: Dr McCleary-Jones, College of Nursing, University of
Oklahoma Health Sciences Center, 1100 N Stonewall Ave, Oklahoma City, Scholar, and Digital Dissertations and Theses through Pro-
OK 73117 (voncella-mccleary-jones@ouhsc.edu). Quest. The selected databases included studies found in
Supplemental digital content is available for this article. Direct URL citations nursing journals, state nurses association publications, full-
appear in the printed text and are provided in the HTML and PDF versions text articles, and dissertations. Search parameters included
of this article on the journals Web site (www.nurseeducatoronline.com).
Accepted for publication: June 13, 2015
the years 2000 to 2014, providing a focused search of current
Published ahead of print: July 30, 2015 literature. Search terms included health literacy and nurs-
DOI: 10.1097/NNE.0000000000000204 ing education.
Submitted by: Marilyn H. Oermann, PhD, RN, ANEF, FAAN, Editor-in-Chief, marilyn.oermann@duke.edu.
References
1. Schmidt RA, Lee TD. Motor Control and Learning: A Behavioral Emphasis. 4th ed. Champaign, IL: Human Kinetics; 2005.
2. Granados C, Wulf G. Enhancing motor learning through dyad practice: contributions of observation and dialogue. Res
Q Exerc Sport. 2007;78(3):197-203.
DOI: 10.1097/NNE.0000000000000245