Page 15 - THE DUTCH TALKING TOUCH SCREEN QUESTIONNAIRE

INTRODUCTION The aim of the research project that is described within this thesis was to develop a tool which would help Dutch and Turkish physical therapy patients with inadequate health literacy (HL) to be more able to take an active part in the decision-making process within the diagnostic phase of physical therapy treatment in the Netherlands. Within this first chapter, the background and motivation for conducting this research project are described. ACTIVE PATIENT PARTICIPATION INCREASES QUALITY OF CARE Health care provision has evolved over the last decades. The traditional paternalistic approach, in which health care professionals were expected to make health care decisions for patients, is increasingly developing towards a patient-centered care (PCC) approach in which patients are expected to take on an active participating role \[1\]. Patient participation has been recognized worldwide as a means to enhance quality of care \[2\]. In contemporary health care systems, patient centeredness is placed alongside effectiveness and safety when it comes to measuring quality of care \[1\]. PCC is advocated in health care policies in many countries, including the Netherlands. Since 1995, the government has introduced a series of laws and regulations aimed at increasing autonomy and self-determination of patients \[3\]. Effective PCC has been proven to enhance patient experiences, reduce health care costs, and improve health \[4\]. Today, policymakers, institutions and health care professionals are striving for further development of shared decision-making and self-management in patients \[5\]. However, not all patients are able to take advantage of the positive effects of PCC, since PCC demands that patients participate as active partners \[6\] and information exchange is key to active patient participation \[7\]. LOW HEALTH LITERACY IS AN OBSTACLE FOR ACTIVE PATIENT PARTICIPATION Inadequate health literacy (HL) is an important limiting factor in the ability of patients to take on an active role and exchange information with their health care provider effectively \[8-10\]. Within the Dutch population, thirty-six percent have inadequate health literacy \[11\]. General introduction 11 1