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Dikeç G, Bilaç Ö, Işleyen Sonkaya H, Aydemir Ö. Development of the medical adherence scale in adolescents using psychotropic medication and evaluation of validity and reliability in Turkish population. J Pediatr Nurs 2024; 78:118-123. [PMID: 38917613 DOI: 10.1016/j.pedn.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 06/15/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE Although treatment non-adherence is relatively high among adolescents, there is a need for standardized measurement tools that measure adherence to treatment in adolescents. This study aimed to develop a new measurement tool to assess the adherence to treatment of adolescents with mental disorders who use psychotropic medication. METHODS The data of this methodologically designed study were collected between 01.04.2022 and 01.07.2023 in the Department of Child and Adolescent Psychiatry of a university hospital in the Aegean Region of Turkey. The Medication Adherence Reporting Scale and Adolescent Medical Adherence Scale draft form were used for data collection. The scale items were formed from the themes, sub-themes, and statements in the qualitative study that the researchers had conducted with adolescents with mental disorders and their parents, clinicians' experiences, and systematic reviews and meta-synthesis in the literature. The study sample consisted of 95 adolescents with mental disorders. Exploratory factor analysis was performed with Varimax rotation to determine the factorial construct validity of the scale. Internal consistency analyses were performed in reliability analyses, and Cronbach's alpha coefficient was used. RESULTS The mean age of the adolescents was 14.18 years (1.81); 50.5% were male, and 96.8% were attending school. When the mental disorder diagnoses were analyzed, 65.3% of the adolescents were being followed up with Attention Deficit and Hyperactivity Disorder diagnoses, and 58.8% were using stimulants. The 12-item form of the Adolescent Medical Adherence Scale was found to have a three-factor structure with item-total correlation values ranging between 0.26 and 0.66, and these factors were named functionality, responsibility in treatment, and medication adherence. Factor loadings ranged between 0.44 and 0.86, and the items explained 62.98% of the total variance. The internal consistency coefficients of the scale were between 0.69 and 0.83 for the subscales and 0.82 for the total scale. CONCLUSION Based on the analysis and results used in this study, the Adolescent Medical Adherence Scale is a valid and reliable new measurement tool. PRACTICE IMPLICATIONS This tool can be used in clinical settings to evaluate adolescents' treatment adherence and prognosis. Clinical studies conducted with adolescents can also determine adherence to treatment and affecting factors.
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Affiliation(s)
- Gül Dikeç
- Fenerbahce University, Faculty of Health Sciences, Department of Nursing, Istanbul, Turkey.
| | - Öznur Bilaç
- Department of Child and Adolescent Psychiatry, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Hilal Işleyen Sonkaya
- Department of Child and Adolescent Psychiatry, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Ömer Aydemir
- Department of Psychiatry, Celal Bayar University Faculty of Medicine, Manisa, Turkey
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Mody M, Hodges AN, Gibson KE, Mantey J, Gontjes KJ. Does high school health education class satisfaction influence student perceptions of public health and pandemic response? Am J Infect Control 2024; 52:719-725. [PMID: 38253288 DOI: 10.1016/j.ajic.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND The COVID-19 pandemic significantly affected high school students. Little is known about the mediators of student perceptions of infection prevention and public health entities. We piloted a survey to evaluate the relationship between student perceptions of COVID-19 topics and satisfaction with their most recent health class. METHODS Students from one private high school in southeast Michigan completed a survey in early 2022. The primary outcomes were 4 domains: vaccination knowledge, intervention effectiveness, intervention impact, and willingness to readopt an intervention. We assessed the associations between health class satisfaction and these outcomes using multiple linear regression. RESULTS One-hundred ninety students reported their health class satisfaction and were eligible for analysis. Students reported high confidence in vaccines (93%) but limited knowledge of COVID-19 vaccination (45%). Students perceived COVID-19 interventions as highly effective (range, 72% [hand hygiene]-93% [vaccination]) and reported a willingness to readopt them (range, 73% [stay-at-home orders]-96% [vaccination]). Health class satisfaction (54%) was positively associated with composite scores on vaccination knowledge and intervention effectiveness. DISCUSSION Assessing students' intrapandemic perspectives on infection prevention illuminated areas of strength (ie, intervention confidence) and areas for improvement (ie, intervention knowledge and institutional confidence). CONCLUSIONS Students reported favorable perceptions regarding common infection prevention interventions. Future work should investigate the role of educational satisfaction in mediating confidence in public health interventions and institutions.
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Affiliation(s)
- Malay Mody
- Ross University School of Medicine, Bridgetown, Barbados
| | - Asia N Hodges
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Gainesville, FL
| | - Kristen E Gibson
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI; Department of Internal Medicine, Center for Research and Innovations in Special Populations, University of Michigan Medical School, Ann Arbor, MI
| | - Julia Mantey
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI; Department of Internal Medicine, Center for Research and Innovations in Special Populations, University of Michigan Medical School, Ann Arbor, MI
| | - Kyle J Gontjes
- Department of Internal Medicine, Center for Research and Innovations in Special Populations, University of Michigan Medical School, Ann Arbor, MI; Department of Microbiology & Immunology, University of Michigan Medical School, Ann Arbor, MI.
