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Table 2 Themes, sub themes and categories

From: The development of health literacy in patients with a long-term health condition: the health literacy pathway model

Themes Sub themes Categories
   1. Health knowledge Knowledge of health in general and own health concerns Knowledge of science and health
   Knowledge of condition
   Knowledge of health service
   Knowledge of patients' rights
   2. Self management skills Managing medication Organising medications and managing a medication regime (self-injecting, taking pills)
  Self-monitoring Self monitoring blood sugar/coagulation
  Managing a diet Managing diabetes with diet
   3. Active information seeking and use Engaging with written materials Reading medical reference books, dictionaries, leaflets, newspaper reports
  Accessing online information Health-related websites, health organisations
  Using social media Posting messages on discussion boards, web chat with other patients, using video sharing websites to view procedures
  Engaging with research Reading research papers
  Critical appraisal of information and considering it within context Assessing the reliability and quality of information and the source of information, assessing relevance of the information in context of own concerns
   4. Actively communicating with health professionals Preparation Keeping a record of symptoms, preparing questions to ask in consultations
  Exchanging information Bringing information to a consultation, discussing results, medications
  Expressing needs and concerns Asking to change a medication, talking about problems, communicating preferences, asking for a referral to another service, asking for monitoring devices, asking to see results
  Conveying information Reiterating health information given by one health professional to another
  Managing communication Managing communication with multiple health professionals
   5. Seeking and negotiating treatment options Seeking treatment options Seeking alternative treatment options online
  Negotiating medication or treatment Asking doctor to try a new medication or alternative treatment method
   6. Decision making Desire for involvement Making informed decisions about treatment preferences
  Opportunities for involvement Taking part in shared decision making
   7. Influences on health literacy Negative influences (personal and professional barriers) Patients: poor acceptance, compliance, reliance on health professionals for information, emotional barriers (shock fear, anxiety), avoidance of information
   Health professionals: poor communication styles, conflicting information
  Positive influences (personal and professional motivators, facilitators) Patients: manage emotions (reducing fear), make sense of symptoms
   Friends and family: distributed health literacy skills
   Health professionals: GP support information seeking, pharmacy support with understanding of medications, nurse support with self-management, access to services and mediate communications with doctors
   8. Health literacy outcomes Develop knowledge, skills, understanding and coping  
  Active involvement in consultations