Incorporating health literacy into family nurse practitioner practice: an integrative literature review

In Canada, primary health care (PHC) has been endorsed by numerous reports and health care researchers as a mechanism for improving the health and well-being of all Canadians. The family nurse practitioner (FNP) plays an important role in the provision of PHC in Canada. As relatively new providers of primary health care, FNPs have struggled to demonstrate how their patient-centred focus can contribute to positive patient outcomes. The Canadian Nurses Association describes competencies that ensure that FNPs employ a patient-centred focus, but missing is a conceptualization of a framework that offers up a way for FNPs to describe and measure those competencies that allow them to practice in a way that is patient-centred. The concept of health literacy offers a means to address this gap. An integrative literature review was conducted to examine how FNPs can incorporate health literacy into their practice in order to demonstrate their patient-centred competencies and thereby make an impact on patient outcomes. The review of the literature revealed that working from a framework of health literacy promotion offers opportunities to describe and better provide the value-added, public health component of FNP practice, how this component relates to patient-centredness, and how by implying the framework, FNPs can impact patient outcomes. While there is not yet consensus within the literature as to what health literacy frameworks and strategies are most applicable to practice, this in itself presents important opportunities for FNPs to contribute to an emerging body of knowledge. --Leaf ii.