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

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.

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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
Authors/Creators:van der Ploeg, WJ
Keywords: health literacy, healthcare navigation, chronic disease, cardiac
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Copyright 2012 the author

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