Journal of health psychology
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Insights for action in the relatively new field of health literacy have been constrained by the emphasis on the literacy skills of the individuals. Early studies into the relationship between literacy and health outcomes were not appropriately balanced with examinations of individuals' skills and health system demands. ⋯ Early studies in health literacy did not attend to context-the physical and social environment of health-care settings. New initiatives in health literacy must bring attention to the demands and expectations of health systems and to the proficiencies of the various health professionals who prepare documents and information for the public and who interact with communities and patients.
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The concept of health literacy is evolving. The re-emergence of Freireian-inspired health literacy projects moves the conceptualisation of health literacy from merely the ability to apply functional literacy skills in a health-care context to a wider ability to exert control over the determinants of health. ⋯ Based within a small indigenous community in the Philippines, participants were engaged in critical reflection to gain a better understanding of how health is conceptualised within their socio-economic and political environment and its implications for practice, power relations and subjective experiences. The article concludes with the assertion that although developing health literacy skills is important, we must never lose sight of unbalanced power relations and unfair structures that hinder positive social change.
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Editorial
Health literacy: exploring future directions and potential contributions from health psychology.
Health psychology has the potential to contribute meaningfully to our understanding of the concept, processes, and outcomes of health literacy. Three areas for discussion are presented here: (1) health literacy as a multimodal concept; (2) the role of the health-care system, the professional, and tools of the trade; and (3) the relevance of social context, participation, and empowerment. The three levels of health literacy proposed by Nutbeam are mapped onto the four evolving approaches in health psychology proposed by Marks to explore the synergy between these research areas. It is hoped that this Special Section on Health Literacy will generate more discussion and activity among health psychologists into health literacy research and practice.
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This article explores the concept and measurement of health literacy in the context of shared health decision-making. It draws upon a series of qualitative and quantitative studies undertaken in the development and evaluation of a bowel cancer screening decision aid for low literacy populations. The findings indicate that different types of health literacy (functional, interactive and critical) are required in decision-making and present a set of instruments to assess and discriminate between higher level health literacy skills required for engagement in decision-making. It concludes that greater sophistication in both the definition and measurement of health literacy in research is needed.
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We examined the relative impact of baseline anxiety, depression and fear of movement on health related quality of life at 12-month follow-up after a multidisciplinary pain management programme. One hundred and eleven patients who had chronic musculoskeletal pain (mean age 45 years, 65% women) attended during 2003-2005 a multidisciplinary three-phase pain management programme with a total time frame of six to seven months, totalling 19 days. The Beck Anxiety Inventory was used to rate anxiety, the Beck Depression Inventory depression, the Tampa Scale of Kinesiophobia fear of movement. ⋯ Fear of movement did not predict any significant change in the health related quality of life. We concluded that patients with chronic musculoskeletal pain and mild to moderate depression benefit from a multidisciplinary pain management programme in contrast to anxious patients. The findings imply further research with bigger sample sizes, other than HRQoL outcome measures as well as with other groups of patients.