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Zhu X, Wen M, He Y, Feng J, Xu X, Liu J. The Relationship Between Level of Education, Cognitive Function and Medication Adherence in Patients with Schizophrenia. Neuropsychiatr Dis Treat 2023; 19:2439-2450. [PMID: 38029047 PMCID: PMC10657742 DOI: 10.2147/ndt.s424694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Several studies have explored the relationship between level of education and medication adherence, as well as the relationship between level of education and cognitive function. However, there have been few studies on the relationships between level of education, cognitive function, and medication adherence. This study aimed to explore whether cognitive function has a mediating effect between level of education and medication adherence in patients with schizophrenia. Patients and Methods A total of 329 participants were included in this study. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia, and medication adherence using the Medication Adherence Questionnaire. The relationships between the clinical factors and cognitive function that contributed to medication adherence were tested through multivariable linear regression analysis. The mediating effect of medication adherence was tested using the bootstrapping approach with the PROCESS macro. Results Family history, insight and executive function were associated with medication adherence in individuals with schizophrenia, and executive function had a mediating effect between level of education and medication adherence. Conclusion Adopting specific education programs that promote cognitive development as well as actively intervening in executive function might be conducive to improve medication adherence in patients with schizophrenia.
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Affiliation(s)
- Xiaodan Zhu
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Min Wen
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Ying He
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Jing Feng
- Inpatient Department, Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia, People’s Republic of China
| | - Xuebing Xu
- Inpatient Department, Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia, People’s Republic of China
| | - Juan Liu
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
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Bierut LJ, Hendershot TP, Benowitz NL, Cummings KM, Mermelstein RJ, Piper ME, Vrieze SI, Wagener TL, Nelms MD, Ives C, Maiese D, Hamilton CM, Swan GE. Smoking cessation, harm reduction, and biomarkers protocols in the PhenX Toolkit: Tools for standardized data collection. ADDICTION NEUROSCIENCE 2023; 7:100081. [PMID: 38645895 PMCID: PMC11027214 DOI: 10.1016/j.addicn.2023.100081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The use of standard protocols in studies supports consistent data collection, improves data quality, and facilitates cross-study analyses. Funded by the National Institutes of Health, the PhenX (consensus measures for Phenotypes and eXposures) Toolkit is a catalog of recommended measurement protocols that address a wide range of research topics and are suitable for inclusion in a variety of study designs. In 2020, a PhenX Working Group of smoking cessation experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in smoking cessation and smoking harm reduction studies. The broader scientific community was invited to review and provide feedback on the preliminary recommendation of the Working Group. Fourteen selected protocols for measuring smoking cessation, harm reduction, and biomarkers research associated with smoking cessation were released in the PhenX Toolkit ( https://www.phenxtoolkit.org) in February 2021. These protocols complement existing PhenX Toolkit content related to tobacco regulatory research, substance use and addiction research, and other measures of smoking-related health outcomes. Adopting well-established protocols enables consistent data collection and facilitates comparing and combining data across studies, potentially increasing the scientific impact of individual studies.
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Affiliation(s)
- Laura Jean Bierut
- Department of Psychiatry, Washington University School of Medicine of St. Louis, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA
| | - Tabitha P. Hendershot
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Neal L. Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Megan E. Piper
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
| | - Scott I. Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Theodore L. Wagener
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Mark D. Nelms
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Cataia Ives
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Deborah Maiese
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Carol M. Hamilton
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Gary E. Swan
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Guo C, Cui Y, Xia Z, Hu J, Xue Y, Huang X, Wan Y, Fang J, Zhang S. Association between health literacy, depressive symptoms, and suicide-related outcomes in adolescents: A longitudinal study. J Affect Disord 2023; 327:15-22. [PMID: 36707037 DOI: 10.1016/j.jad.2023.01.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Health literacy is associated with mental disorders in adolescents. This study aimed to examine the associations between health literacy, depressive symptoms, and suicide-related outcomes. METHODS In terms of participants, 937 middle school students in Shenyang City, China were enrolled between December 2018 and December 2019 to assess health literacy, depressive symptoms and suicide-related outcomes. Multiple logistic regression models were used to examine possible associations. RESULTS Adequate health literacy was negatively associated with 12-month follow-up depressive symptoms (RR = 0.115, 95 % CI: 0.032-0.411) and suicide-related outcomes (RR = 0.230, 95 % CI: 0.085-0.618) in females. Meanwhile, in females, interpersonal relationship, stress management, and self-actualization were negatively related to depressive symptoms, while physical activities, self-actualization, and health awareness are protective factors for suicide-related outcomes (P < 0.05 for each). LIMITATIONS Recall and reporting bias might be inevitable for self-reported data, and due to the small sample size, the predictive effect may not be very significant. CONCLUSIONS These findings suggest that adequate health literacy may serve as a critical and independent protective factor for poor long-term mental health outcomes and that the predictive effect is more pronounced in female students. Public health efforts to enhance health literacy levels are required to maintain and improve adolescents' mental health outcomes.
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Affiliation(s)
- Chunyu Guo
- Department of Microbiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan; Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Department of Toxicology, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yingying Cui
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Department of Toxicology, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Zhengmei Xia
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Department of Toxicology, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Jie Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yanni Xue
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xuexue Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Jun Fang
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Department of Toxicology, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto 860-0082, Japan.
| | - Shichen Zhang
- School of Public Health and Health Management, Anhui Medical College, No 632 Furong Road, Hefei 230601, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei 230032, Anhui, China.
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Bae EJ, Jang AR, Park H, Yoon JY. Investigating knowledge structure and research trends in child and adolescent health literacy research through network text analysis. J Pediatr Nurs 2022; 67:57-63. [PMID: 35952487 DOI: 10.1016/j.pedn.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aims to investigate the knowledge structure and research trends in child and adolescent health literacy research over the past 30 years by using network text analysis. METHOD The study was conducted in four steps: 1) collecting abstracts, 2) keyword extraction and preprocessing, 3) creation of co-occurrence matrix, and 4) text network analysis. RESULTS As a result of the centrality analysis, the upper-ranked core keywords were "health care," "health behavior," "prevention," "treatment," and "health promotion." In contrast to earlier times, "barrier," "caregiver," "school setting," and "QOL" have recently emerged as core keywords. CONCLUSIONS Over the past 30 years, child and adolescent health literacy has been importantly addressed in both clinical and public health approaches. The results of the current study provide references for future research in child and adolescent health literacy. IMPLICATION FOR PRACTICE AND RESEARCH This study suggests the need for additional research on school-based practices that can improve health literacy and for identifying validated and reliable multidimensional health literacy assessment instruments.
