Conceptual Framework of Health-Literate Nursing System: A Proceduralized Grounded Theory Approach

Area of Science:

• Nursing Science
• Health Literacy Research
• Healthcare Systems

Background:

• Health literacy is now recognized as a system-level responsibility, extending beyond individual patient factors.
• Existing frameworks often overlook the specific roles and contributions of nursing within healthcare systems.
• There is a need for structured guidance to integrate health literacy into nursing practice and management.

Purpose of the Study:

• To develop and define a conceptual framework for a system-level nursing approach to address patients' health literacy needs.
• To provide clear, structured guidance for integrating health literacy into nursing practice and management.
• To establish a framework that enhances the nursing system's capacity to support patient health literacy.

Main Methods:

• A proceduralized grounded theory approach was utilized.
• Data were collected through in-depth interviews with 23 healthcare professionals and field observations in two hospitals.
• Analysis involved open, axial, and selective coding, with theoretical saturation confirmed by further interviews.

Main Results:

• A conceptual framework, the Health-Literate Nursing System (HLNS), was developed.
• HLNS consists of five interrelated elements: nurse leadership, patient participation, a health-literate material environment, a health-literate management system, and a health-literate external system.
• These elements work together to improve communication, access to care, and health information dissemination.

Conclusions:

• The study proposes the HLNS framework as a system-level approach to enhance patient and nursing system health literacy.
• The framework highlights the importance of nurse leadership, patient engagement, supportive environments, effective management, and collaboration.
• The HLNS provides practical guidance for nursing leaders to advance health literacy within healthcare systems.