• Internal Code :
  • Subject Code : NUM1204
  • University : Edith Cowan University
  • Subject Name : Nursing

Table of contents


Importance of health literacy of family carers in physical as well as psychological illnesses

Health literacy and communication

Research gaps





Health literacy is an essential component of nursing care and heavily influences the overall wellbeing of the patient (Yuen et al., 2016). Caregivers play an important role in providing essential support to the elderly. The care needs of the elderly are far different from that of a young person as they require more efforts with decreased physical abilities and aging body. When providing care to the elderly, it is also essential to ensure psychological wellbeing along with the physical care needs of the patients. Low health literacy of the caregiver can significantly impact the health outcomes of the care recipient. The caregivers determine the physical, practical, social, and emotional support to their patients and therefore, the health literacy of these plays an essential role in the overall health and beneficence of the patients (Pascoal et al., 2019).

Provision of care is inclusive of awareness through health literacy, development of responsibility and meeting the care demands of the patient. Family caregivers are the primary source of care for the patient and therefore, they need to have adequate knowledge of the care needs of the patient. When the family provides care for needs of the patients, there is improved communication and the patient needs can be addressed more effectively (Cianfrocca et al., 2018). However, to achieve the desired outcome, the caregiver needs to possess adequate health literacy about the health condition so that proper care can be provided (Wittenberg et al. 2019). In continuation with the last assessment, this literature review will analyze the published literature to explain the importance of health literacy of the family caregivers on the functional health of the elderly.

This study will be conducted with the development of themes that include importance of health literacy of family carers in physical as well as psychological illnesses and health literacy and communication. This literature review also provides an appraisal for the selected researches and identifies their strengths and limitations. Further, research gaps have been identified concerning the existing research information and provide recommendations to improve the health literacy among the family carers working with elderly.

Importance of Health Literacy of Family Carers in Physical as Well as Psychological Illnesses

A detailed study by Mehrotra et al. (2018) assessed the knowledge of the family caregivers about mental health. The study performed a comparative analysis regarding the health literacy of the family caregivers about mental health over the time span of 23 years from 1993 to 2016. The study was assessed and compared based on the knowledge and orientation towards the mental illness scale (OMI) and was compared to the dataset of a study done with similar parameters in 1993. The study asserted that in contrast, there has been an improvement in the overall health literacy in the patients. However, there was an impending gap in the existing knowledge as it was not adequate regarding the mental health conditions of the patients.

This gap affects the overall care received by the patients and impacts their quality of life and overall recovery (Wittenberg et al., 2019). The study was insightful and included a total of 140 participants and with statistical significance drawn using unpaired t-test. However, a major limitation in this analysis was identified was the absence of equal sample size. The study used for contrast regarding the mental health literacy included 80 participants or family caregiver whereas the current study involved only 60 impacting the overall analysis and research quality (Blæsild & Granfeldt, 2018).

Another study was conducted by Jiang et al. (2017) to assess the health literacy of informal or family caregivers with elderly patients with memory loss. The study was done among the informal caregivers associated with the patients for their abilities associated with health literacy and skill models. The study analyzed the caregiver health literacy with 91 individuals associate with the care of the elderly who were suffering from health conditions like dementia and memory loss. The study revealed that health literacy in these individuals was associated with the age and education of the caregivers among other factors.

Lower health literacy rates of the informal caregivers have been associated with medication errors, the study identified that there is a need for personalized support for the informal caregivers that possessed limited health literacy (Cianfrocca et al., 2018). The study was done comprehensively, however, it did not include any measures to limit the biases. The abilities, skills, and knowledge model was used for the assessment of the existing knowledge of health literacy among informal caregivers. The study used the sociodemographic skills of the participants to be constant to enhance the uniformity in the analysis. Bivariate correlation was drawn with age and education among the informal caregivers associated with the care of the elderly patients.

These researches asset the significance of the importance of health literacy among the family care providers associated with the elderly. Health literacy is crucial for both physical as well as psychological assistance for the elderly so that they can get holistic care (Fields et al., 2018).

Health Literacy and Communication

Family caregivers of patients with complex conditions play an essential role in sharing and facilitating information about the disease. This health literacy is also important for understanding the health complications and taking the suitable management strategies to ensure beneficence and safety of the patient. A comprehensive analysis on caregiver health literacy and communication was conducted by Wittenberg et al. (2016). The study included the model of six domains of family caregiver health literacy skills to assess the caregivers' health literacy rates. The six domains of the family caregiver literacy include an understanding of the information, accessing the available information, relationship and communication of the caregiver with the recipient, communication and the relationship with the healthcare providers associated with the patient, communication within the existing support systems, and management of challenges of the caregiving (Yen et al., 2015).

The study asserted that there is an essential need for improving health literacy among family caregivers for the beneficence of the elderly in chronic clinical conditions like cancers. The caregivers also asserted that the material presented in the study is essential and helps in the improvement of care practice by sharing useful details and also eased the process of communication. The study examined the available health literacy sources that are used by the family carers for providing support to the patients and assessed their readability, accessibility, understanding and effectiveness. The participants expressed a major hindrance in the readability and understanding of the technical information available associated with health literacy in chronic conditions like cancer.

Moreover, the major issue that was highlighted in the study was that since the family caregivers focus largely on the psychological well being of the patient, they may avoid crucial discussions about illness and disease trajectory. Even when this study has been performed with adequate resources and effective analysis, the sample size of the study was limited with only 69 participants impacting the overall statistical significance of the study (Blæsild & Granfeldt, 2018). The health literacy of family caregivers is also essential for mental illnesses. Elderly may often develop psychological ailments in association with the primary physical ailment (Yuen et al., 2016).

