Kuo Chien-Lin
PhD, RN, Associate Professor, Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
Hu Li Za Zhi. 2023 Apr;70(2):4-6. doi: 10.6224/JN.202304_70(2).01.
Health literacy (HL) is an essential ability used by people throughout life to access, understand, appraise, and apply health related information and services and is widely recognized as a key determinant of health. HL has been the focus of increasing international attention in the 21st century, with the World Health Organization identifying HL as a 2030 sustainable development target (World Health Organization, 2016). "Strengthening health communication and improving HL nationwide" is also an issue targeted in a Taiwan government white paper for improvement by 2025. Key related actions and strategies noted in this paper include investigating the HL of each life course; disseminating accurate, easy-to-access, and implementable health and safety information; improving the public's awareness and use of mobile tools; using multiple marketing models (public, organization, interpersonal communication); combining cloud technology to develop a health management system; setting up websites; providing cloud care; and developing other e-media (Ministry of Health and Welfare, 2016). The COVID-19 pandemic has greatly challenged the global healthcare system as well as individual health. Due to the difficulties and uncertainties associated with emerging diseases, updating regularly changing information in a timely manner is not easy. Ensuring public access to and application of updated information is a key challenge to improving public HL. Abel & McQueen (2020) pointed out that "critical health literacy", the ability of individuals to reflect on complex health issues and critically evaluate available information, will be the key to promoting and enhancing healthy behaviors in response to emerging diseases. Taiwan is rapidly moving toward becoming a super-aged society, at which time frail older adults, individuals with dementia, and individuals with disabilities and multiple chronic diseases are expected to be the primary targets of healthcare system services. During the pandemic, many individuals in vulnerable groups died quickly due to COVID-19-related severe illnesses, leaving their families with insufficient time to respond and adjust. This experience highlights the importance of palliative and end-of-life care communication with clients and of permitting family members to grieve. In addition, disease control measures such as isolation, wearing masks, and reducing visits to patients have also affected communication between people, widening the distance between patients, their families, and healthcare professionals. This experience has made us reflect on how to better use online and mobile tools to support self-care for patients and their families. In this issue, Professor Li first expounds on promoting HL in the elderly through the use of health education strategies such as formulating public policies related to HL, adjusting the orientation of health services, constructing a friendly environment for HL information dissemination, strengthening community resources for HL education, and promoting geriatric learning and shared decision-making. Professor Wu encourages nurses in long-term care facilities to apply the U-R-PEACE strategy to promote understanding, respect, planning, expression, act, care, and education in a manner that facilitates effective palliative care communication with patients and their families as early as possible. Because dementia care relies heavily on family caregivers, Professor Luo suggests using family-caregiver-created and managed Facebook groups to share health information and facilitate social support, shedding light on how to use social media to effectively empower caregivers. Interactions between patients and healthcare professionals are critical to effective healthcare delivery. The unequal power dynamic between physicians and patients may lead to communication conflicts, especially as generational replacement progresses and public health awareness improves. Facing the differences between these two interest groups, Professor Ye suggest nurses handle conflicts proactively by increasing their emotional drive to address disagreements, enhancing their cognitive abilities to handle interpersonal dynamics, and engaging actively in communicative measures.
健康素养(HL)是人们一生中用于获取、理解、评估和应用与健康相关信息及服务的一项基本能力,被广泛认为是健康的关键决定因素。在21世纪,健康素养日益受到国际关注,世界卫生组织将健康素养确定为2030年可持续发展目标(世界卫生组织,2016年)。“加强全国健康传播与提高健康素养”也是台湾地区政府白皮书设定的到2025年要改善的一个目标。本文指出的关键相关行动和策略包括调查每个生命阶段的健康素养;传播准确、易于获取且可实施的健康与安全信息;提高公众对移动工具的认知和使用;采用多种营销模式(公众、组织、人际传播);结合云技术开发健康管理系统;建立网站;提供云护理;以及开发其他电子媒体(卫生福利部,2016年)。新冠疫情给全球医疗系统以及个人健康带来了巨大挑战。由于新兴疾病存在诸多困难和不确定性,及时更新不断变化的信息并非易事。确保公众获取并应用最新信息是提高公众健康素养的一项关键挑战。阿贝尔和麦昆(2020年)指出“批判性健康素养”,即个人反思复杂健康问题并批判性评估现有信息的能力,将是促进和加强应对新兴疾病的健康行为的关键。台湾地区正迅速迈向超老龄化社会,届时体弱的老年人、痴呆症患者以及残疾和患有多种慢性病的人预计将成为医疗系统服务的主要对象。在疫情期间,许多弱势群体中的个体因新冠相关重症迅速死亡,致使其家人没有足够时间做出反应和调整。这一经历凸显了与患者进行缓和医疗及临终关怀沟通以及允许家庭成员悲痛的重要性。此外,隔离、戴口罩和减少探视患者等疾病控制措施也影响了人们之间的交流,拉大了患者、其家人与医护人员之间的距离。这一经历促使我们思考如何更好地利用在线和移动工具来支持患者及其家人的自我护理。在本期中,李教授首先阐述了通过制定与健康素养相关的公共政策、调整健康服务方向、构建有利于健康素养信息传播的环境、加强健康素养教育的社区资源以及促进老年学习和共同决策等健康教育策略来提高老年人的健康素养。吴教授鼓励长期护理机构的护士应用U-R-PEACE策略,以促进理解、尊重、规划、表达、行动、护理和教育,尽早与患者及其家人进行有效的缓和医疗沟通。由于痴呆症护理严重依赖家庭护理人员,罗教授建议利用家庭护理人员创建和管理的脸书群组来分享健康信息并促进社会支持,阐明如何利用社交媒体有效增强护理人员的能力。患者与医护人员之间的互动对于有效的医疗服务至关重要。医生和患者之间不平等的权力动态可能导致沟通冲突,尤其是随着代际更替的推进和公众健康意识的提高。面对这两个利益群体之间的差异,叶教授建议护士通过增强处理分歧的情感驱动力、提高处理人际动态的认知能力以及积极参与沟通措施来主动处理冲突。