Health literacy in stroke disease: A systematic review

Background: Health literacy has been demonstrated to be a factor that influences patients’ ability to retain clinical education and counselling. Aims: To describe: (1) the importance of health literacy in the prevention of stroke; (2) the correlation of risk factors with health literacy; and (3) the importance of health literacy in post-stroke outcomes. Methods: A systematic review was conducted using the following databases: PubMed (via Medline), CINAHL (via EBSCO), PsycINFO (via EBSCO), and Web of Science (via EBSCO) for studies focused on health literacy in stroke. We included qualitative, quantitative and observational studies. The critical appraisal tool of JBI-Checklists was used to assess the methodological quality of the included studies. Results: Thirty-three studies, involving 35,935 participants, were selected for this systematic review. Most of the studies (41 %) were cross-sectional. Health literacy levels among the general population and stroke patients were found to be relatively low, indicating the need for increased stroke education. Hyperten- sion and stress were the most frequently identified risk factors while pregnancy and oral contraceptives, and anticoagulants were the least. People at risk of stroke have indicated a desire for more practical information and individually tailored behavioral interventions. Conclusions: The results of this study highlighted the deficiency in health literacy among different pop- ulations. We noticed that even a simple educational intervention can help to improve health literacy. Targeting the general public is important in order to rapidly translate knowledge into action and to re- duce the time from symptom onset to hospital arrival as time plays an important role in stroke.