Evaluation of health literacy and appropriateness of the educational materials to the health literacy of the patients who applied to the healthcare centers

This descriptive and cross sectional study has been conducted at Baskent University Ankara Hospital and Prof. Dr Celal Ertug Etimesgut State Hospital?s medical outpatient clinics aiming to determine health literacy of the patients who applied to the healthcare centers and evaluation of the appropriateness of educational materials that have been used in these centers to the health literacy.Study included total of 688 patients who volunteered to interview and were able to communicate verbally; 385 patients from Baskent University Ankara Hospital and 303 patients from Prof. Dr Celal Ertug Etimesgut State Hospital participated.Data was obtained via using questionnaire to evaluate health literacy, General Health Survey, ?Evaluation of the Written Materials Appropriateness? form to evaluate available patient educational materials in healthcare centers, DISCERN (Quality Criteria for Consumer Health Information) tool to determine reliability and information quality of the education materials.Data was collected via face-to-face interview with patients and was analyzed with using One-Way ANOVA, T test and chi-square tests.Mean age of the patients was 46. 21 ±15.76; more than half of them were married (72.2%) and women (67.6%), 44.8 % of them are not working and one in third have less income than expenditure.It was found that 40.2% of the patients evaluated their health literacy level as poor and very poor; 69.5% of them has computer and 52.5% know how to use; one in third of them were always using internet to reach health information; less than half (43%) of patients stated that they always and sometimes (30.7 %) receiving help from others for reading and writing activities. Patients? very often reaching health related information healthcare professionals (93.1%).Majority of patients evaluated their health status as good/very good and excellent; 68.9 % have one disease, 67.7% have at least one experience of hospitalization; majority of them taking medication, having specific diet (44.3 %) and informed by health professionals (86.9%) and given written educational materials. According to General Health Survey (GHS) almost half of them were at moderate and high risk group, referral to the health maintenance activities and performing level were low.In general mean score of patient responses to the activities related health literacy was high. It was determined that patients who are illiterate and only literate, have low income, evaluated their health literacy as poor /very poor and high risk group based on GHS had lower score for health literacy activities than others.In the context of study 35 written educational materials have been examined and of them 7 were found inappropriate in terms of information quality and appropriateness.Based on the results from this study, planning activities to increase self-responsibility about their health, focusing on more images rather than text in written materials, giving special attention for individual who has low education level and elderly during treatment and caring process are proposed. Further research was recommended comparing with the low literacy group and patients who applied to primary health care institutions.