| Abstract|| |
Introduction: Nurses as professional care providers, have adequate health literacy to understand and use it to provide health promotion and community members. The aim of this study was to determine the relationship between health literacy and health promotion in nurses of Medical Sciences University of West Country has been done. Methods: The present study is applied and correlation and cross-sectional that was performed in 2016. The population consisted of the nurses of University of Medical Sciences in West Country (Ilam-Kermanshah-Kurdistan-Hamadan) formed and 346 centers through two-stage cluster sampling were selected. A questionnaire for data collection was used with 57 items. The validity of the study was content validity, and its reliability (Cronbach's vary from 850) was confirmed. The data using SPSS version 22, using descriptive statistics (mean and standard deviation), and inferential statistics (binomial test, Pearson correlation, Kruskal–Wallis, and Mann–Whitney) analysis were reported. Results: The results showed that 97% of nurses and 80% of nurses in health literacy and good health promotion was acceptable. Variable between health literacy and health promotion with a correlation coefficient (0.556) was positive and significant relationship, as well as differences in health promotion nurse-square statistic (56.52) and differences in health literacy nurse-square statistic (31.80) was significant in various hospitals (P < 0.05). Conclusion: The present study demonstrates the relationship between health literacy and promoting health nurses, and this suggests that the managers and officials plan to improve health literacy and health promotion for this stratum of society done.
Keywords: Health education, health promotion, nurse
|How to cite this article:|
Rahimi A, Dabbaghi F, Mahmoudi G. Assessment and comparison of health literacy and its application in health promotion of Nurses in Medical Sciences University of West Country. Ann Trop Med Public Health 2017;10:891-6
|How to cite this URL:|
Rahimi A, Dabbaghi F, Mahmoudi G. Assessment and comparison of health literacy and its application in health promotion of Nurses in Medical Sciences University of West Country. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 11];10:891-6. Available from: http://www.atmph.org/text.asp?2017/10/4/891/215859
| Introduction|| |
In the field of health care as well as for practitioners and clients in the field of health literacy discussion (Health Literacy) raised which in recent years has been of interest to health planners macro., According to World Health Organization (WHO) definition, health literacy is cognitive and social skills, people's ability to reach comprehension, and use of existence information to promote and maintain the health. Agency for Health Care Research and Quality define health literacy as written or printed set of skills such as literacy, mathematical literacy and literacy, and verbal or oral. For formal and informal health literacy activity that occurs throughout life. The informal, family health education and informal education for their children and provide health information, through peer groups, social interaction and in the workplace continues. Officially, health literacy can be through schools, primary health-care centers, hospitals, workplaces, and in public places continues. Unlike the past, when patients did not have access to medical information, the new system to seek information from patients wants to maintain their health, prevent disease, improve the quality of life, less anxiety when dealing with the disease and their participation in health-care programs. The foundations of the knowledge and skills in the health-care setting any demand are called health literacy. The purpose of health literacy, health promotion, and disease prevention is through education and training. You may have noticed that training knowledge, attitudes, and behavior of individuals or notice increased awareness about the need for a healthy public policy and political measures. In many developing countries, health education, health promotion activities is a prominent element. Health promotion involves the use of energy and potential of individuals, improved quality of life, productivity and the ability of the person is in relation to health. Nowadays, instead of only focusing on therapeutic strategies, it tries to promote health using correct planning and training to the community. Researches have demonstrated that doing health-promoting behaviors is one of the best ways that help people to maintain and control their health. In fact, health promoting behaviors and health is one of the major criteria. Health promoting behavior expressing the human tendency to excellence that leads to optimal well-being, personal development, and creative life in it. Health promotion practices multidimensional models of self-efficacy, retaining and promoting the welfare and prosperity of the people is complete and thus health promoting behaviors and mental well-being, social entities of the important determinant of health status. Promoting public health can potentially impact on the health status of nurses and promote health, and their quality of life had and to correspondingly reduce the costs of health care.
Nurses' health is a major issue among team members, that they have multiple roles such as clinical care, counseling and follow proper implementation of treatment, patient education and disease prevention techniques. They have to accomplish this works by scientific, ethical and accurate method to communicate with clients. Also, their ability and physical health is required., However, statistics show that the health of these nurses is inferior to other health care providers. For example, salt intake and lack of sufficient physical activity or mental health nurses is more common down, on the other hand, the rising cost of health care, along with the fact that the disease is not always effective, supporting and promoting the concept of health promotion and health-care workers, especially nurses, it has increased and nurses cannot meet clients' needs without much attention paid to their lives and health promotion practices.
