O—Options

Options are provisions of care that a nurse can provide, primarily through successfully created and shared messages. This chapter contends that patient and caregiver health literacy is co-created between providers, systems, and communities. This approach to health literacy moves from an information-based focus on health education with patients to the realization that knowledge does not equate with understanding and, importantly, understanding does not equate with behavior. Cultural and linguistic preferences cannot and should not be essentialized or assumed based on appearance, ethnicity, origin, or other individualized variables. Cultural humility moves beyond cultural competence to recognize each patient and their caregiver(s) as individuals. Communication accommodation theory (CAT) grounds the themes in this chapter and is a useful foundation as nurses consider all patients and families unique in their culture and health literacy needs. CAT includes three categories of accommodation that occur in all communication events. Convergence, the most successful path described in CAT, is characterized by alignment and adaptation in communication and relationship.