Health Literacy as a Key Determinant of Patient Safety among Nurses in Pakistan

Articles in Press

Document Type : Original Article

Authors

Lahore School of Nursing, The University of Lahore, Lahore, Pakistan.

Abstract

Background and objective: Patient safety remains a critical concern in low- and middle-income countries such as Pakistan. Nurses’ health literacy may contribute to improved patient safety through better clinical decision-making; however, factors such as heavy workload and limited training may compromise both health literacy and safety practices. This study aimed to examine the relationship between health literacy and patient safety culture among nurses in a single hospital in Pakistan.

Materials and Methods: This cross-sectional study was conducted in 2026 in one hospital in Pakistan. A total of 150 nurses participated. Data were collected using the Health Literacy Questionnaire (HLQ) and the Hospital Survey on Patient Safety Culture (HSOPSC).

Results: Participants demonstrated moderate levels of health literacy (mean = 3.13) and patient safety culture (mean = 3.27). A moderate positive correlation was observed between health literacy and patient safety culture (r = 0.42, p < 0.01). However, these findings should be interpreted cautiously due to the cross-sectional design, which limits causal inference, and the single-center sampling, which restricts generalizability. Therefore, the results should be considered preliminary.

Conclusion: This study provides preliminary evidence of an association between nurses’ health literacy and patient safety culture in a limited hospital setting. However, the observed relationship cannot be interpreted causally. Further large-scale, multi-center, and longitudinal studies are required to confirm these findings and explore additional contextual and organizational factors influencing patient safety.

Keywords

Acknowledgments: The researchers appreciate the sincere collaboration of all nurses who participated in this study.


Availability of data and materials: The datasets used or analyzed during the current study available from the corresponding author on reasonable request.


Conflict of Interest: There is no conflict of interest in this study.


Consent for publication: Not applicable.


Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki; the study protocol and informed-consent procedures were assessed and approved by Institutional Research Ethics Board of the University of Lahore (UOL/IREB/26/17/03/07), and written informed consent was obtained from all participants. 


Funding: This research does not receive any funding.


Authors' Contribution: SH.S.A conceptualized and designed the study. A.Kh, A.I, I.Z and A.A collected the data. SH.S.A performed the analysis, interpreted the findings, drafted the manuscript, provided supervision and critically reviewed the manuscript for important intellectual content. All authors approved the final version for submission.  

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/ 

Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 26 May 2026

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