Journal of Community Medicine & Health Education
Open Access

Abstract

Low literacy can be described as the inability to read, write and use numbers effectively. In South Africa, one in six people are functionally illiterate. The REALM-R is a literacy assessment tool that is designed for use in PHC facilities to identify patients with low literacy. In South Africa there is no validated instrument to assess the health literacy of patients. The impact of low literacy of patients in PHC facilities is that patients may have difficulty in understanding health care instructions as well as making appropriate health care decisions. Most health care professionals are not aware of their patients� low literacy levels. The purpose of the study was to create a quick and reliable literacy assessment instrument that can be used by health care workers in the PHC facilities to determine the literacy level of patients attending PHC facilities. The designs used in the study was exploratory, descriptive, contextual, crosssectional, correlational, mixed method and quantitative survey designs. All the designs used were non-experimental in nature and the approach to the research was mainly quantitative. The target population was patients attending Primary Health Care facilities and health care workers. Sampling was done by convenient sampling and the sample size was 200 patients attending the five selected PHC facilities, 400 patients attending one PHC facility and 7 health care workers. The data gathering was done by self-report questionnaires and the data collection instruments included the three REALM-R (SA) instruments, the LAB and a questionnaire to the health care workers. A cut-off point for the REALM-R (SA) was established as 7 out of 8. Majority of the patients scored 7-8 out of 8 for the three REALM-R (SA) instruments. Majority of the patients scored 21-40 out of 50 for the LAB. The mean difference between the average self-declared school grade and the actual school grade according to the LAB was 3.35 grades. The REALM-R (SA) 2 was chosen for final validation as it correlated best with the results of the LAB with a Spearman�s rho score of 0.4. 65.75% of the participants score 7-8 out of 8 for the REALM-R (SA). The health care workers found that the REALM-R (SA) as a quick, user friendly tool that can be administered in 2-3 minutes in a busy clinical setting. Health promotion through health education is an imperative. Health education given at the patient�s level of understanding can facilitate the patient�s participation in service delivery.

Biography

Zelda Janse van Rensburg has completed her Master’s Degree in Nursing from Tshwane University of Technology and is currentlly completing her Doctorate in Nursing from the same University. She is currently working as a Lecturer at Tshwane University of Technology.

Email: zeldawass@yahoo.co.uk