Given the importance of health literacy on health promotion, studies in this area require special attention which represents health systems understand the importance of health literacy impact on the pattern of use of health services. Habibi et al. demonstrated that nurses who applied based on scientific evidence have been established, and it can make better decisions for their patients. Raeasie et al. revealed that people with higher health literacy, better assess their general health status. Baratei et al. determined that there was a significant relationship between the health of the elderly and mental health promoting behaviors also among the variables of sex, education, and mental health of older people. Kheirjo et al. in their study, the highest correlation between lifestyle and health of its components have gained the level of women's education. As mentioned further studies to assess patients' health literacy, health literacy and health-promoting behaviors, and health literacy in adults and elderly women and shared by the majority of the studies investigating the relationship between health literacy of patients and health service utilization. While this study contrasts to these studies, the relationship between health literacy and the use of nurses as health providers in health promotion nurses. The turning point of the study is due to health provider's health-care recipients. The aim of this study was to determine the relationship between health literacy and its application in health promotion of nurses in University of Medical Sciences of West Country in 2015.
| Methods|| |
The present study is applied and correlation and cross-sectional that was performed in 2016. The population consisted of the nurses of University of Medical Sciences in West Country (Illam-Kermanshah-Kurdistan-Hamadan) formed and samples through two-stage cluster sampling were selected. A questionnaire for data collection was used with 57 items. The validity of study was content validity, and its reliability (Cronbach's vary from 850) was confirmed. The data using IBM SPSS Statistics (Version 22), using descriptive statistics (mean and standard deviation) and inferential statistics (binomial test, Pearson correlation, Kruskal–Wallis, and Mann–Whitney) analysis were reported. Thus, the total number of nurses in hospitals of University of Medical Sciences in West Country (Ilam, Hamedan, Kermanshah, Kurdistan) was 3574 in the hospital of University of Medical Sciences in Ilam was 321 people, Hamedan 1085 people, Kermanshah 1512 people, and Kurdistan 656 people. Based on Cochran's formula taking into an account, the total number of nurses in hospitals was estimated number of nurses needed to study was 346 according to stratified random sampling with proportional allocation of Ilam University Medical Center of 321 people, 32 people, in Hamedan of 1085 people, 106, in Kermanshah of 1512 people, 144 people and in Kurdistan of 656 patients, 64 patients were enrolled. A questionnaire was used to collect data by reading magazines, websites, and other related articles Farsi and English were designed.,,, The validity of the content and structure of the tools used by 10 professors and experts were measured, and the purpose of the study was confirmed. The reliability of the questionnaire using Cronbach's alpha coefficient (α = 0.85) were determined. The questionnaire included 57 questions 3 parts and the part I was the demographic information such as age, gender, education and work experience, and the name of the hospital service, Part II Information relating to the determination of the Hospital Nurses' Health literacy rate (23 questions), Part III Information on the status of health promotion in selected hospital nurses (29 questions). The questions were answered just three choice (yes, no, somewhat). Grading the questions in this way that the option yes point 2, somewhat option point 1, and no option point 0 and statistical analysis was performed by calculating the maximum and minimum points. The questionnaire 10 maximum points and minimum points was zero, the second part of the questionnaire 46 maximum points and minimum points was zero and a maximum of 58 and minimum points score in the third questionnaire was zero. To analyze the data, descriptive statistics (mean and standard deviation) and inferential statistics (two-sentence, Pearson correlation, Kruskal–Wallis, and Mann–Whitney) with the help of SPSS version 22 was used.
