Simple health information is key to engaging in self-care

Health literacy and education have become increasingly present expressions when it comes to communications capable of enhancing people's empowerment regarding their well-being and quality of life.

Among the axes ACESA Self-Health Care AwardCommunication and self-knowledge form the basis of one of the categories included, which seeks to identify projects that have the potential to empower Individuals obtain, process and understand essential information to make appropriate health decisions.

Knowledge is also essential for the rational use of non-prescription medicines, which is the name of another category of the award. This category aims to highlight initiatives that not only promote the correct use of non-prescription medicines, but also products and services that facilitate the correct use of medicines that No prescription required. Self-care for the entire journey – such as self-exams, technological self-monitoring devices, as well as nutritional supplements and skin cosmetics.

To better understand these concepts and their importance in engaging residents in self-care, we interviewed Dr. Rogerio Malvera, who has been studying the topic for 11 years. Rogerio is a Family and Community Physician from the State University of Rio de Janeiro (UIRG) and holds a Master's degree in Public Health from the National School of Public Health of the Oswaldo Cruz Foundation (Fiocruz). Malvera is also one of the jury members ACESA Self-Health Care Awardnow in its third edition.

As the creator of Pulsares, a platform that aims to simplify prescription language and instructions, can you explain the importance of communication from the perspective of health decisions and the barriers that make it difficult for the population to understand?

The entire health process takes place through the exchange of information, whether written, spoken, or even through gestures and symbols. Since man is a social being who communicates, and health is an inherent aspect of life, health is communication, and vice versa. There is no health unless there is effective communication, and all health care is communicative. More than that, health involves learning information and applying changes, that is, it is a learning process. Health professionals are knowledge brokers, which is unfortunately not a widely held view. Moreover, the challenge in communication and health lies in four main points:

– The information surplus we live in, where true and false information abounds. In the printed edition of the newspaper, for example, there are the same number of signs that man was exposed to during the Middle Ages. How do you navigate this sea of ​​information?

– Technological and scientific knowledge has developed more than the effective dissemination of this knowledge, creating gaps in understanding between people. For whom is knowledge produced and for what benefit? Quantity trumps quality.

– The hierarchy of power in relationships in the health sector still exists. Shyness is the biggest barrier to communication. How many people feel comfortable saying they didn't understand something to a healthcare professional?

– Care and overwork, as there is no space for professionals to actually pay attention to communication. If there is no space for self-care and reflection, there will be no space for human care to emerge.

What is the best definition of health literacy and the most prominent challenges facing the dissemination and application of this concept?

There are many definitions of this term. I would say that health literacy (HL) is an act and action that relates to the reality that is happening, not just to what I want. What does the person do with what I communicate? What do I understand about what this person brings to me? It's about aligning the people involved in the healthcare process. Based on Sorens's 2012 definition, good health is how people access, evaluate, interpret and apply health information to maintain or improve their quality of life. But this process is not individual. Health institutions (Hospitals, clinics, industries, and any entity that produces health information) Engagement, so much so that there is Organizational Health Literacy: How Organizations Support LS. It is important to note that we are talking about health in an expanded sense, not just treating diseases, but promoting health and quality of life. LS involves any health condition and context. It's not just what I say, but how the other person receives it and what they do with it – does that change any habits? Does it reinforce the situation? It is the understanding that quantity without quality and scrutiny does not change reality, but only reaches indicators. The goal of care involves reaching a shared understanding, not just informing and talking about a topic. It is more than just teaching – from Latin signaretick – is learning.

I think the best definition depends on who is asking. For a manager, for example, it can be argued that considering health literacy reduces costs and generates better health outcomes. For the formal health professional, thinking about LS arguably increases treatment adherence and makes consultation time more effective. For people seeking health care (sick), LS represents independence, empowerment and security. For the professional producing labels, packaging or campaigns, LS increases product engagement.

Within literacy learning there are so-called “literacy” techniques and strategies, that is, they enable literacy learning to be achieved. The challenge is that little is still said about these technologies and the term itself. Until 2017, there were less than 40 studies on this topic in Brazil – although here we have popular health education, related to LS. Talking about LS involves changing culture and habits, and sharing the power of decisions, and therein lies the challenge. How willing are we to change something that has been happening for centuries based on the same logic?

Overall, are healthcare professionals ready for more effective and humane communication?

Not generally, but change is happening. For many years in health schools – especially medicine – the biomedical model has dominated, which is related to the Cartesian model, in which the emphasis is on the biological. This model establishes a relationship with the hypodermic needle communication model, where the professional assumes that the information will penetrate the person, like a needle, and they will absorb it in the same way it was intended. In the 1950s, a crisis occurred in medicine, and the biopsychosocial-spiritual model gained strength, leading to an appreciation of factors neglected by the biomedical model. In this “new” – but in fact old and forgotten – model, the biological aspect forms part of a larger and complex network, not just a unique and dominant network. The communication model now includes other elements and is understood as parties reaching a common understanding. It is a logic similar to the classical Newtonian model and the quantum model. In the field of medicine, those who most represent this vision are family and community medicine, as well as other non-medical professionals. Making communication more effective and human means considering LS and, as mentioned, a change in culture. It takes care, dedication, and choosing to do differently. No matter how much a professional wants, there is the limiting factor of the environment: to what extent do health systems prefer human contact?

How can health education encourage people to take a more active role in improving their quality of life?

To the extent that health care is understood as a process in which a person accesses information, evaluates and understands information, then applies it and creates change or transformation, it is possible to create space for responsibility to emerge. Both from those providing health care or information – by understanding that they have a responsibility to make the information as understandable as possible – and from those receiving care, by taking responsibility on their part, depending on their context, it may be more difficult than it usually is. . The health education process recognizes the duality of change, that is, there is a desire to change and at the same time there is a desire not to change. This process favors independence and creates a space of safety for the person to become vulnerable.

Artificial intelligence and digital platforms have transformed healthcare. What technological advances stand out when it comes to self-care?

In general, among the tools that help navigate the sea of ​​information and deal with barriers to change, the following stand out: platforms that connect people with certain health conditions or people involved in changing their habits; Which explains diseases, medications, and habit change processes in a simpler way; Which facilitates treatment and change; Which regulates health information. There is infinity. There is also innovation in more effective self-care products. It is worth noting that simple changes in processes, such as linguistic adaptation, have the potential to produce significant improvements and impacts. Simple things take time and technique to implement.

What is the role of an award like ACESSA in promoting self-care?

The award promoted by ACESA allows for the dissemination of individual and group self-care strategies, as well as the dissemination of the concept. It also recognizes what has been accomplished and is worth reproducing or expanding. In the era of information surplus, it is necessary to make room for practical initiatives that deal with reality and its challenges.