A Health communication model for patient understanding and improving health literacy: ACP model (assertiveness, clarity, positivity)

The communication skills of health professionals are essential to achieve a good level of understanding by the patient. This is one of the dimensions of health literacy. In addition to understanding, access to information and navigability in the complex process of health  services, as well as the use of this information,  so that decisions are made consistent with the health status of the person, or on whom it depends,  are also dimensions that make the individual, groups, communities and society more literate and with better health results.

Methodology: The mixed method used in this research  involved 484 health professionals  (medical doctors and nurses). The techniques used, included  14  focus group,  1 questionnaire survey (Q-COM-LIT),  7 interviews and qualitative content analysis techniques.

For the conceptualization of the ACP Model, the theoretical approaches of communication were used, anchoring ourselves: a) in relational theory; b) in the situational theory of the public and the theory of problem solving; c) the approach to persuasion; d) in Schramm's and Hall model of coding-decoding, e) and in social cognitive theory, related to the theory of rational action and planned behavior.

Results: The use of specific communication skills,  as assertiveness, clarity, and positivity, facilitates the therapeutic relationship and the work of health professional in the process of improving patient understanding and health instruction. Health professionals consider their communication skills an indispensable condition to improve the therapeutic relationship. The assertive, clear and positive language used in the therapeutic relationship contributes to increase the patient's understanding, in view of the orientations transmitted to him by the health professional.

We find that the communication skills are an indispensable condition to increase the quality of health care and patient health literacy. The value of the ACP model in the health  relationship  was  a  recommended health communication model for health and health literacy.