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Health literacy and healthcare system navigation for people who have had, or are at risk of, a cardiac event


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van der Ploeg, WJ (2012) Health literacy and healthcare system navigation for people who have had, or are at risk of, a cardiac event. PhD thesis, University of Tasmania.

PDF (Front matter)
front-vanderplo...pdf | Download (167kB)
Available under University of Tasmania Standard License.

PDF (Whole thesis)
whole-vanderplo...pdf | Download (2MB)
Available under University of Tasmania Standard License.


As the first study looking at health literacy and healthcare system navigation
in Tasmania, the findings make a significant contribution to Australian-based health
literacy research. Derived from a mixed methods survey of 18 mostly senior,
regional participants with cardiac ill health, the data revealed a group for whom the
abilities to access, understand and apply health information were largely
inadequate. Yet remarkably, in light of that finding, most participants' experiences of
healthcare system navigation were positive and most spoke with confidence about
being able to perform the task. Participants' recollections were examined for factors
that contributed to their experiences.
Analysis of the individual, service and system level themes that emerged
from participants' recollections produced a complex picture of factors understood to
impact their navigational experiences. In seeking to interpret and explain that
complexity a framework was developed which highlights the role of health literacy
at the individual level. The cogwheels depicted in the framework represent the
interrelated nature of the factors impacting navigation at the various levels; the
dynamic nature of healthcare navigation; and the influence health literacy may have
on it.
That said, the contribution participants' health literacy made towards
understanding the complexities of their navigational experiences were both
conclusive and inconclusive. Conclusively, the data revealed a positive association
between participants' health literacy and their depth of cardiac knowledge and
subsequent ability to respond appropriately when symptomatic; their understanding
of treatment protocols; and their self efficacy with filling out forms, reading hospital
materials and learning about their cardiac conditions. However, data analysis
revealed that in many ways the contribution participants' health literacy made
towards understanding their navigational experiences was inconclusive. Self management motivation; advice and support with navigational decision making; and
service accessibility, for example, were also shown to assist participants who
achieved across the range of possible health literacy proficiencies.
Collectively, those findings evidenced the vulnerability of participants with
limited health literacy whilst demonstrating health literacy was one of a number of
factors impacting the healthcare navigation experience. Thus, although limited
health literacy risked making navigation more difficult it could be offset by other
factors such as motivation, advice, support and service accessibility to make the
overall experience a positive and manageable one. From the findings of this study it
is recommended health literacy is addressed as part of a multifactorial intervention
strategy to improve individuals' successful navigation of health care systems, whilst
also advocating further research in the area.

Item Type: Thesis (PhD)
Keywords: health literacy, healthcare navigation, chronic disease, cardiac
Additional Information:

Copyright the Author

Date Deposited: 17 Aug 2012 04:33
Last Modified: 15 Sep 2017 01:06
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