Assessing Communicative Health Literacy with Physicians in Healthcare Services

Abstract

Although scholarly attention to COM-HL has increased in recent years, research has predominantly focused on high-income countries. Existing evidence shows that COM-HL is strongly associated with health outcomes. Enhancing COM-HL is therefore essential for improving healthcare services, as it enables individuals to understand health information and actively participate in decisions regarding their health and well-being. The aims were to examine COM-HL in the general adult population, identify levels and determinants of COM-HL in both the Hungarian and Angolan contexts. The first survey validated the Hungarian version of the HLS19-COM-P tool. The mean score of COM-HL was 86.8. Explaining health concerns to a physician was identified as the easiest task, whereas insufficient consultation time was the most challenging. Women had lower COM-HL scores than men, while participants aged 66–75 years scored higher than those aged 18–29 years. Higher COM-HL levels were also associated with stronger social support and the absence of financial hardship, as well as with daily physical activity, fruit and vegetable consumption, and lower odds of health-related limitations. The second survey emphasized the novelty of the Angolan context and validated the Portuguese version of the HLS19-COM-P instrument, which showed good internal consistency. The mean score of COM-HL was 49.9. The lowest scores were observed among individuals aged 70 years and above, those reporting poor health status, and rural residents. Insufficient consultation time was again identified as the most challenging task, while recalling information received from physicians was the easiest. COM-HL was positively associated with urban residence, better perceived health status, and lower financial deprivation. The findings reveal persistent communicative challenges faced by individuals in health care settings, particularly limited consultation time with their doctor. Also, it highlights the significant influence of social and economic factors on COM-HL. These results may assist policymakers and healthcare decision-makers in identifying communicative barriers and developing targeted interventions to strengthen patient–physician interaction and improve healthcare quality.