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Affiliation(s)
- Eun Jung Bae
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ah Ram Jang
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Hyena Park
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, Republic of Korea; Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea; Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Republic of Korea.
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Ewig CL, Wong KS, Chan PH, Leung TF, Cheung YT. Chronic Medication Use and Factors Associated With Polypharmacy Among Outpatient Pediatric Patients. J Pediatr Pharmacol Ther 2022; 27:537-544. [PMID: 36042954 PMCID: PMC9400180 DOI: 10.5863/1551-6776-27.6.537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 01/23/2022] [Indexed: 02/05/2024]
Abstract
OBJECTIVE This study aimed to determine the prevalence and predictors of chronic polypharmacy among pediatric patients in an outpatient setting. METHODS We conducted a review of medications dispensed to patients from an outpatient pediatric facility during a 12-month period. Patients who received chronic medications (≥30 days' supply), which contained at least 1 active pharmaceutical ingredient were included in the study. Descriptive analysis was used to determine prevalence of polypharmacy while predictive factors for polypharmacy were evaluated using logistic regression. RESULTS Our study included 3920 patients (median age, 9.9 years; IQR, 9.4) and 16,401 medications. The median number of chronic medications used among our study cohort was 2.0 (IQR, 1) with polypharmacy identified in 309 (7.9%) patients. Predictors for polypharmacy were age and the use of certain therapeutic class of medications. Patients 12 to <19 years old (OR, 6.95; 95% CI, 4.1-10.1) were more likely to require ≥5 concurrent medications compared with patients younger than 2 years of age. Use of calcium supplements (OR, 21.2; 95% CI, 11.3-39.6), Vitamin D analogues (OR, 14.3; 95% CI, 8.0-25.8), and systemic glucocorticoids (OR, 18.8; 95% CI, 10.7-33.2) were also highly associated with polypharmacy. CONCLUSIONS Adolescents and children with chronic medical conditions who require prolonged systemic glucocorticoids, calcium, and Vitamin D supplements are at higher risk of incurring long-term polypharmacy. This subgroup of pediatric patients may be more vulnerable to the occurrence of negative outcomes resulting from the use of multiple chronic medications.
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Affiliation(s)
- Celeste L.Y. Ewig
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida (CE)
| | - Kai Sang Wong
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong (KSW, PHC, YTC)
| | - Pak Hei Chan
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong (KSW, PHC, YTC)
| | - Ting Fan Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (TFL)
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong (KSW, PHC, YTC)
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Rostamian S, le. Cessie S, Marijt KA, Jukema JW, Mooijaart SP, van Buchem MA, van Hall T, Gussekloo J, Trompet S. Association of cognitive function with increased risk of cancer death and all-cause mortality: Longitudinal analysis, systematic review, and meta-analysis of prospective observational studies. PLoS One 2022; 17:e0261826. [PMID: 34995287 PMCID: PMC8741047 DOI: 10.1371/journal.pone.0261826] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022] Open
Abstract
Background Disturbed cognitive function is associated with several causes of mortality; however, the association between cognitive function and the risk of cancer death has not been extensively investigated yet. We aimed to evaluate the association of cognitive function with the risk of cancer death and all-cause mortality in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) and Leiden 85-plus Study. Additionally, a systematic review and meta-analysis of longitudinal studies were conducted to evaluate the association of cognitive function and risk of cancer death. Methods Risk of cancer death and all-cause mortality were reported using hazard ratios (HRs) with 95% confidence interval (CI) in tertiles of cognitive function of PROSPER and Leiden85-Plus Study. Additionally, PubMed, Embase, Web of Science, Cochrane, PsycINFO, Academic Search Premier, CINHAL, and Emcare were searched up to November 1st, 2020 to perform a systematic review and meta-analysis. The relative risks (RRs) with 95%CI of cancer death per each standard deviation lower performance in cognitive measurements were calculated. Results Participants of PROSPER had 1.65-fold (95%CI 1.11–2.47) greater risk of cancer death (P for trend = 0.016) and 1.85-fold (95%CI 1.46–2.34) higher risk of all-cause mortality (P for trend<0.001), in multivariable models. Results of the Leiden-85 Plus Study showed that subjects with MMSE score below 24 had a lower chance of cancer death (HR 0.79, 95%CI 0.36–1.70, P for trend = 0.820) but had 2.18-fold (95%CI 1.57–3.02) higher risk of all-cause mortality compared to the reference group (P for trend<0.001). Besides, the results of systematic review and meta-analysis showed that per each standard deviation lower performance in cognitive function, individuals were at a 10% higher chance of cancer death (RR 1.10, 95%CI 1.00–1.20, P-value = 0.044). Conclusions Lower cognitive function performance is associated with a marginally increased risk of cancer death, in line with a significantly greater risk of all-cause mortality.
