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Caridi TL, Mariño-Polo F, Farra CG, Mingus AM, Memon A, Grijalva MJ, Bates BR. Health literacy & Chagas disease knowledge: A cross-sectional study in Southern Loja Province, Ecuador. PEC INNOVATION 2024; 4:100287. [PMID: 38799258 PMCID: PMC11126796 DOI: 10.1016/j.pecinn.2024.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/22/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024]
Abstract
Objective Health literacy is associated with many patient outcomes. This study sought to determine the association between a person's level of health literacy and their knowledge about Chagas disease. Methods A cross-sectional survey was conducted with people living in two counties in rural Loja Province, Ecuador who attended a mobile health clinic. The communities in which the study was conducted are at high risk of Chagas disease and have limited access to both health care and educational resources. The Spanish version of Short Assessment for Health Literacy measured health literacy. The Chagas Disease Knowledge questionnaire measured knowledge of Chagas disease. T-tests and correlational analysis were used to assess associations. Results Overall 85 people participated in this study. A majority of the respondents were female (64.1%), and a plurality were married (40.7%) and had education less than secondary (40.7%). The average age of the sample was 44.31 ± 18.85. Health literacy levels and Chagas disease knowledge in the communities were low. About half of people had inadequate health literacy. No association between health literacy and Chagas knowledge was found. Conclusion Health literacy levels and Chagas disease knowledge were not found to be correlated. Explanations for the lack of association may include common causes of inadequate investment in Chagas disease education as well as neglect of health systems in rural Ecuador. Efforts to improve both health literacy and Chagas disease knowledge in poorer, rural areas of Ecuador are needed. Innovation This is the first study to assess relationships between health literacy and knowledge of Chagas disease in an uninfected population. For novel conditions, relationships between health literacy and disease knowledge should be investigated before communication campaigns are adapted.
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Affiliation(s)
- Talia L. Caridi
- Heritage College of Osteopathic Medicine, Ohio University, 6775 Bobcat Way Dublin, Ohio 43016, Dublin, OH, USA
| | - Fernanda Mariño-Polo
- Facultad de Medicina, Pontifical Catholic University of Ecuador, Avenida 12 de Octubre 1076, Quito 170143, Ecuador
| | - Cora G. Farra
- Department of Sociology & Anthropology, Bentley Annex 162, Ohio University, Athens, OH, USA
| | - Alison M. Mingus
- Honors Tutorial College, Ohio University, 35 Park Place, Athens, OH, USA
| | - Athar Memon
- School of Communication Studies, Ohio University, 418 Schoonover Center for Communication, 20 East Union Street, Athens, OH, USA
| | - Mario J. Grijalva
- Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, 191 West Union Street, Athens, OH, USA
- Biomedical Sciences Department, Heritage College of Osteopathic Medicine, Ohio University, Irvine Hall 112, Athens, OH, USA
- Center for Research on Health in Latin America, Pontifical Catholic University of Ecuador, Calle San Pedro y Pambacienda, Quito 170530, Ecuador
| | - Benjamin R. Bates
- School of Communication Studies, Ohio University, 418 Schoonover Center for Communication, 20 East Union Street, Athens, OH, USA
- Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, 191 West Union Street, Athens, OH, USA
- Center for Research on Health in Latin America, Pontifical Catholic University of Ecuador, Calle San Pedro y Pambacienda, Quito 170530, Ecuador
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Xiao L, Zhang F, Cheng C, Yang N, Huang Q, Yang Y. Effect of health literacy on hospital readmission among patients with heart failure: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e39644. [PMID: 39312377 PMCID: PMC11419479 DOI: 10.1097/md.0000000000039644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Patients with heart failure have a high rate of health literacy deficiency, and their hospital readmission is a great burden. Whether health literacy affects hospital readmission remains controversial. OBJECTIVE To investigate the impact of health literacy on hospital readmission among heart failure patients. METHOD Relevant keywords were used to search for Chinese and English literature from Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Digital Journal of Wanfang Data, and Chinese BioMedical Literature Database. Newcastle-Ottawa Scale was used to assess the quality of the studies. Statistical analysis was performed using Stata 15.0, the fixed effect model was used to calculate the pooled effect estimate, and Begg's and Egger's tests were applied to assess the presence of publication bias. RESULTS Nine studies, involving 4093 heart failure patients, were included in this study. The overall rate of inadequate health literacy was 40.3%. Among these articles, 6 were included in the meta-analysis to calculate the pooled effect. The results indicated that, when compared with patients with adequate health literacy, those with inadequate health literacy had a relative risk of hospital readmission of 1.01, which increased to 1.14 after adjusting for follow-up time, the result was not significant (P = .09). CONCLUSIONS About 2 out of 5 heart failure patients had inadequate health literacy, and there was no statistical association between health literacy and hospital readmission among these patients. This finding should be carefully considered and confirmed in further studies.
