Knowledge sharing to support long term condition self-management - patient and healthcare professional perspectives

Background: Increased self management is a suggested solution to the burden on healthcare services of long term conditions (LTCs). This requires effective sharing of knowledge between healthcare professionals and patients, and is an underexplored area. Objective: To understand how patients and healthcare professionals (HCPs) share and utilise knowledge in the social context of healthcare interactions within long term condition management. Methods: Thematic analysis of 93 hours of observations of healthcare interactions and 33 semi-structured interviews involving patients, carers and HCPs. Results: 3 themes were identified: normative social roles, differing professional roles and the value of knowledge. Knowledge sharing was a complex process heavily influenced by social and cultural norms within the healthcare context. Not all knowledge was easily shared within routine healthcare interactions. Discussion: The social context in which healthcare is practiced influences what knowledge is shared and how this is achieved. It favours sharing of clinical knowledge from HCPs to patients, and disadvantages patients in their ability to share their unique knowledge based on lived experience of illness. The opportunities for patients to be supported in their knowledge, skills and confidence within routine healthcare interactions is limited. Conclusion: Both patients and HCPs need support to recognise the characteristics of the social context of healthcare and their understandings of their roles within this in order for them to move beyond accepted behaviours to develop more effective partnership working. Patient or Public Contribution-patients were involved in initial design of the study, particularly ethics of ethnographic observation

Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association

Health literacy is the degree to which individuals are able to access and process basic health information and services and thereby participate in health-related decisions. Limited health literacy is highly prevalent in the United States and is strongly associated with patient morbidity, mortality, healthcare use, and costs. The objectives of this American Heart Association scientific statement are (1) to summarize the relevance of health literacy to cardiovascular health; (2) to present the adverse associations of health literacy with cardiovascular risk factors, conditions, and treatments; (3) to suggest strategies that address barriers imposed by limited health literacy on the management and prevention of cardiovascular disease; (4) to demonstrate the contributions of health literacy to health disparities, given its association with social determinants of health; and (5) to propose future directions for how health literacy can be integrated into the American Heart Association's mandate to advance cardiovascular treatment and research, thereby improving patient care and public health. Inadequate health literacy is a barrier to the American Heart Association meeting its 2020 Impact Goals, and this statement articulates the rationale to anticipate and address the adverse cardiovascular effects associated with health literacy