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Health SA Gesondheid (Online)

On-line version ISSN 2071-9736
Print version ISSN 1025-9848

Health SA Gesondheid (Online) vol.15 n.1 Cape Town  2010




Assessment of the English literacy level of patients in primary health care services in Tshwane, Gauteng province: Part 2



Zelda Wasserman; Todd M. Maja; Susanna C.D. Wright

Adelaide Tambo School of Nursing Science, Tshwane University of Technology, South Africa





Low literacy can be described as the inability to read, write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes. The aim of this study was to assess the English literacy levels of primary health care patients using the Learning Ability Battery (LAB) and the adapted Rapid Estimate of Adult Literacy, Revised (REALM-R) and to determine how the results of the adapted REALM-R correlate with those of the LAB. Data were collected by means of a self-report whereby the participants had to answer the questions that were posed in the LAB and read the words out loud for the adapted REALM-R. The data analysis was performed by means of descriptive and inferential statistics, including the chi-square test and Spearman's rho. The result of the study indicated that in South Africa, school grades achieved and the reading levels of primary health care patients differ with four grades. In terms of the correlation between the results of the adapted REALM-R and those of the LAB, a correlation of r = 0.43 (p < 0.001) could be established. Depending on the cut-off point used for the adapted REALM-R, 67% of the participants had low literacy levels. The study provides evidence of the importance of a validated, quick and easy-to-administer literacy screening tool. The effective assessment of patients' literacy levels will assist registered professional nurses to provide health education on an appropriate level to improve patients' health literacy.

Keywords: English literacy levels; learning ability battery; literacy; primary health care; REALM-R


Lae geletterdheidsvlakke kan beskryf word as 'n persoon se onvermoë om doeltreffend te lees, te skryf of syfers te gebruik. Die beperkte vermoë om te lees en gesondheidsorgvoorskrifte te verstaan, gee direk tot swak gesondheidsuitkomste aanleiding. Die doel van hierdie studie was om die Engelse geletterdheidsvlakke van primêregesondheidsorg-pasiënte deur middel van twee instrumente, naamlik die Learning Ability Battery (LAB) en die aangepasde Rapid Estimate of Adult Literacy, Revised (REALM-R) te assesseer. Daar is voorts ook bepaal hoe die resultate van die aangepaste REALM-R met die LAB korreleer. Data is deur self-rapportering ingesamel, waar die deelnemers vrae uit die LAB-instrument moes beantwoord en spesifieke woorde vir die aangepaste REALM-R hardop te lees. Die data is ontleed deur gebruik te maak van beskrywende en inferensiële statistiek, met inbegrip van 'n chikwadraat-toets en Spearman se rho. Die resultate dui daarop dat die skoolgraad bereik en die leesgeletterdheid van die deelnemers in Suid-Afrika met vier grade verskil. Die korrelasie tussen die resultate van die LAB en die aangepaste REALM-R was r = 0.43 (p < 0.001). Na gelang van die afsnypunt wat vir die aangepaste REALM-R gebruik word, dui die resultate daarop dat 67% van die deelnemers lae geletterdheidsvlakke het. Die studie toon die belang van 'n geldige, vinnige instrument vir geletterdheidsifting. Die doeltreffende assessering van pasiënte se geletterdheidsvlakke kan geregistreerde verpleegkundiges help om gesondheidsonderrig op 'n toepaslike vlak aan te bied ten einde pasiënte se gesondheidsgeletterdheid te verbeter.



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Susanna Wright
Adelaide Tambo School of Nursing Science
Private Bag X680
Pretoria 0001
South Africa

Received: 18 June 2009
Accepted: 17 Feb. 2010
Published: 07 Sept. 2010

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