Respiratory Care

Health literacy in respiratory care – how nurses can bridge the gap

In the 21st century, healthcare should be readily available to all members of the population, regardless of their demographics or socio-economic status. Health literacy – the degree to which individuals have the capacity to obtain, process and understand basic health information – is an essential component to allow individuals to manage their own health, wellbeing, and care.1 Nurses play a crucial role in overcoming disparities in health literacy, thereby helping to improve outcomes for all members of society.2

Health literacy in chronic respiratory disease

Across the globe, the prevalence of chronic disease is on the rise; respiratory conditions such as asthma and COPD are amongst some of the most common. People living with these conditions must obtain, understand, and apply the information required to follow complex treatment plans, and therefore adequate health literacy is required in order to manage their conditions on a day-to-day basis.1

Health materials and information, however, are often complex, laden with jargon and can be challenging to interpret. The consequences of not understanding health information can be serious – poor health literacy is linked with a number of unfavourable outcomes, including poor general health, increased hospital admissions and reduced life expectancy.3

Patient empowerment is paramount to avoiding these outcomes; by truly understanding their condition, people with chronic respiratory conditions can effectively self-manage.1 Of course, health literacy does not solely arise from an individual’s attributes (such as cognitive abilities or literacy skills); but rather is the result of collaboration between patients and their healthcare providers (HCPs). Optimal HCP communication skills and improved ease of access to information can improve patient understanding, and hence improve outcomes4

Within healthcare systems across Europe, nurses are ideally placed to facilitate the frequent communication with patients that is essential in supporting them in making positive changes to their overall wellbeing.5 Indeed, ensuring understanding of accurate health messaging is at the very core of the “make every contact count” ethos.6 Maximising the impact of each and every interaction with patients to promote health literacy and ensure understanding should therefore be a routine part of nursing practice.5

In the context of patients with chronic respiratory disease, improving an individual’s healthcare literacy has been linked with a number of improved outcomes. For instance, ensuring a comprehensive understanding of disease management in patients with COPD and asthma can lead to improved adherence to medication, engagement with treatment plans and the appropriate use of inhalers.4

How can nurses bridge the communication gap between physicians, patients, and communities?

The needs of each individual, and indeed each community, are unique. Literacy levels, communication preferences and prior experience can vary, and identifying barriers to optimal understanding is essential. For nurses working in respiratory care, there are several simple practical actions that can be taken to ensure understanding of information, such as:5,7

  1. Have clear, concise, and measured conversations with patients, using simplified language and avoiding acronyms where appropriate
  2. Identify and build upon a persons existing level of understanding, being mindful of diverse linguistic and educational backgrounds
  3. Check back for understanding of new information; repeat information if necessary
  4. Ensure that your patients feel comfortable, and encourage them to ask questions about their care

It is the moral imperative of all information providers within healthcare systems to ensure that patients have sufficient understanding to carry out any and all tasks required of them in the management of their wellbeing. Implementing simple communication strategies, such as the above, into nursing practice can help to support people with chronic respiratory disease to engage in optimal self-management and create mutually beneficial relationships between each key player in their healthcare journey.

Approval code:   RESP-TPE-NP-00400 Date of preparation:  April 2023


  1. Poureslami I, et al. Respir Res 2022;23:361
  2. Oruche UM, et al. J Psychosoc Nurs Ment Health Serv 2020;58:2–4
  3. NHS Digital Service Manual 2020. Available at: [last accessed April 2023]
  4. van der Heide I, et al. Health Lit Res Pract 2021;5:e179–e193
  5. Gursul D. Nursing Times 2022 [online]; 118;12. Available at: [last accessed April 2023]
  6. Public Health England. Making Every Contact Count (MECC): Consensus statement 2016. Available at: [last accessed April 2023]
  7. DeGroff D. HIT Consultant 2022. Available at: [last accessed April 2023]