Review Article

The Role of Clinical Literacy for Public Well-being

Dr. Anusha Kanagala1, Dr. P. Krishna Priya2
1,2
Asst. Professor, Asst. Professor,Dept. of Business Administration, KoneruLakshmaiah Education Foundation,
Guntur, India – 522 502
Received: 26.12.18, Revised: 26.01.19, Accepted: 26.02.19

ABSTRACT
Literacy is different from illiteracy; where both are quite different from clinical literacy that is what the research
would like to focus with the help of the present study. Clinical literacy is the state of a literacy, where one can
understand or have knowledge on their disease or any others’ diseases/disorders and their control. Clinical literacy
management is to create awareness among people on patients diseases/disorders and treatment. The present study
conducted on patients of urban and rural area hospitals on the basis of literacy levels. Knowledge on clinical
terminology, Must haves’on clinical literacyare tested. The researcher constructed a scale based on knowledge, clinical
understandingand their association with medical and para-medical staff on clinical literacy.

Key words: Health literacy, Clinical literacy, Wellbeing.

INTRODUCTION
Health Literacy is the term denoting to understand,
read, obtain and use healthcare information to make
appropriate health decisions. The rise in healthcare
expenditures is posing a great threat to the country’s’
economic stability. Accessibility to quality healthcare
and information is a difficult task which the
Government of India has to take care of. Patients are
often confronted with complex decisions related to
accessibility of healthcare services, dosage
calculations, analysis of risks and benefits,
communication with healthcare providers and
interpretation of test results. Being health literacy a
wider term the need for the term clinical literacy has
evolved which narrows the scope. Clinical literacy is
the term coinedthe state of a literacy, where one can
understand or provide knowledge on their disease or
any others’diseases/disorders and their control.
Clinical literacy management is to create awareness
amongpatient’s diseases or disorders and their
treatment. In the present study the researcher focused
the awareness of clinical literacy on urban and rural
patients.Clinical literacy includes knowledge on
diseases, disorders, first aid, diagnosis, medication,
drug dosages, its reactions, medical terminology,
and dietary precautions etc.

Figure: Clinical literacy for well being

outcomes for improvement among the Individuals.

Review Of Literature
According to Geboers B (2018), a need for
intervention to improve the health literacy (HL) is a
major challenge. An intervention model is
conceptualized considering the health literacy
Shivangini singh(2018) conducted a research on
diabetics patients health literacy to find about their
understanding of prescription instructions. It was
found that the patients understanding of the
prescription instructions is very low even though they

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are highly literates.Fabbri M(2017), concluded that
from clinical evaluation, risk of hospitalization and
death increased among patients. Ratnakar(2013),
from the research found that health literacy skills of
the patients should not be taken for granted. Hence
necessary attention must be paid in briefing and
educating patients related to healthcare documents.
Chandana Joshi(2014) compared primary care
patients those who are with and without enough
health literacy in terms of various lifestyle risk factors.
It is observed that General Physicians are advising
the patients having no health literacy regarding
lifestyle modifications.Sun X(2013),defined Health
literacy as the degree to which individuals have the
capacity to obtain, process, and understand the basic
health information and services needed to make
appropriate health decisions.
Research Gap
Due to increased patient rush in hospitals,it is need
of the hour to know what is happening around us.
Keeping in view the importance of clinical awareness
Government should take necessary improvements in
imparting clinical education among general public.
There are number of studies in healthcare and
hospital management, but very limited research is
available in clinical literacy. At this outset this paper
on clinical literacy made an attempt to find out the
need and importance of preventive care towards
public.
Research Objective
To examine the relationship between clinical literacy
among patients and medical practioners and also to
suggest appropriate ways to improve clinical literacy
levels in public.
Research Methodology
The researcher constructed a sample frame of 2000
patients in 10 days, based on average visitors.
Sample unit is one urban and one rural hospital near
Vijayawada area in A.P. Out of which 20% i.e., 200
respondents were selected as a sample on random
basis. 10 respondents were chosen every day from
both the rural and urban areas. A sum total of 200
respondents were chosen for the study and a
structured questionnaire was distributed among
them.
Findings And Discussion
The respondents of the study were patients of
different occupation, qualifications and income. Their
distributions is shown in the tables

Table:1 Occupation wise classification among patients

Occupation URBAN RURAL
Farmers 15 44
Employees 45 27
Self employed 40 29

Table:2 Qualification wise classification of a patient

Qualification of a patient URBAN RURAL
Upto SSC 20 40
Upto UG 37 27
Upto PG 33 23
Above PG 10 10

Table:3. Income level of patients

Income levels URBAN RURAL
Less than 100000 15 6
100000-200000 15 18
200000-500000 30 63
above 500000 40 13

Table:4 Reliability Statistics

Cronbach's Alpha N of Items
.988 14

According to Lee Cronbach,1951, as the value is >0.9 the internal consistency or reliability of the scale is
excellent from the above table.

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Regression that there exists a strong relationship between clinical

Multiple regression analysis of clinical association on
clinical awareness and clinical knowledge of
patients.
Dependent variable = Clinical association (y)
Independent variable = a) clinical awareness (x 1)
b) Clinical knowledge (x2)
Multiple R value = 0.911
R square value = 0.829
Adjusted R square value = 0.828
F value = 478.440
P value = <0.001**
Multiple R value shows how strong is the linear
relationship and from the result it shows that 0.911
(91.1%) strong is the linear relationship. It means
association, clinical awareness and clinical
knowledge. R square value is the ratio of explained
variation to total variation and from the result there is
0.829 (82.9%) of total variation in the dependent
variable can be explained by the independent
variable. It means that there is 82.9% variation in
clinical awareness can be explained by the total
clinical knowledge and clinical association of
patients. Adjusted R square value predicts the
reliability of the regression equation and from the
result it shows that 0.828 (82.8%) reliability is present
in the regression equation. The high adjusted R
square shows that the model is doing well in
predicting profit.

