Understanding health literacy through the lens of Phronesis #ecil2018

Venkata Ratnadeep Suri from the Indraprastha institute of Information technology in Delhi. He reported on a study to understand health literacy in respect of coronary artery disease which is a major disease in Singapore, the context of the study. The goal of health information is to make informed choices about health and increase their quality of life, which begs the question how do we define health literacy to achieve this goal. Often health information literacy uses self-reported measures to gauge health literacy, but does this mean that the individual can make the right changes to their lives? People can have information that they understand poorly, and lack the competency to apply correctly, which is more common in chronic disease patients. The training that health professionals receive is different from the expertise that patients develop in their particular condition. Chronic disease patients are often very effective mentors for other patients due to the knowledge and expertise they have developed. From a research point of view it suggests that current conceptions of health literacy are limited and need further interrogation.

The study aimed to explore patients perspective on health literacy, and identify skills that patients perceive as important for managing their health, with a focus on experiential knowledge. Phronesis is defined as “practical wisdom” derived from experience of making health decisions. Purposive sampling was used to recruit participants from Singapore Heart Centre. 36 participants took part in focus groups and a grounded theory approach was used. The results revealed the importance of being proactive vs reactive, and understanding the body to interpret health. Participants identified that they needed to understand their own limits, and to know when to seek help from a medical practitioner. They understood that health information could be biased, particularly diet information which is very cultural. Understanding complex interdependencies between different pieces of information is critical for managing health. The experiential knowledge gained through understanding a patients journey of managing their health provide insights into health information literacy.