Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The effect of Autonomy-Supportive Patient-Centered Communication on Health Literacy: Exploring the Mediating Role of the Patient Health Engagement Model

Version 1 : Received: 23 January 2020 / Approved: 28 January 2020 / Online: 28 January 2020 (10:29:43 CET)

A peer-reviewed article of this Preprint also exists.

Barello, S.; Palamenghi, L.; Graffigna, G. The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills. Int. J. Environ. Res. Public Health 2020, 17, 1741. Barello, S.; Palamenghi, L.; Graffigna, G. The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills. Int. J. Environ. Res. Public Health 2020, 17, 1741.

Journal reference: Int. J. Environ. Res. Public Health 2020, 17, 1741
DOI: 10.3390/ijerph17051741

Abstract

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

Subject Areas

health literacy; patient health engagement model; Health Care Climate Questionnaire; patient autonomy; PHE-s; Patient Health Engagement Scale; health communication; patient centered communication; patient engagement

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