Table 5
Unstandardized Standard
Variables SE of B T value p value
coefficient (B) coefficient (beta)
Constant 0.673 0.106 - 6.371 <0.001**
x1 -0.284 0.140 -0.245 -2.035 0.043
x2 1.128 0.118 1.146 9.532 <0.001**

** Denotes significant at 1% level.

From table 8 the multiple regression equation is
y = 0.673 – 0.284x1 + 1.128x2
Clinical association = 0.673 – 0.284 x Clinical knowledge + 1.128 x Clinical Awareness.
From the above equation it is found that if there is an increase in clinical knowledge there will be a decrease
in clinical association and if there is an increase in clinical awareness then clinical association will be
increased.

Recommendations Researchers could consider other regions for further

1. It is suggested that Clinical literacy practices are
necessary for everyone irrespective of the literacy
levels.
2. It is suggested that governing bodies, and
educational institutions take mandatory steps to
create minimum awareness on Clinical literacy
among public.
3. It is also suggested that all clinical related
members, like doctors, nurses, pharmacists,
counselors, Radiologists have to help the patients, as
well as general public to improve Clinical literacy
awareness.
Conclusion
Heath Literacy is the widely known broader concept
where clinical literacy is a narrow concept covering
diseases/disorder and their control. The present study
explains that though the patient is highly literate
he/she is finally dependent upon the medical and
para medical practioners for their preventive or
curative care. But, the frequency of the contact with
the practioners certainly provides all the relevant
Information needed for his/her treatment.
Limitations And Scope For Further Research
The study is related to Vijayawada region. This might
somewhat limit the generalizability of the findings.
research. It isimportant to understand clinical literacy
management to improve clinical literacy levels
among public.
References
1. AHRQ (Agency for Healthcare Research and
Quality) Health Literacy Interventions and
Outcomes: An Updated Systematic Review. Agency
for Healthcare Research and Quality http://www
.ahrq.gov/clinic/epcsums/litupsum.htm.
2. Baker, D.W. The meaning and the measure of health
literacy. J Gen Intern Med. 2006; 21: 878–883.
3. Chandni Joshi, “Does health literacy affect patients’
receipt of preventative primary care? A multilevel
analysis”, BioMed Central Ltd., October 2014
4. Connie Schardt Health information literacy meets
evidence-based practiceJ Med Libr Assoc. 2011 Jan;
99(1): 1–2
5. Dewalt, D.A., Berkman, N.D., Sheridan, S., Lohr,
K.N., and Pignone, M.P. Literacy and health
outcomes: a systematic review of the literature. and
health outcomes: a systematic review of the
literature. J Gen Intern Med. 2004; 19: 1228-1239
6. Geboers, B., Reijneveld, S.A., Koot, J.A.R., and de
Winter, A.F. Moving towards a comprehensive
approach for health literacy interventions: the
development of a health literacy intervention
model.Int J Environ Res Public Health. 2018; 15: E1268

449| International Journal of Pharmaceutical Research |January- March 2019 | Vol 11 | Issue 1
 Anusha et al / The Role of Clinical Literacy for Public Well-being
7. Kutner, M., Greenberg, E., Jin, Y., and Paulsen,
C. The Health Literacy of America's Adults: Results
From the 2003 National Assessment of Adult
Literacy. National Center for Education Statistics,
US Department of Education, Washington,
DC; 2006
8. Nielsen-Bohlman L, Panzer AM, Kindig DA Health
Literacy: A Prescription to End Confusion.
Washington (DC): National Academies Press (US);
2004
9. Pandit, A.U., Tang, J.W., Bailey, S.C. et al. Education,
literacy, and health: mediating effects on
hypertension knowledge.
10. Paasche-Orlow, M.K. and Wolf, M.S. The causal
pathways linking health literacy to health
outcomes. Am J Health Behav. 2007; 31: S19–
S26control. Patient EducCouns. 2009; 75: 281-385.
11. Rathnakar U.P, Madhuri Belman, “Evaluation of
Health Literacy Status Among Patients in a Tertiary
Care Hospital in Coastal Karnataka”, India Journal of
Clinical and Diagnostic Research. 2013 Nov, Vol-
7(11): 2551-2554.
450| International Journal of Pharmaceutical Research |January- March 2019 | Vol 11 | Issue 1
12. Shivangini Singh, SahanaDevadasa Acharya, “Health
Literacy Status and Understanding of the
Prescription Instructions in Diabetic Patients”,
Journal of Diabetes ResearchVolume 2018, Article
ID 4517243, 5 pages.
13. Sorensen, K., Pelikan, J.M., Röthlin, F., Ganahl, K.,
Slonska, Z., Doyle, G. et al. HLSEU Consortium.
Health literacy in Europe: comparative results of the
European health
14. literacy survey (HLS-EU). Eur J Public
Health. 2015; 25: 1053-1058
15. Sun, X., Shi, Y., Zeng, Q. et al. Determinants of
health literacy and health behavior regarding
infectious respiratory diseases: a pathway
model. BMC Public Health. 2013; 13: 261
16. Ventura, H.O. and Piña, I.L. Health literacy: an
important clinical tool in heart failure. Mayo Clin
Proc. 2017; 93: 1–3
17. Von Wagner, C., Steptoe, A., Wolf, M.S., and
Wardle, J. Health literacy and health actions: a
review and a framework from health
psychology. Health EducBehav. 2009; 36: 860–877