Sağlık Okuryazarlığı, Ortak Karar Alma ve Yanlış Sağlık Bilgisiyle Baş Etme
Özet
Sağlık okuryazarlığı; bireylerin sağlıkla ilgili bilgiye ulaşma, anlama, değerlendirme ve doğru kararlar için kullanma yetisidir. Gastroenteroloji pratiğinde tanı, endoskopik işlem, ilaç uyumu, beslenme ve kanser taraması gibi çok sayıda karar; hastanın bu bilgiyi anlamasına ve sürece katılımına bağlıdır. Yetersiz sağlık okuryazarlığı; hatalı ilaç kullanımı, düşük tedavi uyumu, gereksiz acil başvurular, kötü klinik sonuçlar ve artmış maliyetle ilişkilidir. Ortak karar alma ve aydınlatılmış onam, bu bilgiyi hastayla birlikte kullanılabilir kılan temel araçlardır. Günümüzde internet, sosyal medya, yapay zekâ sohbet araçları ve bitkisel/gıda takviyeleri, hastaların bilgi kaynaklarını hızla dönüştürmüş; doğru bilgiyle birlikte “yanlış sağlık bilgisi (infodemi)” de yaygınlaşmıştır. Bu bölümün amacı; sağlık okuryazarlığının klinik önemini, ortak karar almanın ve aydınlatılmış onamın ilkelerini, düşük okuryazarlığı fark etme ve destekleme yöntemlerini (teach-back, sade dil, evrensel önlemler) ve internet/sosyal medya/yapay zekâ/bitkisel ürünler kaynaklı yanlış bilgiyle baş etme stratejilerini (ön-çürütme/ aşılama, çürütme, empatik sorgulama, güvenilir kaynak yönlendirmesi) güncel kanıtlar ışığında sunmaktır. Ayrıca standart hasta bilgilendirme metni, sık sorulan sorular ve tehlike belirtileri verilmiştir.
Health literacy is the ability of individuals to find, understand, appraise and use health information to make appropriate decisions. In gastroenterology, many decisions — regarding diagnosis, endoscopic procedures, medication adherence, nutrition and cancer screening — depend on the patient's understanding and participation. Limited health literacy is associated with medication errors, poor adherence, unnecessary emergency visits, worse outcomes and higher costs. Shared decision-making and informed consent are the key tools that make information usable together with the patient. Today, the internet, social media, artificial intelligence chatbots and herbal/dietary supplements have rapidly transformed patients' information sources; alongside accurate information, “health misinformation (the infodemic)” has also proliferated. This chapter presents the clinical importance of health literacy, the principles of shared decision-making and informed consent, methods to recognize and support limited literacy (teach-back, plain language, universal precautions), and strategies to counter misinformation from the internet, social media, AI and herbal products (pre-bunking/ inoculation, debunking, empathic inquiry, guidance to trusted sources), in light of current evidence, together with standardized patient information, FAQs and warning signs.
Referanslar
Santana S, Brach C, Harris L, et al. Updating Health Litera¬cy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health. J Public Health Manag Pract. 2021;27(Suppl 6):S258-S264.
Nutbeam D. Health literacy as a public health goal: a chal¬lenge for contemporary health education and communi¬cation strategies into the 21st century. Health Promot Int. 2000;15(3):259-267.
Agency for Healthcare Research and Quality (AHRQ). Health Literacy Universal Precautions Toolkit. 3rd ed. Rockville, MD: AHRQ; 2024.
Elwyn G, Durand MA, Song J, et al. A three-talk model for shared decision making: multistage consultation process. BMJ. 2017;359:j4891.
Stacey D, Lewis KB, Smith M, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Da¬tabase Syst Rev. 2024;(1):CD001431.
Storm AC, Fishman DS, Buxbaum JL, et al. American So¬ciety for Gastrointestinal Endoscopy guideline on informed consent for GI endoscopic procedures. Gastrointest Endosc. 2022;95(2):207-215.e2.
Everett SM, Triantafyllou K, Hassan C, et al. Informed con¬sent for endoscopic procedures: European Society of Gastro¬intestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2023;55(10):952-966.
Office of the U.S. Surgeon General. Confronting Health Mi-sinformation: The U.S. Surgeon General’s Advisory on Buil¬ding a Healthy Information Environment. Washington, DC: US Department of Health and Human Services; 2021.
Calleja N, AbdAllah A, Abad N, et al. A Public Health Resear¬ch Agenda for Managing Infodemics: Methods and Results of the First WHO Infodemiology Conference. JMIR Infodemio¬logy. 2021;1(1):e30979.
Chan MS, Jones CR, Hall Jamieson K, Albarracín D. De¬bunking: A Meta-Analysis of the Psychological Effica¬cy of Messages Countering Misinformation. Psychol Sci. 2017;28(11):1531-1546.
Roozenbeek J, van der Linden S, Goldberg B, et al. Psychologi¬cal inoculation improves resilience against misinformation on social media. Sci Adv. 2022;8(34):eabo6254.
World Health Organization. Ethics and Governance of Artifi¬cial Intelligence for Health: Guidance on Large Multi-Modal Models. Geneva: WHO; 2024.
Likhitsup A, Chen VL, Fontana RJ. Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults. JAMA Netw Open. 2024;7(8):e2425822.
National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury — Herbal and Dietary Supple¬ments. Bethesda, MD: NIDDK; 2024.