According to research findings (36.2%) males and (63.8%) females, (89.4%) have a bachelor's degree (10.6%) of those with a master's degree or higher, (40.2%) <5 years, (33%) of samples 5–10 years, (15.2%) of samples 10–15 years, (9.2%) of samples 15–20 years, and (3.2%) of the samples had more than 20 years of experience [Table 1].
|Table 1: Frequency distribution and percentage of respondents' demographic characteristics|
Click here to view
According to statistics collected by the average age of participants (31.52) years, the median age of the patients (30.50), the highest rate in 30 years, standard deviation is = 6.12, minimum age 22 years and older 53 years. To check the nurses' health literacy teaching hospitals of University of Medical Sciences in West Country binomial test were used. For variable number of people who rated the level of health literacy nurses earned an average score of ≤1 against with 23 (7%) and the number of people who have scores >1 is = 325 (93%), according to the significant value of <0.05 and the ratios obtained, we conclude that almost 97% of the nurses in the study of optimal health and literacy rates were acceptable. To check the status of nurses in health promotion hospitals of University of Medical Sciences in West Country as well as the binomial test was used. The results showed that nurses promote health for variable number of points earned an average score of ≤1 against with 69 (20%) and the number of people who scores them is no more than 1 of 279 patients (80%), according to the significant value of <0.05, and the ratio obtained almost 80% of the nurses in the study, with the promotion of good health and were acceptable to investigate the association between health literacy and promote health status of nurses in hospitals of University of Medical Sciences in West Country correlation analysis was used. Pearson correlation coefficient between health literacy and health promotion nurse with (0.556) is significant at the 1% level, which means that there is a positive significant relationship between these two variables, this means that for nurses with higher education levels were also observed higher levels of upgrade. Differences in health education and health promotion based on different hospital centers, the Kruskal–Wallis (nonparametric analysis of variance) showed the highest level of health literacy in Kermanshah Motazedi hospitals with an average (37.50), standard deviation (8.34) average rating (236.38), Farabi Hospital in Kermanshah with an average (37.42), standard deviation (7.48) and the average rating (219.21) and the lowest health literacy in Tohid Hospital in Sanandaj with an average (28.78), standard deviation (8.37), and the average rating (98.43). Also, according to the amount of square statistic, Kruskal–Wallis is = 31.80 and significant value <0.05, we conclude that differences in health literacy levels of nurses in different hospitals were significant [Table 2].
|Table 2: Kruskal–Wallis to compare the average health literacy in various hospitals|
Click here to view
The Kruskal–Wallis test results showed that the highest amount of health promotion in hospitals with an average Motazedi Kermanshah (46), standard deviation (5.88) and the average rating (269.88), Hamadan Farshchian hospital with average (41.43), standard deviation (9.33), and average rating (211.03) and the lowest health promotion in Ayatollah Taleghani Hospital in Ilam, with an average (29.58), deviation from criterion (8.08), and the average rating (88.50). According to the Kruskal–Wallis test, square statistic is = 56.52 and significant value <0.05 concluded that health promotion of nurse in difference hospitals was statistically significant [Table 3].
|Table 3: Kruskal–Wallis test for the comparison of health improvement in various hospitals|
Click here to view
Investigating the relationship between age and job experience with the nurses' health literacy and promote health nurses in hospitals of University of Medical Sciences in West Country, according to Pearson correlation test showed the correlation between age and level of education nurses' health (0.004) and nurses correlation between age and health promotion (−0.084) which shows the relationship was not significant. The Pearson correlation coefficient (0.048) between job history, education level, health of nurses and by a factor of (−0.061) between nurses employed by the health promotion of relations was not significant. According to Mann-Whitney test results, the average, standard deviation, and averages rating of health literacy in men's were equal to 35.61, 6.79, and 189.35 respectively, whilst these measures for women were equal to 34.94, 5.77, and 166.07, respectively. Also, the results of Mann-Whitney test proved that there was significant difference between men and women health literacy (Pv<0.05). Whilst the average, standard deviation, and averages rating of health promotion in men's were equal to 38.72, 8.58, and 186.65, respectively, and these measures for women were equal to 36.90), 9.24, and 167.6, respectively. According to Mann–Whitney test's significant value of >0.05, there is no significant difference between men and women in the nurses' health promotion [Table 4].
