Health Literacy Knowledge Level of Chinese Registered Nurses and Associated Practices: A Cross-sectional Survey

Abstract BackgroundHealth literacy is recognized as a social determinant of health based on its impact on health outcomes. Nurses play a vital role in the promotion of health literacy, health literacy practices enable nurses to offer understandable health information to all people and contribute to health equity. The aims of this study were to investigate health literacy knowledge level and associated practices among Chinese registered nurses and identify related factors.MethodsA cross-sectional study design was used. The Chinese version of the Health Literacy Knowledge and Experience Survey was adapted among registered nurses (N=768) from six hospitals in Zhejiang Province of China. Descriptive statistics, one-way analysis of variance and multiple linear regression were used to analyze the data of demographic characteristics, knowledge and associated practices.ResultsThe health literacy knowledge level of 768 nurses was 12.78±3.54, of the five content areas, basic facts about health literacy had the lowest correct answer rate 43.2%. Educational background (P=0.000), position (P=0.010), professional title (P=0.030), department (P=0.009), and whether they had heard about health literacy (P=0.022) were significantly correlated with health literacy knowledge level. The multiple linear regression analysis found that educational background and whether they had heard about health literacy were positively associated with health literacy knowledge level. In the aspect of health literacy education practice, using written materials to provide healthcare information (P=0.000), using computer software to provide healthcare information (P=0.003) and using teach-back to examine the effect of health education (P=0.000) were positively correlated with health literacy knowledge level.ConclusionThis study indicated that registered nurses in Zhejiang Province of China had low health literacy knowledge level and applied health literacy-associated practices inadequately. It is urgent to improve the knowledge level of nurses' health literacy. Educational background, position, professional title, department, and whether they had heard about health literacy were significantly correlated with health literacy knowledge level. In the continuous training, it is very important to design corresponding health literacy courses according to different departments and different levels of nurses.