The association of self-efficacy and health literacy to chemotherapy self-management behaviors and health service utilization

Relationship between big five personality and health literacy in elderly patients with chronic diseases: the mediating roles of family communication and self-efficacy

The significance of health literacy for elderly individuals with chronic illnesses lies in managing and delaying disease development, which is affected by personal and environmental factors. Family communication can provide an emotional support environment; self-efficacy is an important factor of subjective initiative and personality. A relatively persistent thinking and behavior pattern can affect the environment, subjective initiative, and individual health outcomes. This study aims to explore the effects of the Big Five personality traits on the health literacy of elderly individuals with chronic illnesses and to hypothesize that family communication and self-efficacy mediate the Big Five personalities and health literacy. A cross-sectional study of 2251 elderly individuals with chronic diseases was conducted through nationwide random quota sampling. The structural equation model was used to explore the mediating role of family communication and self-efficacy between the Big Five personality and health literacy. Family communication played a simple mediating role in the influence of extraversion, agreeableness, conscientiousness, and neuroticism on health literacy. Self-efficacy played a simple mediating role in the influence of the Big Five personalities on health literacy. Self-efficacy and family communication played a chain mediating role between extraversion, agreeableness, conscientiousness, neuroticism, and health literacy. Nurses can enhance the health literacy of elderly individuals with chronic illnesses with extraversion, agreeableness, conscientiousness, and neuroticism through family communication and self-efficacy while promoting the health literacy of those with openness through self-efficacy.

Influencing factors of health screening among retirees: an extended TPB approach

Background

Health screenings are promoted worldwide as they help detect and prevent overall health issues. Despite expanding coverage, the participation rate among the retired population has not significantly increased. Given the special role of health screenings in promoting health and healthy aging, understanding the behavioral intentions, and influencing factors of retirees' voluntary participation in health screenings is crucial. This study aims to explore the participation intentions in health screenings among the Chinese retired population by integrating the Theory of Planned Behavior (TPB) and Self-Efficacy (SE).

Methods

This study used a cross-sectional design to conduct an online questionnaire among 311 retirees in 2023. The questionnaire, tailored for the Chinese retired population, combines the TPB theory and Self-Efficacy theory, including demographic structure, the basic structure of TPB, and SE.

Results

A Structural Equation Modeling (SEM) approach was used to identify factors related to health screening behaviors. Of the respondents, 311 completed the survey (88.9% response rate). The most crucial determinant of health examination behavior was behavioral intention, with a correlation score of (1.524, p < 0.001). Significant correlates of behavioral intention included Subjective Norms (SN) and Self-Efficacy (SE), followed by Perceived Behavioral Control (PBC) and Attitude (AT), with correlation scores of (0.401, p < 0.001), (0.339, p < 0.001), (0.082, p < 0.001), and (0.060, p < 0.05), respectively.

Conclusion

This study provides insights for enhancing the willingness and behavior of retirees to participate in health screenings.

Feasibility of Microlearning for Improving the Self-Efficacy of Cancer Patients Managing Side Effects of Chemotherapy

Lung cancer patients have a high symptom burden that negatively affects their quality of life. Increasing patient self-efficacy to deal with treatment side effects can ameliorate their symptom burden. Education programs can help enhance patient self-efficacy by giving patients more control over their condition through increased disease literacy. This study aimed to evaluate the feasibility of microlearning for delivering lung cancer patients' information on side effects of chemotherapy. Secondary objectives of the program are to understand the acceptability of microlearning for delivery this type of education to lung cancer patients and the potential impact of microlearning on patient self-efficacy, knowledge and confidence managing side effects of chemotherapy. A mixed-methods prepost test (or quasi-experimental) study design was used to better enable patients to identify and manage the side effects of their condition and chemotherapy. Participants were patients diagnosed with stage II to stage IV lung cancer, who had a life expectancy of greater than 3 months and were aged 18 years or older. Multiple validated scales were used to assess patient self-efficacy pre- and post-intervention. The online program was evaluated using quantitative data of completion rates extracted from the online platform. Semi-structured interviews were used to explore the impact of the online program on perceived self-efficacy and quality of life. Twenty-three participants agreed to participate in the study and five agreed to complete a semi-structured interview. Participants found the content comprehensive, relevant and engaging. The program improved perceived disease literacy and helped participants develop coping strategies to manage side effects. Participants also found the platform easy to use and navigate. Additional courses and features were requested. Patients with a diagnosis of cancer receive a large amount of information about the side effects of chemotherapy and how to manage them. This information is often provided soon after diagnosis or upon commencement of therapy, which can be overwhelming for some patients. Microlearning, a method of online learning that spaces distributing of content over several weeks, may be a useful tool for supporting delivering of health information to this group of patients.