|Table 4: The mean level of education and promoting the health of nurses in two groups of women and men based on the Mann–Whitney|
Click here to view
| Discussion and Conclusion|| |
The findings show the similarities and differences between the results of previous research. Javadzade et al. In a study, investigate the relationship between knowledge and practice regarding the application of strategies in education to the patient's health literacy and their results showed that nurses' awareness of health literacy is low and appropriate action to implement strategies to patient health literacy in education and the role of training effectiveness will not. The results of Chew et al. it clear that 5.4% of participants Medical Center researcher with inadequate health literacy, 7.5% had marginal health literacy and the results of these research findings of the present study showed that 97% of nurses are good levels of literacy were not confirmed. This mismatch could be due to differences in methodology of this research is because it is descriptive studies and the survey that was conducted with the qualitative method, while the study was small, the study Chlerwezi et al. demonstrated the high health status of nurses in the study were also confirmed. The results Raeasie et al. demonstrated a significant relationship and a positive correlation between health literacy by improving nurses' health study was like, while the results Downey et al. and the reason for this inconsistency can be traced to the study mentioned in this although those with adequate health literacy longer and at least 1 day a week was devoted to sports and people with higher health literacy were less likely to smoke, but there is statistically significant association between health literacy and health promotion research. Dickens et al. demonstrated that career development, health literacy is a crucial target and low health literacy causes of poor health in the community, but the extent and speed up hospital readmission in patients with low health literacy is one reason for this difference can be geographical area hospitals and requirements and measures that hospitals in their planning is in relation to recruitment and retention of troops. Another reason for this difference is likely due to the low education level of client's surveyed hospitals in urban areas is low.
Ghanbari et al. according to their study showed that limited health literacy can be prevented from understanding messages and health advice. Javadzade et al. in another study showed the development plan for education and health promotion behaviors in the elderly also there is a significant relationship between job tenure and health and the result of a significant relationship between age and job tenure and the level of health literacy and health literacy study is not consistent, this mismatch could be due to difference and diversity in the population of this research is to study. Because a similar study to examine your goals in a specific center has dealt with in a limited area while this study has examined large populations of cities. In general, the results of various studies indicate that poor knowledge and practice nurses and other health professionals about health literacy and adopt strategies are relevant in patient education accordingly, researchers in different research that the lack of academic training in the field of health literacy for all health-care providers, especially nurses as the most important obstacle in the lack of attention, in fact, learning about health literacy training again as one of the most important priorities for health service providers introduced and most recently the subject of one of the most important aspects of the national action plan published in America to be allocated. Check the status of health promoting behaviors and cognition are important factors affecting it, however, and can improve the quality of life. However, the need for policy and planning in the field is palpable. The importance of health promoting behaviors should be considered further and be involved in health policy and planning. Given the key role of nurses in the health-care system improve health literacy plan this stratum of society is vital and lack of planning and policy in the field of serious social problems, economic and health for the population, will follow in the not too distant future. That more studies be done in this area and various segments because the health literacy of individuals have the capacity to obtain, process and understand basic information, and health services, it is appropriate to decide more studies are needed, as well as the reasons for the difference between the average health literacy among women and men be nurses integrated strategies to promote health literacy and health among men and women should be provided.
This article resulted of dissertation entitled “The relationship between health literacy and its application in health promotion nurses, hospitals of medical universities in the West Country in 2015” a master's degree in the years 2015–2016 that have been implemented with the support of Sari Islamic Azad University.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Tehrani Bani Hashemi S, Amirkhani M, Haghdoost A, Alavian S, Asgharifard H, Baradaran H, et al.
Health literacy in 5 provinces and the factors affecting it. J Med Educ Dev 2007;4:1-9.
Kickbusch L, Wait S, Maag D. Navigating Health: The Role of Health Literacy. International Encyclopedia of Public Health 2008;3:204-11.
McNaughton C, Wallston KA, Rothman RL, Marcovitz DE, Storrow AB. Short, subjective measures of numeracy and general health literacy in an adult emergency department. Acad Emerg Med 2011;18:1148-55.
Khosravi A, Ahmadzadeh Kh. The level of health literacy of patients admitted to hospital in Bushehr and identify its risk factors. South Medical Journal 2015;6:1245-53. [Persian].
Kim MT, Song HJ, Han HR, Song Y, Nam S, Nguyen TH, et al.
Development and validation of the high blood pressure-focused health literacy scale. Patient Educ Couns 2012;87:165-70.
Raeasie M, Jawadzade S, Mostafavi F, Sharifirad GH. Health education and health promotion behaviors in elderly. J Health Syst Res 2013;9:827-36.
Altun l. Effect of a health promotion course on health promoting behaviors of university students. Eastern Mediterranean Health Journal 2008;14:880-87.
