The role of distributed health literacy in asthma integrated care: A public medical context from Portugal

• Autor(a) principal: Abreu, Liliana
• Data de Publicação: 2018
• Outros Autores: Nunes, João Arriscado, Taylor, Peter, Silva, Susana
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10316/80486; https://doi.org/10.5334/ijic.3301
• topic: Health mediators; Health literacy; People-centred care; Integrated care; Asthma

Background: Improvements in asthma integrated care might be achieved through in-depth knowledge about how health literacy is dispersed through a group. This study intends to map out health literacy mediators (those who makes his/her literacy skills available to others for them to accomplish specific literacy purposes) and how they enable self-management skills in patients with asthma. Methods: Twenty interviews were conducted in a Primary Care Center of Porto using the McGill Illness Narrative Interview. Data were thematically analyzed as case-based and process-tracing-oriented. Results: Interviewees with a dense network of mediators revealed a low impact of asthma on their lives, dependence on primary care physician for instrumental support and dependence on family members to provide emotional/pragmatic support. Interviewees who relied on a restricted network of mediators (belonging to formal sources of health services and providing informational support) described episodes of crisis as disruptive and demonstrated a reactive approach to self-management skills. Conclusions: The roles performed by core health mediators (health professionals, family/friends, media) in support of asthma management varied according to patients’ narratives of minimization/disruption, connected to dense/restricted social networks. To clarify the boundaries of responsibility-shifting and to enrich support provided by formal sources of health services and peer education groups is needed.