Does health literacy in respiratory patients impact on their rating of important topics for education in pulmonary rehabilitation?, Nicola Roberts, UK

Background: Pulmonary rehabilitation (PR) should incorporate education that is adapted to patient preferences to ensure patients are to engage fully with the intervention. Methods: An online survey was disseminated via social media and respiratory charities/organisations to elicit the views of respiratory patients about the educational component in pulmonary rehabilitation (PR). Results: Survey responses (N=93) were analysed descriptively; respondents had a mean age of 70 years (13.6), were predominately female (55%, 51/93), ex-smokers (67%, 62/93), retired (79.6%, 74/92) with a mMRC score of ≥2 (66%, 61/93). Participants were asked to rate a list of educational topics in terms of importance for them. More than three quarters of the participants rated knowing about the warning signs of a flare up (83.9% 78/81), understanding how their lungs worked (82.8%, 77/81), and the breathing tests that might help their diagnosis and management (82.8%, 77/81) as very important or important to them. Sub group analysis examined participant characteristics, school leaving age was used as a proxy for health literacy (HL). Those with low HL were more likely to want guidance on; how to manage interactions with healthcare staff (91.7% (33/36) compared to those with higher health literacy (73.3%, 33/45) p=0.035), changes in family relationships (69.4% (25/36) vs 42.2% 19/45, p=0.015) and setting goals (91.7% (33/36) versus 73.3% (33/45) p=0.035). Those with low health literacy skills were more likely to want longer educational sessions (45 mins or longer) compared to those with higher health literacy skills (p=0.05)Conclusions: It is important to tailor individual education sessions to the needs of participants, it is not always apparent who may have low health literacy skills but their learning needs may be significantly different to others.