Communicative health literacy with physicians in healthcare services- results of a Hungarian nationwide survey.

BACKGROUND

In an efficient and effective healthcare delivery, good communication plays an essential role. The communicative health literacy (COMM-HL) of the patients is an important attribute, but the number of validated COMM-HL assessment tools is low, and they do not cover all aspects of COMM-HL. That's why a new scale has been developed within an international collaboration. Our aims are to check the measurement properties of the Hungarian version of this COMM-HL questionnaire, to describe the COMM-HL of the Hungarian adult population and to investigate its determinants.

METHODS

A total of 1205 adults completed the telephone interview in 2020 as part of the European Health Literacy Population Survey 2019-2021. The questionnaire included items on sociodemographic data, self-perceived health, social support and COMM-HL. The questionnaire's measurement properties were assessed using Cronbach's alpha, Spearman-Brown, and item-total correlation coefficients, while the construct validity was investigated with principal component (PCA) and confirmatory factor analysis. The determinants of the COMM-HL were investigated by linear regression.

RESULTS

Both the value of Cronbach's alpha and the Spearman-Brown correlation were 0.87. The items belonged to one factor and 62.2% of the total variation was explained by this factor based on the PCA. The fit indices indicated that the one-factor structure of the six-item questionnaire exhibited a good fit for the data. The mean score on the COMM-HL scale was 86.8. The easiest task was explaining health concerns while getting enough time in the consultation was rated as the most difficult one. COMM-HL was lower among females, while it was higher among people aged 66-75 years (compared with 18-25 years), those with greater social support and those without financial deprivation.

CONCLUSIONS

The questionnaire can be characterized with good internal consistency and the structure of the COMM-HL questionnaire was best explained as a one factor model. In consultations with patients, the effectiveness of communication should be improved, so that patients do not feel that there is not enough time for consultation. At-risk groups with low COMM-HL need special attention during the interactions and the role of social support has to be clarified, too.