School Nurses' Assessment of Parental Health Literacy for Students with Chronic Health Conditions

School nurses interact closely with parents of children with chronic health conditions. Understanding how they perceive and respond to parental health literacy (HL) is essential. In this study, we assessed the accuracy of school nurses' evaluations of parental HL by comparing their assessments with parents' objectively measured HL. A cross-sectional design was employed with a convenience sample of 52 parent-school nurse pairs. Parental HL was measured using the HLS-EU-Q16 and adapted items from previous studies. Data were analyzed using cross-tabulation, Kappa, intraclass correlation coefficient (ICC) and sensitivity-specificity metrics. The results demonstrated very low agreement between nurses' estimations and parents' actual HL (κ = 0.060, p = 0.547). Nurses frequently rated HL as 'Adequate', leading to misclassification of 'Problematic' and 'Inadequate' cases. Sensitivity in identifying inadequate HL was low, and ICC values confirmed poor reliability. Findings underscore the need for training school nurses to better identify and address parents' HL needs.