The scenarios of health service approaches for improving health literacy in patients with chronic diseases


  • Araya Chiangkhong Kuakarun Faculty of Nursing, Navamindradhiraj University
  • Chanipa Yoryuenyong Kuakarun Faculty of Nursing, Navamindradhiraj University
  • Arunee Hengyotmark Kuakarun Faculty of Nursing, Navamindradhiraj University


scenarios, health literacy, healthcare service, patients with chronic diseases


The objectives of this research were to study the barriers to develop health literacy in patients with chronic diseases, and to propose the scenarios of health service approaches for improving health literacy that were suitable for their social conditions and expectations. The research implementation applied the future research by using the methodology of Ethnographic Delphi Future Research (EDPR). This research started from identifying barriers to utilize health information by gathering data from patients with chronic diseases who had low scores of health literacy. A health intelligence measurement for patients with diabetes mellitus and hypertension were accessed from 25 patients including three healthcare providers working in the chronic disease clinics at least 10 years. Data from the barriers findings were applied as the main topic for interviewing 20 experts using the EDFR techniques at the first to third rounds. The qualitative data were analyzed using content analysis, while the quantitative data were analyzed using descriptive statistics and interquartile range. 

The results showed that the barriers to develop health literacy included 4 domains:1) health knowledge; 2) competency of searching and using health information; 3) negotiation to enhancing self–care; and 4) ability of self-management for controlling and preventing chronic diseases. The future of health service approaches to improve the health literacy for patients with chronic diseases comprised 4 aspects: 1) changing health culture to healthy lifestyle for controlling chronic diseases; 2) supporting accessibility and expanding the distribution of channels for health information exchanges; 4) integrating public health system and education; and   5) developing the strategies of communication between healthcare recipients and providers.

This study suggested that health administrators should apply the evidence from this research to develop policy and implementation plan of health care services for chronic diseases patients in order to improve their health literacy appropriate for self-care and to delay complication from chronic diseases.


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How to Cite

Chiangkhong A, Yoryuenyong C, Hengyotmark A. The scenarios of health service approaches for improving health literacy in patients with chronic diseases. Thai J Cardio-Thorac Nurs. [Internet]. 2022 Mar. 12 [cited 2024 Jul. 24];32(2):217-32. Available from:



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