Table 2 Themes, sub themes and categories
Themes | Sub themes | Categories |
|---|---|---|
   1. Health knowledge | Knowledge of health in general and own health concerns | Knowledge of science and health |
| Â | Â | Knowledge of condition |
| Â | Â | Knowledge of health service |
| Â | Â | Knowledge of patients' rights |
   2. Self management skills | Managing medication | Organising medications and managing a medication regime (self-injecting, taking pills) |
| Â | Self-monitoring | Self monitoring blood sugar/coagulation |
| Â | 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 |
| Â | Accessing online information | Health-related websites, health organisations |
| Â | Using social media | Posting messages on discussion boards, web chat with other patients, using video sharing websites to view procedures |
| Â | Engaging with research | Reading research papers |
| Â | 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 |
| Â | Exchanging information | Bringing information to a consultation, discussing results, medications |
| Â | 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 |
| Â | Conveying information | Reiterating health information given by one health professional to another |
| Â | Managing communication | Managing communication with multiple health professionals |
   5. Seeking and negotiating treatment options | Seeking treatment options | Seeking alternative treatment options online |
| Â | 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 |
| Â | 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 |
| Â | Â | Health professionals: poor communication styles, conflicting information |
| Â | Positive influences (personal and professional motivators, facilitators) | Patients: manage emotions (reducing fear), make sense of symptoms |
| Â | Â | Friends and family: distributed health literacy skills |
| Â | Â | 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 |  |
| Â | Active involvement in consultations | Â |