Health professionals and health literacy - Interview with Wolter Paans
Wolter Paans is Hanze University of Applied Science, Groningen. In this interview he tells us about his work in IROHLA and the importance of health literacy for health professionals.
Could you tell me about your background? What sparked interest health literacy and the IROHLA project?
I worked on the IROHLA project with my colleague, Herman Veenker. We are both researchers in the health domain. My interests focus on nursing and allied health care professionals (such as physical therapists and psycho therapists, etc.) and Herman’s on pedagogy and education. We specialise in different fields, but we both focus on health literacy and the communication part of it.
How does the level of health literacy influence healthcare use? Is there any correlation between low health literacy and high levels of healthcare use?
I’d like to tackle this question from a somewhat broader perspective – meaning how we perceive health literacy communication. Although health literacy may be more of a problem for people with low literacy, it is an important issue for people with high levels of literacy as well. From our experience, health literacy is closely related to healthy ageing action. This action supports citizens during their life course to self-manage their health issues, and to understand how lifestyle choices affect health. It also educates them, for instance, about institutional pathways to take in case they need medical support and empowers them to make informed decisions. To be able to communicate effectively, it is very important to take health literacy into account.
What does ‘health literate communication’ mean for health professionals?
Care givers should use several different communication models, not only the ones that everybody is used to. For instance, we are used to the “sender-message-receiver” communication model. In other words, the health professional simply communicates all the information to the patient. Nowadays, we know that we should focus more on the interaction with the patient. In fact, we think interaction is key in health literacy. This implies that you don’t want the person only understanding you. Instead, what you really want is that they can estimate, for example, what kind of benefits a certain lifestyle change might bring. This person can later make a change in their life, but also be helpful and give support to their community and family. So health literacy is all about health professionals’ real interest in their patient, asking questions, to make sure whether a person understands the information, not only on the level of cognitive understanding, but also at the behavioural level. That is why effective communication between the caregiver and the patient requires a high level of interaction.
What is the level of health literate communication among doctors in the EU?
We conducted a literature review in the IROHLA project and the outcomes of this systematic review suggested that the sender-message-receiver model is mainly used in doctor-patient communication. We think that there is not enough emphasis put on interaction and on encouraging real understanding and empowerment among patients to make their own informed health decisions.
You recently conducted a pilot study to train health professionals in health literate communication. What did it involve? Did you face any obstacles or challenges?
Our goal is to bring the interaction model into healthcare and nursing education programmes. We developed a pilot programme together with the UMCG to train health professionals to interact with their patients. This programme will focus on the “teach back model”. It is not implemented yet, so what we want to do is an experiment to see whether this kind of interaction will influence students in their communication with patients.
Is there anything else besides interaction that health professionals can do during contact with patients to promote health literacy and patient empowerment?
We think that health literacy communication is closely related to methods used in family care. There is quite a lot of research about methods used in family care and we think that these methods would be highly effective in increasing health literacy among patients. These methods really help to understand people’s problems. Family caregivers use methods to empower people in their own social context and we think that we can learn from that. There might be a paradigm shift towards supporting healthy people to stay healthy instead of thinking in terms of illness and care support, and putting more focus on supporting healthy people in their healthy period of life.
Is there anything you'd like to add?
I think that it's very important health literacy stays on the agenda beyond the lifetime of the IROHLA project. It is an important issue to research and examine in greater depth, particularly how we can empower people in their own communities. Another possibility of reaching people and supporting health literacy is use of modern ICT. We found few studies related to healthcare technology designed to support health literacy, so there is a lot of potential development in this area.