Another comprehensive study was conducted by Young et al. (2016) to assess the family caregiver communication in the Intensive care unit (ICU) in association with health literacy. 18 family caregivers were questioned about their experiences in the ICU. The narrative of the study was aimed to determine the relationship of health literacy. The paper assesses healthcare literacy and information regarding the conceptual model of caregiver health. The themes of ICU communication like agency, coordinated communication, and the evolving role of caregiver were analyzed. The study revealed that there has been a dependent correlation between rational communication and the health literacy of the caregiver.

The family caregivers have to interact with several healthcare professionals and therefore, effective communication and health literacy play an important role in understanding the care needs of the patients. Low caregiver knowledge and literacy impact the critical care services provided to the patients. This is even more crucial when the patients are elderly and require primary care with the understanding, appraisal, and use of health literacy information for the management of the health condition and patient’s beneficence. Poor health literacy within the family caregivers is associated with medication adherence and health improvement. The health literacy for the care is defined as a rhetorical process that is also associated with self-efficacy and acts as a catalyst that can help in the development of the healthcare advocacy and empowerment in the carers as well as the patients.

The strength of this research is that it has used highly descriptive analysis through semi-structured interviews conducted over six months in the palliative care units. However, the study uses only a limited number of participants in this study impacting the overall statistical significance and generalization of this study. Involvement of a larger study sample would have improved the statistical significance so that the results of this analysis could be applied to a larger population (Blæsild & Granfeldt, 2018).

These researches assert the significance of effective communication of the family caregivers of elderly patients with healthcare professionals. Effective communication is necessary as it helps in the determination of care needs and provides methods to ensure the care of the patients by the application of suitable management strategies and interventions. Since the family carers are the primary source of information for the elderly as well as the healthcare professionals, it is important to have adequate health literacy so that the needs of the patients and the importance of management strategies, medications and interventions are effectively communicated for high quality care of the patient (Fields et al., 2018).

Research Gaps

Only limited research has been conducted where the health literacy of the family carers associated with the elderly has been identified. Therefore, there is a need for extensive primary studies that can help in the determination of the impact of health literacy among different communities and socio-economic structures (Yuen et al., 2016). It is also crucial to identify the impact of health literacy on the health promotion, disease prevention, increased life expectancy of the affected patients so that a targeted approach can be designed to ensure beneficence and promote health (Pascoal et al., 2019).


First, it is important to ensure that the caregivers are provided with adequate literacy regarding the health condition associated with the caregiver. This must be done using suitable mediums like face to face interactions with the healthcare professionals, providing readable material, and providing demonstrations (Pascoal et al., 2019). Secondly, the health information provided to the caregivers must be assessed using feedback and effective health literacy assessment tools to ensure the understanding and importance of health literacy (Cianfrocca et al., 2018). Thirdly, the communication between the family caregiver and the healthcare practitioner must be promoted so that there is no hesitation and the needs of the patient are effectively communicated. Effective communication will also enhance the building of trust and promote wellness through a participatory approach (Wittenberg et al., 2019).


This literature review summarizes the importance of health literacy among the family carers in the care needs of the elderly. The elderly patients require assistance with their physical as well as psychological wellbeing. The research evidence that the health literacy of the family caregivers impacts the overall health and beneficence of the patients along with their medication needs and the care needs of the patients. Therefore, it can be concluded that health literacy is an essential component of care and must be addressed with the highest priority. This review also identifies the existing research gaps and provides suitable recommendations for the improvement of health literacy of the family carers for an overall improvement of the health of the elderly.


Blæsild, P., &Granfeldt, J. (2018). Statistics with applications in biology and geology. USA: CRC Press.

Cianfrocca, C., Caponnetto, V., Donati, D., Lancia, L., Tartaglini, D., & Di Stasio, E. (2018). The effects of a multidisciplinary education course on the burden, health literacy and needs of family caregivers. Applied Nursing Research, 44, 100-106.

Fields, B., Rodakowski, J., James, A. E., & Beach, S. (2018). Caregiver health literacy predicting healthcare communication and system navigation difficulty. Families, Systems, & Health, 36(4), 482.

Jiang, Y., Sereika, S. M., Lingler, J. H., Tamres, L. K., &Erlen, J. A. (2018). Health literacy and its correlates in informal caregivers of adults with memory loss. Geriatric Nursing, 39(3), 285-291.

Mehrotra, K., Nautiyal, S., &Raguram, A. (2018). Mental health literacy in family caregivers: A comparative analysis. Asian Journal of Psychiatry, 31, 58-62.

Pascoal, D., Frazão, I., Galante, R., Figueiredo, M. C., Godinho, C., Spínola, A., & Ferreira, S. (2019). O51 Health literacy in diabetes of family caregivers: A scoping review. European Journal of Public Health, 29(2), 095-025.

Wittenberg, E., Goldsmith, J. V., & Kerr, A. M. (2019). Variation in health literacy among family caregiver communication types. Psycho‐Oncology, 28(11), 2181-2187.

Wittenberg, E., Goldsmith, J., Ferrell, B., & Ragan, S. L. (2017). Promoting improved family caregiver health literacy: zevaluation of caregiver communication resources. Psycho‐oncology, 26(7), 935-942.

Young, A. J., Stephens, E., & Goldsmith, J. V. (2017). Family caregiver communication in the ICU: Toward a relational view of health literacy. Journal of Family Communication, 17(2), 137-152.

Yuen, E. Y. N., Dodson, S., Batterham, R. W., Knight, T., Chirgwin, J., & Livingston, P. M. (2016). Development of a conceptual model of cancer caregiver health literacy. European Journal of Cancer Care, 25(2), 294-306.

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