ผู้ช่วยศาสตราจารย์ พันเอกหญิง ดร. นงพิมล นิมิตรอานันท์ ผู้ช่วยศาสตราจารย์ พันเอกหญิง ดร. นงพิมล นิมิตรอานันท์ คณะพยาบาลศาสตร์ มหาวิทยาลัยคริสเตียน 6 กรกฎาคม 2561 รูปถ่ายนี้ โดย ไม่ทราบผู้เขียน ลิขสิทธิ์ของ CC BY-NC

รูปถ่ายนี้ โดย ไม่ทราบผู้เขียน ลิขสิทธิ์ของ CC BY-SA

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วิวัฒนาการแนวคิดความรอบรู้ด้านสุขภาพ ค.ศ.1974 ตีพิมพ์เผยแพร่ครั้งแรก ค.ศ.1992 ค.ศ.1998 ประชุมส่งเสริมสุขภาพโลกครั้งที่ 7 ค.ศ.2016 ประชุมส่งเสริมสุขภาพโลก ครั้งที่ 9 มีการประเมินระดับ ความรอบรู้ในผู้ใหญ่ 5/26/2019

Mainly located in critical settings Mainly found in community settings Promoting HL a key determinant of health !!! Access & utilized of healthcare Interacting with health service providers Caring for one’s own health and the health of others Participating in health debates and decision- making Mainly located in critical settings Mainly found in community settings

Health literacy framework (Baker, 2006)

Domain 1 Individual Capacity Reading Fluency - Prose - Quantitative - Document Prior Knowledge - Vocabulary - Conceptual Knowledge of health and health care

Complexity and difficult of Complexity and difficult of printed massage Health-Related Oral Literacy (Ability to Orally communication about health) Health-Related Print Literacy (Ability to understand written health information) Complexity and difficult of spoken massage

Improve health outcome New Knowledge Positive Attitudes Greater Self-Efficacy Behavior Change Improve health outcome

Health literacy framework (Nutbeam, 2008) Functional HL level Communicative/Interactive Critical 5/26/2019

กองสุขศึกษา กระทรวงสาธารณสุข (Conceptual model of Health Literacy: Nutbeam, 2008)

แผนพัฒนาสุขภาพแห่งชาติ ฉบับที่ 12 (พ.ศ. 2560-2564)

How health literacy applied in Nursing practice ?

Nurses………. (Speros, 2005) …have a professional and ethical obligation to communicate in a clear, purposeful way that addresses the unique information needs of each Pts. Evidence – based strategies that promote HL must be incorporated in every Pts’ plan of care and become part of the routine practice of nursing. The goal of all Pts interactions should be to empower the Pts to obtain, understand, and act on information that is needed for optimal health. Nurses use this strategies to assess, communicate with, and evaluate comprehension in Pts with low literacy skills. (Speros, 2005)

Nurses…………(Beauchamp & Sparkes, 2014) Health education is important for those we care for, however, HL is a more comprehensive concept that considers the health knowledge and skills requires for our Pts to engage with our health care system and participate actively in their own health care.

Nurses………. (Speros, 2011) ..plays a critical role in facilitating the communication processes that are associated with promoting HL. Assessing individual motivators, identifying barriers to comprehension, communicating clearly, making health information readable and accessible, adapting the massage to the cultural and linguistic needs of the patient, promoting health decision – making, …… ……and evaluating comprehension are basic HL promotion strategies that nurses must use to facilitate Pts understanding and empowerment.

Indications for nursing practice Every RN needs to identify Pts with limited HL for health education to be effective in assessing Pts to self – manage their disease process. The strong recommendation * Improving communication between health care providers “RN” & their Pts. Collaboration between health care providers and Pts as they make health care decisions. The conclusion – HL should be a routine assessment so that education can be provided based on that assessment (Mancuso, 2008)

Pts’ self – management skills will improve Simple communication and confirming comprehension will help Pts with limited literacy. Pts’ self – management skills will improve Pts may learn that their providers really care about the specific tasks, which may promote adherence.

Issues – Pts are trained to say that… Issues – Pts are trained to say that….. they understand everything clearly. Issues – Clinician frequently fail to evaluate comprehension adequately and rarely take the time to teach their Pts until they can confirm that critical self – management skills are understood. Issues – Pts with limited literacy often conceal their lack of understanding to avoid shame.

Health Literacy – Environment – “Shame” People with limited health literacy often report feeling a sense of shame about their skill level. Individuals with poor literacy skills are often uncomfortable about being unable to read well, and they develop strategies to compensate.

Communication/Verbal skill Cognitive skills Social skills Communication/Verbal skill Reading skill Writing skill 5/26/2019

Calculation/Numeracy skill Shame free zone Ask me 3 Teach back Medical term Calculation/Numeracy skill HL rapid screening 5/26/2019