Wittayapun Y, Tanasirirug V, Butsripoom B, Ekpanyaskul CH. Factors affecting health-promoting behaviors in nursing students of the faculty of nursing Srinakharinwirot University. J Public Health 2010;40:215-25.
Motlagh Z, Mazloomy-Mahmoodabad S, Momayyezi M. Study of Health-promotion behaviors among university of medical science students. Zahedan J Res Med Sci 2010;13:29-33.
Habibi S, Nikpoor S, Syedalshuhday M, Haqqani H. Investigation of health-promoting behaviours and quality of life in elderly. J Ardabil Univ Med Sci 2008;8:29-36.
Soleimani A, Taghlili F, Rasouli M. Study of health behaviors of first year undergraduate nursing students in relation to risk factors of coronary artery disease. J Nurs Midwifery Hamedan 2005;24:26-31.
Mazloomi Mhamoodabad S, Fazelpour SH, Askarshahi M. Health- promoting behaviors and psychosocial well-being of University Shahid Sadoqi Yazd Academic Staff in Iran. J Ilam Univ Med Sci 2013;21:12-51.
Andrews GA. Promoting health and functioning in an aging population. Br Med J 2001;322:728-9.
KemppianeuV. Nurses'roles in health promotion practice: An integrative review. Health promotion international 2013;28:490-501.
Hojati H, Taheri N, Sharifnia H. Study of mental and physical health of nurses working in hospitals of Golestan University of Medical Sciences. J Urmia Nurs Midwifery Fac 2010;8:144-9.
Motaghi M, Basirimoghadam M, Rohani Z, Basirimoghadam K, Irani H. The Survey of Prevalence of Vertebral Column Pain and Some Related Factors in Nurses Employed in Gonabad Hospitals. Ofogh-e-Danesh. Journal of Gonabad University of Medical Sciences 2011;17:51-7. [Persian].
Vastani M, Karmalani R, Petrucka M. Integration of Health Promotion into Nursing Practice: A Case Study in Pakistan. Open Journal of Nursing 2016;6:37-45.
Baker DW. The meaning and the measure of health literacy. J Gen Intern Med 2006;21:873-83.
Habibi SH, Rezaei Hachesoo P, Tabaghi R. Enhancing information literacy as a base of developing evidence-based nursing. Health Inf Manage 2010;7:378.
Raeasie M, Mostafavi F, Hasanzade A, Sharifirad Gh. The relationship between health literacy and general health status and health behaviors in elderly, Journal of Health System Research, seventh year, Quarter Results. 2011;7:469-80. [Persian].
Baratei M, Fathi YE, Soltaneyan AL, Moeini B. The mental health status and health promoting behaviors in older adults Hamedan, Scientific Journal of Hamadan Nursing & Midwifery, Twentieth period, 2012;20:12-22. [Persian].
Kheirjo E, Jomhari F, Ahadi H, Farshbaf Manisefat F. Comparing lifestyle health Artqa'dhndh Patients with rheumatoid arthritis to women Healthy and its relation to demographic factors, Knowledge and Research in Applied Psychology Year XIII. 2012;13:61-70. [Persian].
Javadzade S, Sharifirad GH, Raeasie M, Mahaki B, Nasresfahani M, Mostafavi F. The relationship between knowledge and practice regarding the application of health literacy strategies in education patient. Mil Care Sci 2014;1:33-40.
Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med 2004;36:588-94.
Kalroozi F, Pishgooie A, Taheriyan A, Khayat S, Faraz R. Health promotion behaviors and related factors in nurses in selected military hospitals. Military Care Journal 2016;1:73-80. [Persian].
Downey LV, Zun LS. Assessing adult health literacy in urban healthcare settings. J Natl Med Assoc 2008;100:1304-8.
Dickens C, Lambert BL, Cromwell T, Piano MR. Nurse overestimation of patients' health literacy. J Health Commun 2013;18 Suppl 1:62-9.
Ghanbari SH, Majlesi F, Ghaffari M, Mahmoudi M. Evaluation of health literacy of pregnant women in health centers of Shahid Beheshti University of Medical Sciences. Med J 2011;19:1-13.
Javadzade SH, Sharifirad GH, Reisi M, Tavassoli E, Rajati F. Health literacy among adults in Isfahan, Iran. J Health Syst Res 2013;9:540-9.
Hospital Administration Research Center, Sari Branch, Islamic Azad University, Sari
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4]