The Evaluation of Health Literacy Interventions for Palliative Care Patients
DOI:
https://doi.org/10.53713/htechj.v3i6.533Keywords:
health literacy, palliative care, terminal careAbstract
Health literacy is crucial in palliative care, where patients often face complex medical conditions and must make end-of-life decisions. This literature review aims to evaluate the effectiveness of health literacy interventions in improving patient outcomes in palliative care settings. The review synthesized evidence from high-quality studies, including randomized controlled trials (RCTs) and quasi-experimental designs, with a focus on various intervention strategies such as educational programs, multimedia tools, and health coaching. The review utilized the PRISMA framework for study selection and the JBI critical appraisal checklist for assessing study quality. It included studies from databases such as Scopus, PubMed, and Google Scholar, focusing on publications from 2016 to 2025. The studies consistently showed that these interventions enhance patient understanding, engagement in treatment decisions, and overall quality of life. However, challenges remain in identifying the most effective interventions due to variations in study designs and outcome measures. This review highlights the significance of health literacy interventions in palliative care, advocating for additional research that focuses on LHL-specific strategies and standardized outcome measures to improve patient care.
References
Çalık, K.Y., Küçük, E. & Halimoğlu, B. (2022). The effect of an educational palliative care intervention on the quality of life of patients with incurable cancer and their caregivers. Supportive Care in Cancer, 30(3), 2427–2434. https://doi.org/10.1007/s00520-021-06672-1
Cheng, Y.S. et al. (2024). Short-Term Effects of an eHealth Care Experiential Learning Program Among Patients With Type 2 Diabetes: Randomized Controlled Trial. Journal of Medical Internet Research, 26. https://doi.org/10.2196/53509
Dionne-Odom, J.N. et al. (2018). Adapting an Early Palliative Care Intervention to Family Caregivers of Persons With Advanced Cancer in the Rural Deep South: A Qualitative Formative Evaluation. Journal of Pain and Symptom Management, 55(6), 1519–1530. https://doi.org/10.1016/j.jpainsymman.2018.02.009
Holden, C. E., Wagland, R., Harle, A., & Wheelwright, S. (2024). The experiences and decision making of patients with incurable cancer and health literacy difficulties. PLOS ONE, 19(10), e0309104. https://doi.org/10.1371/journal.pone.0309104
Howell, D. et al. (2017). Self-management education interventions for patients with cancer: a systematic review. Supportive Care in Cancer, 25(4), 1323–1355. https://doi.org/10.1007/s00520-016-3500-z
Hu, Y. et al. (2024). The effect of coaching on health information literacy in patients with chronic kidney disease: a randomized controlled trial. Trials, 25(1). https://doi.org/10.1186/s13063-024-08365-6
Hugar, L. A., M., E., Winzelberg, G. S., Jacobs, B. L., & Davies, B. J. (2021). Incorporating palliative care principles to improve patient care and quality of life in urologic oncology. Nature Reviews Urology, 18(10), 623-635. https://doi.org/10.1038/s41585-021-00491-z
Jeon, M., Jeon, H. & Kim, S. (2025). Targeted Digital Health Intervention in End-of-Life and Hospice Care: A Scoping Review. Journal of Advanced Nursing, 81(9), 5678–5690. https://doi.org/10.1111/JAN.16734
Kanagalingam, G. et al. (2025). Palliative care & chronic liver disease: barriers to care, health disparities & the role of health literacy. Annals of Palliative Medicine, 14(4), 35368–35368. https://doi.org/10.21037/APM-25-15
Kozlov, E., Reid, M.C. & Carpenter, B.D. (2017). Improving patient knowledge of palliative care: A randomized controlled intervention study. Patient Education and Counseling, 100(5), 1007–1011. https://doi.org/10.1016/j.pec.2016.12.022
Larsen, M.H. et al. (2022). A Bit of Everything': Health Literacy Interventions in Chronic Conditions – A Systematic Review. Patient Education and Counseling, 105(10), 2999–3016. https://doi.org/10.1016/J.PEC.2022.05.008