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Affiliation(s)
- Somayeh Rostamian
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Medicine, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Saskia le. Cessie
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Koen A. Marijt
- Department of Clinical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Simon P. Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mark A. van Buchem
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Thorbald van Hall
- Department of Clinical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jacobijn Gussekloo
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Stella Trompet
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
- * E-mail:
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Parizek RA. Health Literacy Does Not Protect Against Underage Alcohol Use During the COVID-19 Pandemic. J Psychosoc Nurs Ment Health Serv 2021; 59:13-21. [PMID: 34432596 DOI: 10.3928/02793695-20210819-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Limited health literacy (HL) and alcohol use increase teens' risk for preventable disease burden and adverse outcomes. In the current study, relationships between HL and alcohol use were explored in 39 secondary school students sheltering-at-home during the coronavirus disease 2019 pandemic. HL was assessed using the Newest Vital Sign. Alcohol use was assessed with questions from the Youth Risk Behavior Survey (YRBS). Most students (76.9%) had adequate HL. Males had higher HL than females. Many teens (42.9%) reported drinking and recent alcohol use (18.2%). Drunk driving and riding with someone under the influence were comparable to the YRBS. Lifetime and recent alcohol use and positive alcohol expectancies were comparable among teens with adequate and limited HL. More teens with adequate HL had negative expectancies. Only teens with adequate HL reported recent binge drinking (10.3%), drunk driving (10.5%), or riding with someone under the influence (17.9%). Adequate HL does not protect teens from alcohol use and misuse. [Journal of Psychosocial Nursing and Mental Health Services, 59(12), 13-21.].
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Sheerin F, Eustace-Cook J, Wuytack F, Doyle C. Medication management in intellectual disability settings: A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:242-276. [PMID: 31735106 DOI: 10.1177/1744629519886184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There is a high level of medication usage among people with intellectual disability due to the presence of significant morbidity and co-morbidities. This review sought to explore medication management and administration in intellectual disability settings, identifying frameworks for practice, analysing whether collaborative practice led to better outcomes, identifying key processes associated with practice, locating tools to support practice and describing metrics for outcome measurement. A systematic review was conducted with analysis of 64 sources which remained following screening and appraisal. Limited evidence was identified with some insight into the processes underpinning medication management and administration. No assessment tools were found, but two potential outcome measures, adherence and errors, were noted. The paucity of guidelines and frameworks is concerning as this is a complex area of practice. There is a need for further practice development and research to be undertaken that takes note of the unique issues that can present in intellectual disability settings.
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Affiliation(s)
- Fintan Sheerin
- University of Dublin, 214057Trinity College Dublin, Ireland
| | | | | | - Carmel Doyle
- University of Dublin, 214057Trinity College Dublin, Ireland
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Ozturk Haney M. Health Literacy and Predictors of Body Weight in Turkish Children. J Pediatr Nurs 2020; 55:e257-e262. [PMID: 32553474 DOI: 10.1016/j.pedn.2020.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE This study assessed the association between health literacy (both of children and their parents) and body weight in Turkish schoolchildren. This study also aimed to determine the predictors of body weight in children. DESIGN AND METHODS This was a descriptive, correlational study that enrolled students and their parents from Turkish secondary schools. Data were collected using the Health Literacy Scale for School-Aged Children, Adult Health Literacy Scale, socio-demographic questionnaires and anthropometric measurements. RESULTS The mean child age was 12.76 ± 1.27; 40.2% were male, 41.5% had higher health literacy and 17.2% were obese. Child health literacy did not correlate with body mass index (r = 0.04, p > 0.05), but correlated positively with parent health literacy (r = 0.17, p < 0.05). Parent body mass index was the only explanatory variable in child body mass index. CONCLUSIONS Obesity in schoolchildren correlates with parental obesity. The results showed parents should participate in practising strategies that aim to prevent and treat childhood obesity. PRACTICE IMPLICATIONS Children's health literacy skills can be improved to develop their health and academic achievements.
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Affiliation(s)
- Meryem Ozturk Haney
- Public Health Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey.
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12
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Stirling J. Understanding Medical Neglect: When Needed Care Is Delayed or Refused. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:271-276. [PMID: 33088383 PMCID: PMC7561645 DOI: 10.1007/s40653-019-00260-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Though the most common form of child maltreatment, neglect can prove among the hardest to diagnose, and intervention is equally difficult. In considering neglect of a child's medical needs, a number of factors play important roles. Diagnosis should be motivated foremost by the intent of providing the best ongoing care for the patient, supplying what the child has not been able to receive from the caregiver. Characteristics peculiar to the patient, the parents, the pathologic condition, its possible treatments, and the mutual understanding between the child's caregivers and the treating professionals all help determine why the therapeutic relationship has failed and which interventions will be most effective. Religious and cultural considerations may lead a family to refuse medical treatments, occasionally to the child's detriment. The caregivers' wishes must be taken into account, but legal precedent has affirmed that the patient's welfare remains the paramount concern. Sorting through the opinions and providing clarity can be a challenge. Finally, good medical care can help prevent medical neglect in many cases. Clear communication and empathy remain hallmarks of good medical practice.
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Affiliation(s)
- John Stirling
- Chadwick Center for Children and Families, Rady Children’s hospital, 3665 Kearney Villa Rd, San Diego, CA 92123 USA
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Lindly O, Crossman M, Eaves M, Philpotts L, Kuhlthau K. Health Literacy and Health Outcomes Among Children With Developmental Disabilities: A Systematic Review. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:389-407. [PMID: 32936893 DOI: 10.1352/1944-7558-125.5.389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 12/07/2019] [Indexed: 06/11/2023]
Abstract
Developmental disabilities (DDs) are prevalent and associated with health disparities among children. Family health literacy of parents and/or children is one modifiable factor associated with child health; however, little is known about family health literacy for children with DDs. This systematic review was conducted to determine evidence on associations of health literacy with health outcomes among children with DDs. Medline, CINAHL, Embase, ERIC, PsycInfo, and Web of Science were searched through August 2018. Of 2,768 unique records, 53 full text articles were reviewed and four articles were included. Associations of family health literacy with health outcomes among children with DDs were mixed. Future research should include more diverse samples, greater breadth in health outcomes assessed, and increased methodological rigor.
