Informal Caregivers' Health Literacy and Nursing Practices Perceived as Supportive of Health Literacy in Primary Care: A Sequential Mixed-Methods Study.

BACKGROUND/

OBJECTIVES

Informal caregivers support home care while having health, information and self-care needs. This study assessed general and domain-specific health literacy among informal caregivers registered with a Portuguese Family Health Unit and explored, with QUAL interpretive priority for the nursing-practice objective, perceptions of nursing practices supportive of health literacy.

METHODS

A sequential mixed-methods design (quan → QUAL) was used. The quantitative phase included 30 informal caregivers who completed a sociodemographic questionnaire and the Portuguese European Health Literacy Survey (HLS-EU-PT). The QUAL phase included five informal caregivers selected from the highest recorded caregiving-intensity category and interviewed at home. Quantitative data were analysed descriptively; 95% confidence intervals were calculated for principal means and proportions. Qualitative data were analysed using Bardin's content analysis. Integration occurred through connection and aggregate interpretation; individual HLS-EU-PT scores were not linked to interviews.

RESULTS

Informal caregivers were mostly women (83.3%), older than 55 years (80.0%) and cohabiting with the dependent person (83.3%). The mean general HLS-EU-PT score was 26.64 ± 8.40 (95% CI 23.50-29.78); 22/30 informal caregivers had limited health literacy (73.3%; 95% CI 55.6-85.8). Health promotion was the lowest-scoring domain (25.34 ± 8.31; 95% CI 22.24-28.44), with 28/30 informal caregivers showing limited health literacy (93.3%; 95% CI 78.7-98.2). QUAL findings highlighted personalised information, checking understanding, caregiver experience, decision support and resource guidance.

CONCLUSIONS

Limited health literacy was frequent. The QUAL phase deepened understanding of perceived nursing support, but findings indicate perceived needs rather than effects.