Role of the health literacy assessment in healthcare: Content validation of "Health Literacy Behaviour" nursing outcome.

PURPOSE: To validate the content of the "Health Literacy Behaviour" nursing outcome (NO). METHODS: A content validation study was conducted during 2022. Each indicator was included in the NO, and its response levels were operationally defined. The initial version of each indicator and its response levels were refined and validated through the Delphi method. A panel of health literacy (HL) and nursing taxonomies experts evaluated the content through two content validity indicators. The content validity of the NO and each index was determined by calculating the content validity index (CVI). A qualitative analysis of the recommendations provided by the experts was carried out to improve the understanding of the indicators and their levels. FINDINGS: A total of 108 experts participated in this study. Mostly females with more than 10 years of professional experience. The results demonstrated a high CVI of the indicators and the NO "Health Literacy Behaviour." All indicators achieved excellent (CVI ≥ 0.80) relevance and clarity. The CVI universal average method (CVI-p) of the NO achieved an excellent result of 0.90. CONCLUSIONS: The indicators included in the NO "Health Literacy Behaviour" have content validity. IMPLICATIONS FOR NURSING PRACTICE: These findings provide evidence-based indicators to measure the patient's actions to obtain, process, and understand information about health and disease, interact with the health system, and make informed health decisions. The validation of this NO would identify populations with low HL, allowing the health of this community to be promoted. Health literacy should be a priority objective of health management and policies.

OBJETIVO: Validar el contenido del resultado de enfermería "Comportamiento de alfabetización en salud". MÉTODOS: Se realizó un estudio de validación de contenido durante el año 2022. Se definió operativamente cada indicador incluido en el resultado de enfermería y sus niveles de respuesta. La versión inicial de cada indicador y sus niveles de respuesta fueron refinados y validados mediante el método Delphi. Un panel de expertos en alfabetización para la salud y taxonomías de enfermería evaluó el contenido a través de dos indicadores de validez de contenido. La validez de contenido del resultado de enfermería y de cada indicador se determinó mediante el cálculo del Índice de Validez de Contenido. Se realizó un análisis cualitativo de las recomendaciones brindadas por los expertos para mejorar la comprensión de los indicadores y sus niveles. RESULTADOS: En este estudio participaron un total de 108 expertos. En su mayoría mujeres con más de diez años de experiencia profesional. Los resultados demostraron un CVI alto de los indicadores y del resultado de enfermería "Comportamiento de alfabetización en salud". Todos los indicadores lograron una relevancia y claridad excelentes (CVI ≥ 0.80). El Índice de Validez de Contenido Método Promedio Universal CVI­p del resultado de enfermería alcanzó un resultado excelente de 0.90. CONCLUSIÓN: Los indicadores incluidos en el resultado de enfermería "Comportamiento de alfabetización en salud" tienen validez de contenido. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: Estos hallazgos proporcionan indicadores basados en evidencia para medir las acciones del paciente para obtener, procesar y comprender información sobre la salud y la enfermedad, interactuar con el sistema de salud y tomar decisiones de salud informadas. La validación de este resultado de enfermería identificaría poblaciones con baja alfabetización en salud, permitiendo promover la salud de esta comunidad. La alfabetización para la salud debería ser un objetivo prioritario de la gestión y las políticas sanitarias.

Content and Clinical Validation of the Nursing Outcome "Health Literacy Behaviour": A Validation Protocol.

Health literacy (HL) is a result of health promotion and education that has been included as a nursing intervention since 2013. It was proposed, as a nursing activity, to "determine health literacy status at initiation of contact with the patient through informal and/or formal assessments". Because of that, the outcome 'Health Literacy Behaviour' has been incorporated in the sixth edition of the Nursing Outcomes Classification (NOC). It collects the patient's different HL levels and allows them to be identified and evaluated in a social and health context. Nursing outcomes are helpful and provide relevant information for the evaluation of nursing interventions. OBJECTIVES: To validate the contents of the nursing outcome 'Health Literacy Behaviour (2015)' in order to use them in nursing care plans, and to evaluate their psychometric properties, application level, and effectiveness in nursing care to detect low health literacy patients. METHODS: a methodological two-phased study: (1) an exploratory study and content validation by expert consensus, who will evaluate revised content of nursing outcomes; (2) methodological design by clinical validation. CONCLUSION: The validation of this nursing outcome in NOC will enable the generation of a helpful tool that would facilitate nurses to set individualised and efficient care interventions and identify low health literacy populations.

Empathy training in health sciences: A systematic review.

Effective empathy training interventions based on scientific evidence becomes essential. A theoretical framework should guide the proposed interventions and be coherent with the evaluation of the dimensions taking in account that empathy is currently a multidimensional concept. The study aimed to determine, in health care professionals and/or students, what is the effectiveness of experiential versus humanistic training, in terms of improvement of empathic ability (dimensions) and maintenance over time of what has been learned, and to establish the degree of coherence between the proposed theoretical model and the trained and evaluated dimensions. A systematic review using six databases was performed. The data were synthesised, and the risk of bias was analysed using the Equator Guidelines. Twenty-three articles were selected. Further evidence of the effectiveness of experiential intervention against humanistic educational strategies was observed. Most studies were not based on a solid theoretical framework and, in these cases, inconsistency between empathic trained dimensions and those evaluated was detected. Although a better understanding of training time variable is required, middle-term interventions are recommended. Increasing the multicentre controlled trials; specifying the intervention that includes the empathy dimensions; triangulating the data from health professionals, patients, and external observers; and including monitoring, becomes a necessity.