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Affiliation(s)
| | | | | | | | - Karen Kuhlthau
- Karen Kuhlthau, Massachusetts General Hospital & Harvard Medical School
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14
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Song X, Li D, Hu J, Yang R, Wan Y, Fang J, Zhang S. Moderating Role of Health Literacy on the Association between Alexithymia and Depressive Symptoms in Middle School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155321. [PMID: 32721998 PMCID: PMC7432623 DOI: 10.3390/ijerph17155321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/17/2020] [Accepted: 07/18/2020] [Indexed: 12/11/2022]
Abstract
Depression is a common psychological problem in adolescents. At present, few studies have described the moderating role of health literacy on the association between alexithymia and depressive symptoms among adolescents. The purpose of this study was to explore the relation among health literacy, alexithymia, and depressive symptoms and the moderating role of health literacy in middle school students. In December 2017, data were collected from a school in Shenyang by the convenient sampling method using a questionnaire including demographic information, health literacy, alexithymia, and depressive symptoms. A total of 1068 junior and senior high school students were selected as subjects, and 1062 valid questionnaires were retained for analysis. Logistic regression models were used to examine the association between health literacy and alexithymia with depressive symptoms. The prevalence of depressive symptoms was 48.2%, and the prevalence of alexithymia was 17.9%. Low health literacy was significantly associated with depressive symptoms (odds ratio (OR) (95% confidence interval (CI)) = 3.648 (2.493–5.338)). Alexithymia was significantly correlated with depressive symptoms (OR (95% CI) = 3.091 (2.156–4.429)). Low health literacy was related to a greater increase in the risk of depressive symptoms for students with alexithymia (OR (95% CI) = 10.566 (5.175–21.570)). The findings suggest that alexithymia and health literacy are important factors influencing depressive symptoms and health literacy has a moderating role on the association between alexithymia and depressive symptoms. Enhancing health literacy of middle school students with alexithymia may improve their mental health.
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Affiliation(s)
- Xianbing Song
- Department of Human Anatomy, Histology & Embryology, Anhui Medical College, Hefei 230032, China;
| | - Danlin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; (D.L.); (J.H.); (R.Y.); (Y.W.)
- MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Jie Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; (D.L.); (J.H.); (R.Y.); (Y.W.)
- MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Rong Yang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; (D.L.); (J.H.); (R.Y.); (Y.W.)
- MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; (D.L.); (J.H.); (R.Y.); (Y.W.)
- MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Jun Fang
- MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
- Faculty of Pharmaceutical Science, Sojo University, Kumamoto 860-0082, Japan
- Correspondence: (J.F.); (S.Z.)
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China; (D.L.); (J.H.); (R.Y.); (Y.W.)
- MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
- Correspondence: (J.F.); (S.Z.)
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Gupta A, Wood M, Kumar S, Misra S, Turner T. No Faculty Required: Use of a Health Literacy Low Inference Self-Assessment Measure to Promote Behavior Change. Acad Pediatr 2020; 20:712-720. [PMID: 32087380 DOI: 10.1016/j.acap.2020.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/07/2020] [Accepted: 02/16/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine if use of a health literacy low-inference, self-assessment measure (LISAM), promoted behavior change as measured by increased use of health literacy communication skills (HLCS). METHODS The LISAM is a tool used by educators to self-assess their performances after giving a lecture. The tool is low inference because it self-assesses behaviors that are specific, with little room for subjectivity. Forty-four third-year medical students self-assessed HLCS using a LISAM modified to include health literacy communication skills (LISAM-HLCS). Self-assessment followed participation in an audio recorded, standardized patient encounter and again after listening to the recording. Students also created 3 written goals for improvement. This session was repeated 1 week later. RESULTS At Session 2, 71.4% of students met at least 2 of their 3 self-created objectives. The 3 most commonly created objectives were using teach-back, asking more open ended questions, and obtaining patient input into the management plan. Use of the LISAM increased HLCS use at Session 2 versus Session 1 as assessed by both students and study investigators (P < .05). CONCLUSIONS Without faculty present, students met and adjusted objectives, catalyzing changes in HLCS. The LISAM-HLCS has the potential to empower students to improve communication skills and to reduce dependence on faculty observations.
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Affiliation(s)
- Aditi Gupta
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital (A Gupta, M Wood, S Kumar, S Misra, and T Turner), Houston, Tex.
