The Agreement between Patients' and Healthcare Professionals' Assessment of Patients' Health Literacy-A Systematic Review

Int J Environ Res Public Health. 2020 Mar 31;17(7):2372. doi: 10.3390/ijerph17072372.


Healthcare professionals (HCPs) can play a key role in promoting health literacy (HL) in patients to help them navigate the healthcare system effectively. This involves assisting patients to locate, comprehend and evaluate health information. HCPs should assess patients' health literacy needs and check the patient´s understanding to communicate adequate health information. This review investigates the agreement between the patients' and HCPs assessment of patients' HL. A systematic literature search in PubMed, Scopus, PsycINFO, CINAHL and the Cochrane Library was performed in November 2019. The search yielded 6762 citations, seven studies met the inclusion criteria. The following HL measurement instruments were completed by the patients in the included studies: REALM (n = 2), REALM-R (n = 1), S-TOFHLA (n = 1), NVS (n = 1), SILS (n = 1), HLSI-SF (n = 1) and HLS-EU-Q16 (n = 1). The HCPs assessed patients' HL by answering questions that reflect the content of standardized tools. Six studies reported that a high proportion of patients assigned to have HL needs based on their self-report were overestimated by their HCPs in terms of the HL level. The results demonstrated that HCPs had difficulty determining patients' HL adequately. Differences between the HL estimation of HCPs and the actual HL skills of patients might lead to communication problems.

Keywords: HCP; HL; HL needs; estimation; measurement; patient-provider relationship; physicians.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Comprehension
  • Cross-Sectional Studies
  • Health Literacy*
  • Health Personnel*
  • Humans
  • Prospective Studies
  • Self Concept*