Janse van Rensburg Zelda
Department of Nursing, University of Johannesburg, Johannesburg.
Afr J Prim Health Care Fam Med. 2020 Jan 30;12(1):e1-e6. doi: 10.4102/phcfm.v12i1.2047.
Health literacy is a relatively new concept in the South African primary healthcare (PHC) sector as well as globally, and limited new literature is available on the topic. In this study, we focused on investigating, describing and comparing health literacy scores calculated using three different tools to assess a patient's level of English comprehension. Health literacy is defined as the degree to which patients have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions. South Africa is a linguistically and culturally diverse country, yet English is often used as the main language for imparting health education in PHC facilities. Patients often do not comprehend the health education received. Primary healthcare workers need to determine the health literacy levels of their patients before imparting health education. The REALM-R (SA 1, 2 and 3) tools are adapted from the original REALM-R to test health literacy levels of South African PHC patients. The Learning Ability Battery (LAB) is a tool used to determine English comprehension levels.
The aim of this was to investigate, describe and compare health literacy and English comprehension levels of PHC patients using three locally adapted REALM-R (SA) tools and the LAB.
This study was conducted at five PHC facilities in the City of Tshwane, Gauteng.
A prospective, quantitative and comparative design was chosen for this study. In general, a descriptive design was applied for the presentation of the results. The sample size was 200 patients from five different PHC clinics. Data were collected using REALM-R (SA 1, 2 and 3) to determine the health literacy levels and the LAB to determine the English comprehension levels.
Majority of the patients scored high using the REALM-R (SA) tools. For the LAB, 68% scored 11-40 out of 50. Only 8% scored 41-50 out of 50. A significant difference was found between the actual school grade achieved and the school grade according to the LAB.
The results of the study indicated that although patients are able to read and pronounce medical words as such used in the REALM-R (SA) tools, it does not necessarily mean that they are able to comprehend the meaning of the words as indicated by the results of the LAB. Currently, the REALM-R (SA) tools only test health literacy levels based on word recognition and pronunciation. It is recommended that a word comprehension section be added to determine patients' understanding of the words.
健康素养在南非初级卫生保健（PHC）部门以及全球都是一个相对较新的概念，关于该主题的新文献有限。在本研究中，我们专注于调查、描述和比较使用三种不同工具计算得出的健康素养分数，以评估患者的英语理解水平。健康素养被定义为患者获取、处理和理解基本健康信息及服务以做出适当健康决策的能力程度。南非是一个语言和文化多元的国家，但在初级卫生保健机构中，英语常被用作传授健康教育的主要语言。患者往往不理解所接受的健康教育。初级卫生保健工作者在传授健康教育之前需要确定患者的健康素养水平。REALM - R（SA 1、2和3）工具是在原始REALM - R的基础上改编而来，用于测试南非初级卫生保健患者的健康素养水平。学习能力测试组合（LAB）是一种用于确定英语理解水平的工具。
本研究的目的是使用三种本地化改编的REALM - R（SA）工具和LAB来调查、描述和比较初级卫生保健患者的健康素养和英语理解水平。
本研究在豪登省茨瓦内市的五家初级卫生保健机构进行。
本研究选择了前瞻性、定量和比较性设计。一般来说，采用描述性设计来呈现结果。样本量为来自五个不同初级卫生保健诊所的200名患者。使用REALM - R（SA 1、2和3）收集数据以确定健康素养水平，使用LAB收集数据以确定英语理解水平。
使用REALM - R（SA）工具时，大多数患者得分较高。对于LAB，68%的患者在50分中得分为11 - 40分。只有8%的患者在50分中得分为41 - 50分。实际取得的学校年级与根据LAB得出的学校年级之间存在显著差异。
研究结果表明，尽管患者能够阅读和发音REALM - R（SA）工具中使用的医学词汇，但这并不一定意味着他们能够理解这些词汇的含义，正如LAB的结果所示。目前，REALM - R（SA）工具仅基于单词识别和发音来测试健康素养水平。建议增加一个单词理解部分以确定患者对单词的理解。