| | - Margaret Wood
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital (A Gupta, M Wood, S Kumar, S Misra, and T Turner), Houston, Tex
| | - Shelley Kumar
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital (A Gupta, M Wood, S Kumar, S Misra, and T Turner), Houston, Tex; Center for Research, Innovation and Scholarship in Medical Education, Texas Children's Hospital (S Kumar and T Turner), Houston, Tex
| | - Sanghamitra Misra
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital (A Gupta, M Wood, S Kumar, S Misra, and T Turner), Houston, Tex
| | - Teri Turner
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital (A Gupta, M Wood, S Kumar, S Misra, and T Turner), Houston, Tex; Center for Research, Innovation and Scholarship in Medical Education, Texas Children's Hospital (S Kumar and T Turner), Houston, Tex
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16
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Cheng L, Chen Q, Zhang FY, Wu W, Cui W, Hu X. Functional health literacy among left-behind students in senior high schools in an ethnic minority area: A cross-sectional study. Medicine (Baltimore) 2020; 99:e19167. [PMID: 32080095 PMCID: PMC7034664 DOI: 10.1097/md.0000000000019167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 12/07/2019] [Accepted: 01/11/2020] [Indexed: 02/05/2023] Open
Abstract
To verify the validity of functional health literacy scale and analyze what influences functional health literacy.Using convenience sampling method based on cross-sectional data to select 589 left-behind senior high-school students in an ethnic minority area, using the functional health literacy scale.The scale results were relatively strong, and the absolute fitness index, value-added fitness index, and simple fitness index reached the fitness standards. The overall functional health literacy score was (0.65 ± 0.12), which falls within the upper middle class. Gender(t = 2.40, P < .05), ethnicity (t = 4.28, P < .001), place of residence (t = = 4.51, P < .001), mother's education level (F = 3.608, P < .05), self-assessment of grades for 1 year (F = 25.781, P < .001), and whether the participant liked the health education content (F = 9.416, P < .001) had impacts on overall functional health literacy.The study results show that relatively satisfactory reliability and validity and can be applied further analysis for improving students functional health literacy levels.
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Affiliation(s)
- Linan Cheng
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Qian Chen
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Feng ying Zhang
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Wenwen Wu
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Wenxiang Cui
- Wenxiang Cui, School of Nursing Yanbian University, Yanji, China
| | - Xiuying Hu
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
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17
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Ritter A, Ilakkuvan V. Reassessing health literacy best practices to improve medication adherence among patients with dyslexia. PATIENT EDUCATION AND COUNSELING 2019; 102:2122-2127. [PMID: 31174951 DOI: 10.1016/j.pec.2019.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/09/2019] [Accepted: 05/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Dyslexia is characterized as unexpected and persistent difficulty in reading. In addition to language-based deficits, evidence indicates that people with dyslexia may struggle with tasks related to memory and executive function. This discussion paper explores how these non-linguistic deficits could plausibly affect medication adherence among patients with dyslexia. DISCUSSION There is a dearth of original research literature exploring the intersection of dyslexia and health behaviors in the United States. The authors examine selected best practices from the field of health literacy with potential to improve medication adherence among patients with dyslexia and suggest areas for further research on the intersection of dyslexia, health literacy and medication adherence. CONCLUSION Dyslexia is a high-prevalence condition. Patients with dyslexia may be more likely to experience challenges when learning and implementing complex, multi-step health behaviors, such as the tasks associated with medication adherence. However, there has been no research to assess the specific needs of patients with dyslexia, or design interventions to meet those needs. Foundational research is necessary to develop a health communications framework that meets the needs of these neurodiverse patients.
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Affiliation(s)
- Ann Ritter
- George Washington University, Milken Institute School of Public Health, Washington, DC USA; LARK Consulting, New York, NY USA.
| | - Vinu Ilakkuvan
- George Washington University, Milken Institute School of Public Health, Washington, DC USA.
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Li D, Yang R, Wan Y, Tao F, Fang J, Zhang S. Interaction of Health Literacy and Problematic Mobile Phone Use and Their Impact on Non-Suicidal Self-Injury among Chinese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132366. [PMID: 31277342 PMCID: PMC6651006 DOI: 10.3390/ijerph16132366] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/30/2019] [Accepted: 06/30/2019] [Indexed: 11/18/2022]
Abstract
Non-suicidal self-injury (NSSI) is prevalent among adolescents. Low health literacy (HL) and problematic mobile phone use (PMPU) are risk factors of NSSI. But so far, no study has examined the interactive role of HL and PMPU on NSSI. In this context, the present study aimed to examine the interactions of HL and PMPU and their impact on NSSI in a school-based sample of Chinese adolescents. A total of 22,628 junior and high school students (10,990 males and 11,638 females) were enrolled in this study. The outcomes were self-reported HL, PMPU and NSSI. Analyses were conducted with chi-square tests and logistic regression models. The prevalence of NSSI was 32.1%. Low HL and PMPU were significantly associated with NSSI independently (ORlow HL = 1.886, 95% CI = 1.723–2.065, ORPMPU = 2.062, 95% CI = 1.934–2.199). Interaction analysis indicated that low HL and PMPU were interactively associated with increased risks of NSSI (OR = 2.617, 95% CI = 2.375–2.884). In all, our findings indicate that HL and PMPU are associated with NSSI independently and interactively. The intervention programs of NSSI should consider the adolescents HL levels and PMPU.
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Affiliation(s)
- Danlin Li
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032, Hefei, Anhui Province, China
| | - Rong Yang
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032, Hefei, Anhui Province, China
| | - Yuhui Wan
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032, Hefei, Anhui Province, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, Hefei 230032, Anhui Province, China
| | - Fangbiao Tao
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032, Hefei, Anhui Province, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, Hefei 230032, Anhui Province, China
| | - Jun Fang
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, Hefei 230032, Anhui Province, China.
- Department of Toxicology, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui Province, China.
- Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto 860-0082, Japan.
| | - Shichen Zhang
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032, Hefei, Anhui Province, China.
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, Hefei 230032, Anhui Province, China.
