{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:46:48Z","timestamp":1790869608664,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"17-18","license":[{"start":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T00:00:00Z","timestamp":1624752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore chronic disease education, self\u2010management and\u00a0health literacy abilities from First Nations Australian adults with chronic disease through the integration of qualitative and quantitative findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic disease management requires good health literacy abilities to manage long\u2010term health needs. First Nations people have a higher burden of chronic disease although little is known regarding chronic disease health literacy of First Nations people.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A concurrent embedded mixed methods study reported using the Consolidated Criteria for Reporting Qualitative Research guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected from First Nations people with one or more chronic diseases living in remote Australia between February\u2013November 2017. Quantitative data (<jats:italic>n<\/jats:italic>\u00a0=\u00a0200) were collected using the Health Literacy Questionnaire along with demographic and health data. Qualitative data (<jats:italic>n<\/jats:italic>\u00a0=\u00a020) were collected via face\u2010to\u2010face interviews to examine chronic disease education and self\u2010management experiences. Data were analysed separately then integrated to develop meta\u2010inferences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Poor communication from healthcare providers coupled with low health literacy abilities is a major barrier to both active and successful management of chronic disease. Communicating in medical jargon resulted in individuals being placed in a power differential causing lack of trust and relationship breakdowns with healthcare providers affecting active chronic disease self\u2010management. The perception of inevitability and ambivalence towards chronic disease and the notion of futility towards self\u2010management were concurred with the low level of active engagement in health care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Yarning is an important strategy used by First Nations people for communication. For nurses, understanding and developing skills in yarning will facilitate cultural safety, communication and understanding about chronic disease self\u2010management in contexts where health literacy abilities are challenged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>Using yarning, and plain language visual aids, and teach\u2010back will readdress the power differential experienced by First Nations people and may also improve understanding of chronic disease self\u2010management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15757","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T05:01:16Z","timestamp":1624856476000},"page":"2683-2695","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Chronic disease health literacy in First Nations people: A mixed methods study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6552-9202","authenticated-orcid":false,"given":"Haunnah","family":"Rheault","sequence":"first","affiliation":[{"name":"School of Nursing Queensland University of Technology Kelvin Grove Queensland Australia"},{"name":"Advanced Heart Failure and Transplant Unit The Prince Charles Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-0081","authenticated-orcid":false,"given":"Fiona","family":"Coyer","sequence":"additional","affiliation":[{"name":"School of Nursing Queensland University of Technology Kelvin Grove Queensland Australia"},{"name":"Intensive Care Services Royal Brisbane and Women\u2019s Hospital Herston Queensland Australia"},{"name":"Centre for Healthcare Transformation Queensland University of Technology Kelvin Grove Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9920-6743","authenticated-orcid":false,"given":"Ann","family":"Bonner","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Southport Queensland Australia"},{"name":"NHMRC Chronic Kidney Disease Centre of Research Excellence University of Queensland Herston Queensland Australia"},{"name":"Kidney Health Service Metro North Hospital and Health Service Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,27]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Health literacy, Australia, 2006","author":"Australian Bureau of Statistics","year":"2008"},{"key":"e_1_2_11_3_1","volume-title":"2016 Census QuickStats, Mount Isa Code SED30057 (SED)","author":"Australian Bureau of Statistics","year":"2016"},{"key":"e_1_2_11_4_1","volume-title":"National Health Survey: Health Literacy, 2018","author":"Australian Bureau of Statistics","year":"2018"},{"key":"e_1_2_11_5_1","volume-title":"Health literacy: Taking action to improve safety and quality","author":"Australian Commission on Safety and Quality in Health Care","year":"2015"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2016.01.001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-2-201107190-00005"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.5204\/ijcis.v3i1.57"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-2-201107190-00015"},{"key":"e_1_2_11_10_1","volume-title":"Health literacy and health disparities: Opportunities for trans\u2010disciplinary collaboration","author":"Cooper L.","year":"2011"},{"key":"e_1_2_11_11_1","volume-title":"Designing and conducting mixed methods research","author":"Creswell J. 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