Prof. Graeme Drummond Smith1, Prof. Ann Bonner2, Dr. Thi Thuy Ha Dinh3, Dr. Hemamali Jagodage2
1Saint Francis University, , Hong Kong, 2Griffith University, , Australia, 3Monash University, , Australia
Biography:
Professor Graeme D. Smith is currently a Professor of Nursing in the S. K. Yee School of Health Sciences, St. Francis University, Hong Kong. He has been a Fellow of the European Academy of Nursing Science since 2003. His Doctoral studies at University of Edinburgh arose from an interest in psychological healthcare, where he is currently a Honorary Professor. Research interests include health literacy in CKD, chronic illness, loneliness in older people, stress and resilience. Professor Smith is editor of the Journal of Advanced Nursing.
Abstract:
Introduction: Adults with chronic kidney disease (CKD) are likely to have increased hospitalisations, accelerated progression to kidney failure, suboptimal adherence with treatment, poorer health outcomes, and higher mortality when health literacy (HL) capabilities are not considered by healthcare professionals. This scoping review aimed to explore contemporary studies of health literacy in CKD.
Methods: Using the Patient-Concept-Context framework to inform the search for studies involving adults with CKD and HL was used. All study designs were included. Six databases were searched for studies published in English between January 2021 and March 2025 were included.
Results: Of the 403 titles and abstracts screened, 16 clinical trials and 13 non-experimental studies met the selection criteria. Studies demonstrated that higher HL profiles were associated with those who had higher education, language proficiency, employment, and social support. Co-designed HL interventions, mostly educational, involved adults with CKD showed improved comprehensibility and increased patient satisfaction. Interventions deliberately incorporating HL strategies reported improvements in patient‐reported outcomes. There was a paucity of multidisciplinary approaches amongst these interventions.
Discussion: A multimodal approach in improving health literacy requires a shift from considering HL as individual abilities to building health literacy responsive healthcare systems and professionals that deliver comprehensive, inclusive and tailored CKD care. Health literacy must also be embedded in organisational policies, healthcare service design, and workforce training to achieve sustainable impact. Strategies should span across individual, community, organizational, and policy levels to strengthen HL, improve health outcomes and reduce the of burden CKD on healthcare services and society.