Critical care medicine
October 14, 2026 · via Europe PMC
Tools Measuring Health Literacy in Critically Ill Patients and Their Caregivers: A Scoping Review.
Poulin TG, Krewulak KD, Arakawa NMC, Shahid A, Stelfox HT, Fiest KM.
AI summary — for doctors, generated from the abstract only
Scoping review of 84 health literacy tools in critical care found they mostly measure knowledge of specific ICU topics rather than how understanding develops through interactions.
What was studied
Scoping review (searched to July 24, 2025; two independent reviewers) of tools used to assess health literacy in critically ill patients or caregivers in NICU, PICU and adult ICU settings.
Key findings
- The review included 92 articles describing 84 tools.
- The most common tool types measured topic-specific clinical knowledge (24/84, 29%) and ICU prognosis, diagnosis and treatment (23/84, 27%).
- Few tools addressed decision-making (3/84, 4%) or information needs (4/84, 5%).
Clinical relevance
Clinicians choosing a tool should recognize that most capture knowledge, and may need interaction-focused approaches to support informed decision-making.
Who should care
Limitations
Scoping reviews map rather than judge tool quality; the abstract does not report psychometric validity of the tools.
Many tools exist but few capture how health literacy works in the ICU context.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objectives
Health literacy, the ability to understand and use health information, is important for critically ill patients and their caregivers in the neonatal ICU (NICU), PICU, and adult ICU to make informed decisions and navigate complex care. This review aimed to identify and summarize tools used to assess health literacy in critically ill patients or their caregivers.
Data sources
We searched MEDLINE, Embase, CINAHL, and PsycINFO through July 24, 2025.
Study selection
Included articles reported on tools to assess health literacy in critically ill patients or their caregivers. Two reviewers independently performed screening and data extraction.
Data extraction
Two independent reviewers extracted data in Covidence. Data items included study characteristics (country in which the study was conducted, study funding, study setting) and health literacy tool characteristics (tool user, types of questions in the tool, method of tool administration, if the tool was created by the study team, and if a full version was available in the publication).
Data synthesis
We included 92 articles describing 84 health literacy tools. Tools measured: 1) topic-specific clinical knowledge (e.g., organ donation, cardiopulmonary resuscitation; n = 24/84, 29%; NICU: n = 9; PICU: n = 1; ICU: n = 14); 2) ICU prognosis, diagnosis, and treatment (n = 23/84, 27%; NICU: 6; PICU: 3; ICU: n = 15); 3) neonatal and parenting (n = 13/84, 15%; all NICU); 4) general health literacy abilities (n = 11/84, 13%; NICU: n = 6; PICU: n = 2; ICU: n = 7); 5) information needs (n = 4/84, 5%; NICU: n = 1; PICU: n = 0; ICU: n = 3); 6) readiness for discharge (n = 3/84, 4%; all NICU); 7) decision-making (n = 3/84, 4%; all NICU); 8) health-related behaviors (n = 2/84, 2%; NICU: n = 1; ICU: n = 1); and 9) research participation (n = 1/84, 1%; NICU).
Conclusions
Although several health literacy tools exist, they often focus on individual knowledge of specific aspects of ICU care, with less attention to how understanding is produced within the clinical context through interactions among patients, caregivers, and healthcare providers. This may limit their ability to reflect how health literacy functions in critical illness. Assessment of health literacy requires pairing the appropriate tools with interaction-focused approaches to guide communication and support informed decision-making in ICU settings.
DOI
10.1097/ccm.0000000000007382
PMID
42872943
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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