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19
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Abstract
UNLABELLED ABSTRACTBackground:Adherence to treatment is a primary determinant of treatment success. Caregiver support can influence medication adherence in people with cognitive impairment. This study sought to characterize medication adherence in older people with dementia from the caregivers' perspective, and to identify influencing factors. METHODS Caregivers caring for a person with dementia and living in the community were eligible to complete the survey. Bayesian profile regression was applied to identify determinants of medication adherence measured using the Adherence to Refills and Medication Scale. RESULTS Out of the 320 caregivers who participated in the survey, Bayesian profile regression on 221 participants identified two groups: Profile 1 (55 caregivers) with a mean adherence rate of 0.69 (80% Credible Interval (CrI): 0.61-0.77), and Profile 2 (166 caregivers) with a mean adherence rate of 0.80 (80% CrI: 0.77-0.84). Caregivers in Profile 1 were characterized with below data average scores for the following: cognitive functioning, commitment or intention, self-efficacy, and health knowledge, which were all above the data average in Profile 2, except for health knowledge. Caregivers in Profile 1 had a greater proportion of care recipients taking more than five medications and with late-stage dementia. Trade, technical, or vocational training was more common among the caregivers in Profile 1. Profile 2 caregivers had a better patient-provider relationship and less medical problems. CONCLUSIONS Bayesian profile regression was useful in understanding caregiver factors that influence medication adherence. Tailored interventions to the determinants of medication adherence can guide the development of evidence-based interventions.
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Keim-Malpass J, Doede A, Showalter SL. Does patient health literacy impact adherence to adjuvant endocrine therapy in breast cancer patients? Patient Prefer Adherence 2019; 13:47-51. [PMID: 30636869 PMCID: PMC6309015 DOI: 10.2147/ppa.s190249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Functional health literacy is critical for patients' functional understanding and management of disease including adherence to medications and treatment recommendations. The purpose of this study was to determine if there is a relationship between self-reported health literacy and 1) decision to take adjuvant endocrine therapy and 2) adherence to adjuvant endocrine therapy at 2 years among women with breast cancer. METHODS We initiated a prospective health literacy assessment to determine the relationship between health literacy and breast health outcomes. Among our overall cohort, we determined women who had estrogen receptor positive (ER+) disease and were recommended to take adjuvant endocrine therapy, those who initiated treatment, and those adherent at 2 years following diagnosis. Descriptive statistics and logistic regression were calculated to determine the relationship between health literacy and both initiation and adherence. RESULTS Among the 340 patients in the sample who were recommended to take adjuvant endocrine therapy, 296 (87.1%) initiated the therapy. Two-year follow-up data are available in 136 patients with ER+ tumors. Among the patients with 2-year longitudinal data available, 108 (79.4%) were adherent and still taking the endocrine therapy at 2 years following diagnosis. In univariate logistic regression analysis, there was no statistical significance between health literacy and initiation of adjuvant endocrine therapy or adherence to adjuvant endocrine therapy at 2 years. CONCLUSION Despite the underpinnings regarding health literacy and medication adherence supporting our hypothesis, we did not find an association between health literacy and the decision to initiate therapy or continued adherence at 2 years following diagnosis. Further study is needed to determine the nuances in adherence to adjuvant endocrine therapy for women with breast cancer.
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Affiliation(s)
- Jessica Keim-Malpass
- Department of Acute and Specialty Care, University of Virginia School of Nursing, Charlottesville, VA 22908, USA,
| | - Aubrey Doede
- Department of Acute and Specialty Care, University of Virginia School of Nursing, Charlottesville, VA 22908, USA,
| | - Shayna L Showalter
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
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21
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Adolescent health literacy and health behaviors: A systematic review. J Adolesc 2018; 62:116-127. [DOI: 10.1016/j.adolescence.2017.11.010] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 10/12/2017] [Accepted: 11/17/2017] [Indexed: 12/18/2022]
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Valerio MA, Peterson EL, Wittich AR, Joseph CLM. Examining health literacy among urban African-American adolescents with asthma. J Asthma 2016; 53:1041-7. [PMID: 27359106 PMCID: PMC5056364 DOI: 10.1080/02770903.2016.1175473] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 03/31/2016] [Accepted: 04/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This exploratory study assessed health literacy among urban African-American high school students to improve understanding of the association between adolescent health literacy and asthma. METHODS We conducted a secondary data analysis of the control group (n = 181) of the Puff City randomized controlled trial (2006-2010), a web-based intervention to promote asthma management among students, grades 9 through 12. A validated self-report 3-item health literacy screening instrument was completed at final online follow-up survey. Logistic regression was used to explore the association between health literacy, demographic characteristics, quality of life, asthma management, and health care utilization. RESULTS Multivariate analysis revealed that an overall inadequate health literacy score was associated with students who were more likely to be younger (OR 0.61; 95% CI 0.44-0.84), not on Medicaid (OR 0.36; 95% CI 0.17-0.76), have at least one hospitalization (OR 1.29; 95% CI 1.07-1.56); and a lower overall quality of life (OR 0.75; 95% CI 0.59-0.95). Those lacking confidence in filling out medical forms, needing help reading hospital materials, and having difficulty understanding written information were more likely to not have a rescue inhaler (OR 0.49; 95% CI 0.25-0.94), have one or more emergency visits (OR 1.21 95% CI 1.02-1.43), and one or more hospitalizations (OR 1.19; 95% CI 1.01-1.41), respectively. CONCLUSIONS The findings indicate a significant association between inadequate health literary and suboptimal asthma management. It is important to advance understanding of adolescent health literacy, especially those at-risk, as they assume asthma self-management tasks and move toward independent adult self-care.
