ABSTRACT
Objective:To construct the concept and its conceptual framework of hospital health literacy(HHL) for exploring the HHL promotion mechanism in the country.Methods:Based on the proceduralised grounded theory, twelve middle or senior managers of hospitals were selected for in-depth interviews and three hospitals were selected for field research from July 2021 to February 2022. Open coding, axial coding, and selective coding were used in data analysis, establishing the concept of HHL and its conceptual framework in China.Results:The conceptual framework of HHL was composed of an internal driver mechanism(hospitals improve their health literacy promotion management system, staff-led health literacy promotion, health literacy promoting physical environment construction), and an external driver mechanism(cooperate with external organizations and institutions to conduct health literacy promotion). The concept of HHL in China was derived as follows: the combination of supportive environments and human resources that health care organizations have in place can improve access and understandability of health information and simplify healthcare services to help patients of different health literacy levels more easily obtain, process, and understand health information as well as to make the most of medical services.Conclusions:Hospital health literacy promotion mechanism in China is a synergy between internal and external driver mechanisms.
ABSTRACT
BACKGROUND: Analyzing students' performance and self-criticism of their roles in promoting health literacy can inform nursing education in a social environment that expects new graduates to be health promoters. OBJECTIVES: The pilot study reported here aimed to a) analyze students' understanding of and sensitivity to issues of health literacy, (b) identify students' perceptions of structural, organizational, and political barriers to the promotion of health literacy in social and health care organizations, and (c) document students' suggestions for curriculum changes that would develop their skills and competencies as health-literacy promoters. DESIGN: A qualitative pilot study. SETTING: A collaborative undergraduate nursing degree program in the metropolitan area of Toronto, Canada. PARTICIPANTS: Sixteen undergraduate, Year 4 nursing students. METHODS: Signed informed consent was obtained from the participants. Participation was unpaid and voluntary. Recruitment was through an email invitation sent by the School of Nursing Student Affairs Coordinator. Three, one-time individual interviews and three focus groups were conducted. All were audio-recorded. Recordings were transcribed, and the transcriptions were coded using the qualitative software ATLAS ti 6.0. The interview data were submitted to thematic analysis. Additional data were gathered from the two-page self-assessments in students' academic portfolios. RESULTS: Sensitivity to health literacy was documented. Students performed best as health promoters in supportive teaching hospitals. Their performance was hindered by clinical settings unsupportive of health education, absence of role models, and insufficient theoretical preparation for health teaching. Students' sensitivity to their clients' diversity reportedly reinforced the interconnection, in multicultural healthcare settings, between health literacy and other social determinants of health and a growing demand for educating future nurses in expanding their role also as health promoters. CONCLUSIONS: Students recommended more socially inclusive and experiential learning initiatives related to health teaching to address education gaps in classrooms and practice.