Martins Pereira, S., Araújo, J. & Hernández-Marrero, P. (2018). Towards a public health approach for palliative care: An action-research study focused on engaging a local community and educating teenagers. BMC Palliative Care, 17(1). https://doi.org/10.1186/s12904-018-0344-y
Meier, C. et al. (2024). End-of-life health literacy, knowledge and behaviours towards advance care planning among older adults: cross-sectional evidence from Switzerland. BMJ Public Health, 2(1), e000600. https://doi.org/10.1136/BMJPH-2023-000600
Mossman, B. et al. (2025). Impact of a psychoeducational intervention to improve caregiver knowledge and attitudes toward palliative cancer care. Patient Education and Counseling, 138. https://doi.org/10.1016/j.pec.2025.109222
Murugesu, L. et al. (2022). Challenges and solutions in communication with patients with low health literacy: Perspectives of healthcare providers. PLOS ONE, 17(5), e0267782. https://doi.org/10.1371/JOURNAL.PONE.0267782
Noordman, J. et al. (2022). A basic understanding of the evaluation of a blended training programme for healthcare providers in hospital-based palliative care to improve communication with patients with limited health literacy. BMC Medical Education, 22(1). https://doi.org/10.1186/s12909-022-03685-0
Peipert, J.D. et al. (2021). A Low Literacy, Multimedia Health Information Technology Intervention to Enhance Patient-Centered Cancer Care in Safety Net Settings Increased Cancer Knowledge in a Randomized Controlled Trial. Cancer Control, 28. https://doi.org/10.1177/10732748211036783
Peng, M., Lu, Y., & Mo, W. (2025). Barriers and facilitators to offering palliative care to patients with heart failure: a mixed-methods systematic review using the COM-B model and theoretical domains framework. BMJ Open, 15(6), e094206. https://doi.org/10.1136/BMJOPEN-2024-094206
Petursdottir, A.B., Haraldsdottir, E., & Svavarsdottir, E.K. (2019). The impact of implementing an educational intervention to enhance a family-oriented approach in specialised palliative home care: A quasi-experimental study. Scandinavian Journal of Caring Sciences, 33(2), 342–350. https://doi.org/10.1111/scs.12628
Pini, S. et al. (2022). A Structured Intervention to Support Early Palliative Care Conversations for Oncology Patients – A Qualitative Feasibility Study. Clinical Oncology, 34(12), e515–e522. https://doi.org/10.1016/J.CLON.2022.05.012
Roodbeen, R. et al. (2020). Communication and shared decision-making with patients with limited health literacy; helpful strategies, barriers, and suggestions for improvement reported by hospital-based palliative care providers. PLoS ONE, 15(6). https://doi.org/10.1371/journal.pone.0234926.
Schulman-Green, D. et al. (2023). Integrating Palliative Care Into Self-management of Breast Cancer: A Pilot Randomized Controlled Trial. Cancer Nursing, 46(3), E169–E180. https://doi.org/10.1097/NCC.0000000000001078
Schulman-Green, D.J. et al. (2022). Adapting a palliative care-focused cancer self- and family management intervention for use in Israel. International Journal of Palliative Nursing, 28(8), 378–387. https://doi.org/10.12968/ijpn.2022.28.8.378
Shahid, R. et al. (2022). Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Services Research, 22(1), 1148. https://doi.org/10.1186/S12913-022-08527-9
Shao, Y. et al. (2023). Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. Patient Education and Counseling, 114, 107829. https://doi.org/10.1016/J.PEC.2023.107829
Wong, K.T.C., Chow, A.Y.M. & Chan, I.K.N. (2022). Effectiveness of Educational Programs on Palliative and End-of-life Care in Promoting Perceived Competence Among Health and Social Care Professionals. American Journal of Hospice and Palliative Medicine, 39(1), 45–53. https://doi.org/10.1177/10499091211038501
Yuan, N. et al. (2023). The relationship between eHealth literacy and palliative care knowledge, attitudes, and practice among nurses: a cross-sectional study. BMC Nursing, 22(1), 76. https://doi.org/10.1186/S12912-023-01237-5
Zanobini, P., Del Riccio, M., Lorini, C., & Bonaccorsi, G. (2023). Empowering Sustainable Healthcare: The Role of Health Literacy. Sustainability, 16(10), 3964. https://doi.org/10.3390/su16103964
Zhang, J. et al. (2025). The impact of health literacy on quality of life in patients with chronic diseases," Frontiers in Public Health, 13, 1544259. https://doi.org/10.3389/fpubh.2025.1544259
