The health literacy scale for Turkey-32 (HLSTR-32)

The HLS-32 was derived from the 47-item European Health Literacy Scale [26, 27] and adapted to the Turkish language in the form of 32 items [28]. HLS-32 differs from the original scale in that it is based not on three, but two basic dimensions, on a 2 × 4 matrix. The scale has 4 options: 1 = Very easy, 2 = Easy, 3 = Hard, 4 = Very Hard. The statement “I don’t know” is coded as 5. Cronbach’s alpha coefficient for the scale was calculated as 0.927 [28]. In the evaluation of the scale, the indices have been standardized on a scale of 0–50, as in the HLS-EU instrument. The formula Index=(mean-1) x (50/3) was used for this. In this formula, the index is the index calculated unique to the individual and the mean refers to the mean of each item the individual responds to. The calculation provides a reading that indicates health literacy, 0 representing the lowest level of health literacy and 50 the highest. Scores of 0–25 signify an inadequate level of health literacy; >25–33, a level of problematic-limited, > 33–42, an adequate level; and > 42–50, excellent health literacy [26, 27]. The Cronbach alpha coefficient of the scale in this study was calculated as 0.978.