When Stakes Are High and Stress Soars: Addressing Health Literacy in the Critical Care Environment

Nowhere more recently has limited health literacy been more apparent than with COVID-19.¹  The pandemic has challenged individuals and communities to grasp the importance of handwashing, mask wearing, and physical distancing to prevent disease transmission. Undeniably, health literacy ranks among social determinants of health^2,3 —housing, environment, education, economic stability, social support, and access to health care. Within the intensive care unit (ICU), more than 5 million Americans receive monitoring and treatment each year⁴  for serious conditions or injuries. These high-acuity or critically ill patients regularly rely on family members to understand their condition, treatment, and prognosis so that the family members can step into surrogate decision-making roles as needed.

Health literacy has been defined as “the degree to which individuals have capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”⁵  This complex process involves (1) oral...