The Perspectives on Barriers and Facilitators in Communication by the Healthcare Professionals and Older Healthcare Users: The Role of Health Literacy

Abstract

Introduction: Older people are the basic users of health services. However, studies have shown that they have relatively low health literacy (HL) levels which results in many negative health outcomes. HL is a major challenge in public healthcare systems and an important determinant of optimised health outcomes and better quality of life for older people. On the other hand, professionals lack knowledge and skills to identify older people’s HL level and therefore, the delivery of care may be insufficient. The study aimed to report the perspectives on the barriers and facilitators in communication during the medical encounter by both the healthcare professionals and older healthcare users. Method: A qualitative study design was applied. One group with seven healthcare professionals and another one with five people over 60 years old discussed about HL knowledge and their experiences (attitudes and behaviors, barriers, and facilitators) of the healthcare professional -patient interaction. The focus groups took place virtually and were coordinated by the senior author. The discussions were analysed using the content analysis method. Results: Communication facilitators during the healthcare professional-patient interaction as reported by the healthcare professionals included: the need to trust and collaborate with the older people, patients’ specific characteristics (high level of education, psychological resilience and good judgmental), carers’ participation, the use of clear language and a person-centred approach. Communication barriers were considered the older people’s rigid beliefs about their lifestyle, the age-related cognitive, psychological, and sensory deficits, the function, and the structure of the healthcare system (e.g., professionals’ excessive workload). On the other hand, older people mentioned the importance of being prepared to ask questions during the medical encounter, being respected and included in the decision-making process. Conclusion: Easy-to-use Health Literacy training tools adapted to healthcare professionals’ everyday needs are considered necessary to improve the professionals-patients interaction, enhance their communication skills and promote the person-centred care within the framework of the Greek National Healthcare System. The integration of the tools as part of the training courses could prepare healthcare professionals with the enhanced the HL skills needed to improve the quality of care they provide and reduce the cost of care in general.