Clinical action plans make a difference at point-of-care

PURPOSE OF REVIEW

The purpose of this review is to provide an update to and roadmap for the practical implementation of various point-of-care clinical action plans for primary care providers.

RECENT FINDINGS

Clinical action plans were first developed to address unmet, home preventive needs for the management of asthma. Over the past 10 years, the advancement of mobile health technologies, the recognition of at-risk populations, and the development of evidence-based concepts to guide the creation of patient education tools have expanded the implementation of clinical action plans for many diagnoses (e.g., functional constipation, atopic dermatitis, and headache migraines). Poor patient-related clinical outcomes have been linked with low health literacy for many chronic diseases of childhood. This has served as a call to action to improve patient education. Clinical action plans address this gap by facilitating superior knowledge transfer from the medical team in the clinic to the patient/caregiver. The use of clinical action plans can serve as clinical decision support tools for the medical team and has been demonstrated to improve patient adherence to complex therapy regimens.

SUMMARY

Clinical action plans have the potential to improve disease-related self-management confidence, increase pharmacotherapy adherence, and enhance guideline-concordant care. These clinical decision support tools are safe, inexpensive, and represent an advancement in the high-value care model in pediatric medicine.

The burden of a brain tumor: guiding patient centric care in neuro-oncology

PURPOSE

Brain tumor patients report an overwhelming sense of uncertainty when navigating the course of their terminal disease. Historically, organizational experts and/or treating physicians have established neuro-oncology programs. However, given the disease burden and incurable nature of current medical treatments, patient-centric care should be prioritized alongside institutional and academic objectives. Integrating patient perspectives into interdisciplinary programmatic development can improve comprehensive care and empower patients to advocate for their own quality healthcare needs.

METHODS

Data was derived from four focus groups with adult brain tumor patients (N = 15; M_age = 46 years, 53% female). A trained moderator led each 90-min group and posed semi-structured questions regarding patients' care needs throughout their neuro-oncological disease trajectory. Emphasis was placed on quality of life and psychological distress reduction for both patients and their loved ones. Common themes were identified via thematic content analysis using NVivo software. A high inter-rater reliability (M_kappa = 0.92, range= 0.85-0.93) was achieved.

RESULTS

Six distinct themes emerged, where the frequency of each theme ranged from 12.5 to 23.3%. Specifically, patients discussed relational concerns, navigation of interdisciplinary care, neurobehavioral impacts, emotional responses to stressors, existential concerns, and caregiver support. A discussion of themes follows.

CONCLUSIONS

It is imperative that we include the patient perspective in the development of neuro-oncology programs; considering the quality of survival in addition to quantity. Neuro-oncology quality care themes identified were relational concerns, navigating interdisciplinary care, neurobehavioral impact, emotional response to stressors, existential concerns, and caregiver support. A paramount concentration for comprehensive neuro-oncology programs must include patients' quality needs.

Effects of Mobile Application Program (App)-Assisted Health Education on Preventive Behaviors and Cancer Literacy among Women with Cervical Intraepithelial Neoplasia

Objective: This study aimed (1) to study the effects of health education on preventive behaviors and cancer literacy among women with cervical intraepithelial neoplasia (CIN); (2) to compare the effects of mobile application program (App)-assisted health education with traditional book-form health education. Participants: A total of 132 women ages 20 to 69 years women. Methods: This prospective longitudinal study enrolled 132 CIN women who were evaluated three times. Propensity score matching was used by controlling subjects’ age strata, body mass index, education level, occupation, and type of surgery. Results: The influences of various educational tools were investigated. Four domains were assessed, including health behavior, attitude towards behavior change, self-efficacy of behavior, and cervical cancer (CCa) literacy. Significant improvements in behavior change and CCa literacy due to a health education program were observed (p ≤ 0.002). The App combined with a traditional booklet had the highest score for behavior change and was significantly greater than the booklet-only learning (p = 0.002). The App-assisted form, either App alone or combined with booklet, had a significantly better impact on health promotion when compared to the booklet alone (p = 0.045 and 0.005, respectively). App-only learning had the highest score of CCa literacy (p = 0.004). Conclusion: Health education interventions can have positive effects in terms of change of behavior and CCa literacy. App-assisted learning could be used as a supportive technology, and App learning alone or combined with a traditional booklet may be an innovative model of clinical health promotion for women with CIN.