**2. What is general literacy, health literacy, and literacy related to medication instructions?**

**General literacy** refers to the basic ability to read, write, and figuring things out without considering the background in which reading, and writing occurs [2]. **Health literacy** on the other hand refers to the "degree to which individuals have the capacity to obtain, process, and understand basic health information and services necessary to make proper health decisions" [3]. Although general literacy has an impact on health literacy, being generally literate does not necessarily mean one will understand the health language. However, [4] asserts that the degree of health illiteracy related to medication instructions was linked to low education level. **Medication instructions** refers to the detailed information on how medication should be taken [5]. These instructions are normally found on the medication packages, bottles, inserts etc.

#### **2.1 Types of health literacy**

Health literacy is the junction between general literacy, health, and health care, but also incorporate attributes of the other types of literacies to varying degrees [6]. The concept of health literacy stemmed from the concern that individuals need more than just having general literacy skills to be able to manage the complexities of health and health system issues. There is a considerable intersection between general literacy and health literacy. Nonetheless, there are strong health-specific demands involved in health literacy that differs from those in general literacy [6]. Therefore, having general literacy alone is not adequate if one has to live a healthy life and to be able to prevent, manage, and control diseases and illnesses.

Therefore, health literacy is divided into three levels namely; basic health literacy, communicative health literacy, and critical health literacy [3].

### *2.1.1 Basic/functional health literacy*

Functional health literacy is characterised by adequate fundamental skills in reading and writing to enable an individual to function efficiently in everyday situations. Therefore, functional health literacy is important to access services and information required to support individual's health, such as reading information about medication on medication labels [3]. Inadequate health literacy can result in difficulty following instructions from a doctor, and taking prescribed medication incorrectly, nonetheless, medical information is well

**273**

**Table 1.**

*Health literacy framework.*

*The Importance of Health Literacy Related to Medications Instructions to Promote Adherence…*

understood when provided slowly, with the use of simple words and avoiding

Interactive health literacy refers to more advanced, cognitive, and literacy skills which, together with social skills, that could be employed to actively participate in everyday activities. These skills are used to excerpt information and derive meaning from different forms of communication, and to apply new information to changing circumstances [3]. The interactive health literacy approach improves individuals' capability to act autonomously on knowledge. So, patients with inadequate health literacy are less likely to understand and take part in disease prevention and health promotion programs [7]. These patients are likely to be hospitalised more often

Patients who reported having confidence in the ability to take medications confirmed a lack of comprehension in understanding medication instructions [8]. Patients further indicated numerous obstacles to effective medication management embedded in poor communication. Hence, patients expressed favouritism for more clearer medication instructions which could address some of the challenges

Critical health literacy includes advanced cognitive skills, which together with social skills can be applied to critically analyse information and to use that information to exercise greater control over life events and situations. Therefore, health literacy moves beyond communication to the development of skills necessary to

From these types of health literacy descriptions, [9] came up with a framework

The ability to recognise the formation of physical activity patterns in daily life.

The ability to put to practice the comprehension of how physical activity patterns are made, and to employ, and exercise a lively everyday lifestyle within

The capability to relate judgementally to physical activity recommendations, to comprehend the effect of social determinants on physical activity ranks, and to draw on these capabilities to bring change to the prevailing conditions in enhancing the acceptable everyday lifestyle for self and others.

the prevailing. Conditions.

**Types of health literacy Nutbeam's (2000) definitions Categories of analysis**

An individual capability to seek and comprehend health

An individual capability to put health information into practice to achieve good health outcomes in various daily

evaluate health information and utilise information to achieve maximum control, including addressing structural determinants of health including empowerment skills; capabilities to act to bring change in conditions for ones'

health and others.

information.

practices.

3.Critical health literacy Possessing skills to critically

*DOI: http://dx.doi.org/10.5772/intechopen.95902*

*2.1.2 Communicative/interactive health literacy*

than those with adequate health literacy.

effect social change to support health [3].

for health literacy (**Table 1**) as follows:

they face.