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Affiliation(s)
- Melissa A Valerio
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Edward L Peterson
- b Department of Public Health Sciences , Henry Ford Health System , Detroit , MI , USA
| | - Angelina R Wittich
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Christine L M Joseph
- c Department of Public Health Sciences , Health Disparities Research Collaborative, Henry Ford Health System , Detroit , MI , USA
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Liu CH, Liao LL, Cheng CCJ, Chang TC. Development and validation of the Taiwan Children’s Health Literacy Test. Glob Health Promot 2016; 25:34-46. [DOI: 10.1177/1757975916656365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Currently, health literacy (HL) worldwide is measured primarily among adults from a medical perspective. A children’s HL test from a health promotion perspective is needed. This study develops the Taiwan Children’s Health Literacy Test (TCHL) targeted at Taiwanese sixth-graders. Methods: HL indicators were identified through interviews of sixth-grade teachers, primary caregivers, and sixth-graders. They were used to develop a 25-item online test, which was finalized after pretesting and administered to a stratified random sample of 671 students across 29 sixth-grade classes. Results: The response rate was 87.2% (585 participants). Cronbach’s α was 0.60–0.78 for the HL subtests and 0.79 for the overall HL test. Correlation coefficients among subtests ranged from 0.49 to 0.87. The average proportion correct was 0.80 for overall HL. In item response theory analysis, the difficulty level ranged from −2.77 to −0.40, while the degree of discrimination was 0.44–2.65. Item information peaked when the ability value was approximately −1.8. Furthermore, HL scores had a significant positive correlation with health behaviors. Conclusions: Overall, the test was found to be reliable and valid, with a low level of difficulty for basic HL ability. The present results can be used as a reference by government health education units to investigate national HL in children.
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Affiliation(s)
- Chieh-Hsing Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Taiwan
| | | | - Tzu-Chau Chang
- Graduate Institute of Environmental Education, National Taiwan Normal University, Taiwan
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Kim CJ, Park E, Schlenk EA, Kim M, Kim DJ. Psychometric Evaluation of a Korean Version of the Adherence to Refills and Medications Scale (ARMS) in Adults With Type 2 Diabetes. DIABETES EDUCATOR 2016; 42:188-98. [PMID: 26902527 DOI: 10.1177/0145721716632062] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to examine the reliability and validity of the Adherence to Refills and Medications Scale-Korean (ARMS-K) among Korean adults with type 2 diabetes. METHODS The Korean translated ARMS-K was back-translated to ensure translation equivalency. A cross-sectional survey was used to evaluate the psychometric properties with exploratory factor analysis for validity and Cronbach's alpha coefficients for reliability. RESULTS The factor analysis of construct validity identified 3 dimensions of the ARMS-K, explaining 54.7% of the total variance. The internal consistency reliability for the total instrument was acceptable with a Cronbach's alpha of .801. There was good correlation between the ARMS-K and 8-item Morisky Medication Adherence Scale-Korean version (r = -0.698), indicating that these scales measure theoretically related constructs as evidence of convergent validity. As evidence of known groups validity, there was a significant association between the ARMS-K score and glycemic control (P = .048), indicating that the good glycemic controlled group was more likely to have a higher rate of adherence to refills and medications than the poor glycemic controlled group. CONCLUSIONS These results support the cross-cultural applicability of the concepts underlying the ARMS-K. The ARMS-K can be used not only to assess adherence to refills and medications in Koreans with diabetes but also to examine the potential role of adherence to refills and medications in enhanced glycemic control of people with diabetes in a variety of clinical settings.
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Affiliation(s)
- Chun-Ja Kim
- Ajou University College of Nursing Institution of Nursing Science, Korea (Dr Kim)
| | - Eunyoung Park
- Department of Nursing Science, Sangji University, Korea (Dr Park)
| | - Elizabeth A Schlenk
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (Dr Schlenk)
| | - Moonsun Kim
- Ajou University College of Nursing, Korea (Ms Kim)
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Korea (Dr Kim)
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Keim-Malpass J, Letzkus LC, Kennedy C. Parent/caregiver health literacy among children with special health care needs: a systematic review of the literature. BMC Pediatr 2015; 15:92. [PMID: 26242306 PMCID: PMC4525748 DOI: 10.1186/s12887-015-0412-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 07/28/2015] [Indexed: 11/10/2022] Open
Abstract
Background Children with special health care needs (CSHCN) are children with medical or behavioral diagnoses that require services beyond those generally needed by pediatric populations. They account for a significant portion of pediatric health care expenditures and often have complicated treatment regiments. Health literacy has recently been recognized as a key indicator of quality chronic disease self-management and parental/caregiver health literacy of CSHCN is an understudied area. The purpose of this systematic review was to assess the available evidence of studies investigating parent/caregiver health literacy of CSHCN. Methods Databases were searched to retrieve relevant articles for inclusion (dating from 1998 to 2014). Only studies that assessed the relationship between parent/caregiver health literacy on outcomes pertinent to CSHCN were included. Because of the limited number of studies, there were no restrictions placed on type of outcome. Results Thirteen studies were included in the final review with a range of health literacy assessments and outcome ascertainment. The majority of studies; (1) focused on the relationship between parental/caregiver health literacy and asthma outcomes, (2) were cross-sectional study designs, and (3) included samples recruited from pediatric clinics in academic medical settings. Conclusions There were several gaps in the literature where future research is needed including; (1) direct assessment of child/adolescent health literacy, (2) inclusion of children with co-morbid conditions, (3) further assessment of the relationship between health literacy and health care utilization and cost, and (4) assessment of parental/caregiver health literacy in the inpatient care setting.
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Affiliation(s)
- Jessica Keim-Malpass
- University of Virginia School of Nursing, P.O. Box 800782, Charlottesville, 22908, VA, USA.
| | - Lisa C Letzkus
- University of Virginia School of Nursing, P.O. Box 800782, Charlottesville, 22908, VA, USA. .,University of Virginia Children's Hospital, Charlottesville, VA, USA.
| | - Christine Kennedy
- University of Virginia School of Nursing, P.O. Box 800782, Charlottesville, 22908, VA, USA.
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