Adaptation of the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African Context: Part 1

Literacy levels are increasingly important in health care because professional nurses and other health care professionals often use written health education materials as a major component in patient education. In South Africa; no current instrument is available to assess the literacy levels of patients in the primary health care setting; though several instruments have been developed and validated internationally. The purpose of this paper was to adapt and validate the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African context. The REALM-R is a short instrument that is designed to rapidly screen clients in the primary health care setting for low health literacy. A modified Delphi-technique was used to measure the judgement of a group of experts for the purpose of making a decision. Eight experts in the field of Nursing Science were selected purposively to obtain the most reliable consensus. Data was collected by means of a self-report whereby participants responded to a series of questions posed by the researcher. Descriptive statistics was used for analysing data. The REALM-R was adapted to the South African context to ensure that the literacy level of South African clients is measured with an appropriate instrument

Assessment of the eng Literacy Level of Patients in Primary Health Care Services in Tshwane; Gauteng Province: Part 2

Low literacy can be described as the inability to read; write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes. The aim of this study was to assess the eng literacy levels of primary health care patients using the Learning Ability Battery (LAB) and the adapted Rapid Estimate of Adult Literacy; Revised (REALM-R) and to determine how the results of the adapted REALM-R correlate with those of the LAB. Data were collected by means of a self-report whereby the participants had to answer the questions that were posed in the LAB and read the words out loud for the adapted REALM-R. The data analysis was performed by means of descriptive and inferential statistics; including the chi-square test and Spearman's rho. The result of the study indicated that in South Africa; school grades achieved and the reading levels of primary health care patients differ with four grades. In terms of the correlation between the results of the adapted REALM-R and those of the LAB; a correlation of r = 0.43 (p 0.001) could be established. Depending on the cut-off point used for the adapted REALM-R; 67of the participants had low literacy levels. The study provides evidence of the importance of a validated; quick and easy-to-administer literacy screening tool. The effective assessment of patients' literacy levels will assist registered professional nurses to provide health education on an appropriate level to improve patients' health literacy