*2.1.3 Critical health literacy*

1.Functional health literacy

2.Interactive health literacy

more information at a time [7].

*The Importance of Health Literacy Related to Medications Instructions to Promote Adherence… DOI: http://dx.doi.org/10.5772/intechopen.95902*

understood when provided slowly, with the use of simple words and avoiding more information at a time [7].

## *2.1.2 Communicative/interactive health literacy*

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

**2. What is general literacy, health literacy, and literacy related to** 

**General literacy** refers to the basic ability to read, write, and figuring things out without considering the background in which reading, and writing occurs [2]. **Health literacy** on the other hand refers to the "degree to which individuals have the capacity to obtain, process, and understand basic health information and services necessary to make proper health decisions" [3]. Although general literacy has an impact on health literacy, being generally literate does not necessarily mean one will understand the health language. However, [4] asserts that the degree of health illiteracy related to medication instructions was linked to low education level. **Medication instructions** refers to the detailed information on how medication should be taken [5]. These instructions are normally found on the medication

Health literacy is the junction between general literacy, health, and health care, but also incorporate attributes of the other types of literacies to varying degrees [6]. The concept of health literacy stemmed from the concern that individuals need more than just having general literacy skills to be able to manage the complexities of health and health system issues. There is a considerable intersection between general literacy and health literacy. Nonetheless, there are strong health-specific demands involved in health literacy that differs from those in general literacy [6]. Therefore, having general literacy alone is not adequate if one has to live a healthy life and to be able to prevent, manage, and control

Therefore, health literacy is divided into three levels namely; basic health

Functional health literacy is characterised by adequate fundamental skills in reading and writing to enable an individual to function efficiently in everyday situations. Therefore, functional health literacy is important to access services and information required to support individual's health, such as reading information about medication on medication labels [3]. Inadequate health literacy can result in difficulty following instructions from a doctor, and taking prescribed medication incorrectly, nonetheless, medical information is well

literacy, communicative health literacy, and critical health literacy [3].

Limpopo province, South Africa.

**medication instructions?**

packages, bottles, inserts etc.

**2.1 Types of health literacy**

diseases and illnesses.

*2.1.1 Basic/functional health literacy*

and more insight will be shared in the chapter.

be consumed'. This chapter will be based mainly on the study conducted among diabetes mellitus patients on treatment at selected rural area in Capricorn District,

The study employed a convergent parallel mixed method research design. The total population was 144 patients; 18 participated in the semi-structured interviews for qualitative study and 137 respondents for the quantitative study. The major findings of the study were: misconceptions and misunderstanding, unclear instructions, poor explanation by medication dispensers, non-compliance, negligence, experiencing complications, lack of knowledge and need assistance. The study also outlined the demographic data of the participants as factors influencing adherence

**272**

Interactive health literacy refers to more advanced, cognitive, and literacy skills which, together with social skills, that could be employed to actively participate in everyday activities. These skills are used to excerpt information and derive meaning from different forms of communication, and to apply new information to changing circumstances [3]. The interactive health literacy approach improves individuals' capability to act autonomously on knowledge. So, patients with inadequate health literacy are less likely to understand and take part in disease prevention and health promotion programs [7]. These patients are likely to be hospitalised more often than those with adequate health literacy.

Patients who reported having confidence in the ability to take medications confirmed a lack of comprehension in understanding medication instructions [8]. Patients further indicated numerous obstacles to effective medication management embedded in poor communication. Hence, patients expressed favouritism for more clearer medication instructions which could address some of the challenges they face.

### *2.1.3 Critical health literacy*

Critical health literacy includes advanced cognitive skills, which together with social skills can be applied to critically analyse information and to use that information to exercise greater control over life events and situations. Therefore, health literacy moves beyond communication to the development of skills necessary to effect social change to support health [3].

From these types of health literacy descriptions, [9] came up with a framework for health literacy (**Table 1**) as follows:


**Table 1.** *Health literacy framework.*
