The Association of Health Literacy and Health Information Seeking Behaviors with Adherence to Discharge Instructions

Health communication has become a pivotal health related issue as patients are expected to actively engage in the management of their health. Although medical personnel have traditionally been primary sources of health information, the rapid expansion of internet use has provided additional sources of health information for the public. Patients' health information seeking skills and patterns may play a significant role in health self-management. Effective participation in health self-management requires adequate health literacy, or the ability for patients to obtain, understand, communicate about and apply health information.;A growing number of patients access emergency departments (ED) or urgent care (UC) clinics for evaluation and treatment of non-emergent ailments. The nature of the ED/UC encounter requires clinicians to rapidly assess, diagnose, treat and educate their patients without prolonged time for patient teaching or a mechanism for follow-up. Adherence to treatment modalities and advice provided in the ED or UC setting is thought to be necessary to achieve successful resolution of health problems and avoid complications. However, research suggests that many patients do not comply with discharge instructions following an emergency department visit.;Guided by Cox's Interaction Model of Client Health Behavior, the purpose of this study was to investigate the association of client singularity, specifically health literacy and health information seeking behaviors, with the health outcome of adherence to discharge instructions among adults receiving care in an urgent care clinic. Using a descriptive design, 215 adults completed health literacy, information seeking, and demographic questionnaires upon presentation to urgent care, with adherence and repeated information seeking measured 10-14 days after discharge. Results from parametric and nonparametric analyses indicate patients speak with family and friends about their symptoms surrounding episodic illness with greater frequency than medical professionals, the Internet or written materials. This information seeking mechanism was significantly associated (p=.005) with adherence to discharge instructions. Although limited health literacy risk was high (43%) and consistent with other ED studies, it was not associated to adherence. The role of family and friends upon discharge instruction adherence from urgent care settings suggest health communication and discharge teaching implications in this practice setting.