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J Contin Educ Nurs. 1999 Mar-Apr;30(2):56-61.

Low literacy levels in adults: implications for patient education.

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Veterans Affairs Medical Center West Los Angeles, California, USA.



Patients are being discharged with the need for more complex care in the home. Written information frequently is used in health education. Patients and caregivers must be able to read and understand this information.


A comprehensive literature review of articles on literacy and health education materials was performed.


The literature review revealed that low literacy is more prevalent in the United States than is generally recognized. Health education materials often require a reading level higher than the reading level of most patients. There are a number of tools available for assessing reading levels.


Findings indicate there are implications for nursing practice, education, and research. There is a need for nurses to be aware of the prevalence of low literacy. They need to know how to accurately assess reading ability and develop material that is at the appropriate level for patients and caregivers. There is a need for research to investigate possible relationships between health status and low literacy and to examine the effects of remedial reading programs on health practices.

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