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Affiliation(s)
- Lei Xiao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fan Zhang
- School of Public Health, Chongqing Medical University, Chongqing, China
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Cong Cheng
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Ningling Yang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qi Huang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yuan Yang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Chen M, Li J, Chen C, Zhao Q, Huang H. The relationships between quality of life with health literacy, social support and resilience in older stroke survivors: A structural equation model. Nurs Open 2024; 11:e70020. [PMID: 39259719 PMCID: PMC11389827 DOI: 10.1002/nop2.70020] [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: 10/09/2023] [Revised: 07/24/2024] [Accepted: 08/15/2024] [Indexed: 09/13/2024] Open
Abstract
AIM To the determinants and the underlying mechanism of health literacy, social support, and resilience on the health-related quality of life (HRQoL) among older stroke survivors. DESIGN A cross-sectional design was applied at four comprehensive hospitals in Chongqing via convenience sampling from January 2020 to June 2021. METHODS Health literacy, social support, and resilience were designed as independent variables, and HRQoL was measured as a dependent variable. Structural equation modelling with the bootstrap method was used to test the hypotheses. RESULTS The theoretically derived model exhibited a good fit (χ2/df ratio = 2.830, GFI = 0.987, CFI = 0.978, RMSEA = 0.066). Health literacy (β = 0.12, p < 0.05) and social support (β = 0.14, p < 0.05) directly affect HRQoL. Resilience (β = 0.40, p < 0.01) also mediated the relationship between health literacy, social support, and HRQoL. The three variables explaining 29.0% of HRQoL variance. PATIENT OR PUBLIC CONTRIBUTION There was no direct patient or public involvement in the design, conduct, or reporting of this study. Participants were recruited through convenience sampling from four comprehensive hospitals in Chongqing, and their perspectives or contributions were not explicitly sought. The study focused on examining the determinants and underlying mechanism of health literacy, social support, and resilience on the health-related quality of life among older stroke survivors. Nonetheless, the findings of this research may inform the development of interventions aimed at improving the health-related quality of life in post-stroke older patients.
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Affiliation(s)
- Mei Chen
- Department of Nursing, Bishan Hospital of Chongqing (Bishan Hospital of Chongqing Medical University), Chongqing, China
| | - Jinghong Li
- Department of Nursing, Chongqing Emergency Medical Center, Chongqing, China
| | - Chunyan Chen
- Department of Nursing, Bishan Hospital of Chongqing (Bishan Hospital of Chongqing Medical University), Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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McKinn S, Chapman N, Sharman JE, Nash R, Nelson MR, Sutton L, Yung C, Doust J, Hawkes AL, Bonner C. How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study. PATIENT EDUCATION AND COUNSELING 2024; 125:108299. [PMID: 38657560 DOI: 10.1016/j.pec.2024.108299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/12/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Low health literacy is associated with worse health outcomes, including for cardiovascular disease (CVD). However, general practitioners (GPs) have limited support to identify and address patient health literacy needs in CVD prevention consultations. This study explored GPs' experiences of patient health literacy needs during CVD risk assessment and management consultations. METHODS Semi-structured interviews with 18 GPs in Tasmania, Australia in 2021. A Framework Analysis approach was used to code transcripts to a thematic framework. RESULTS GPs perceptions on patient health literacy informed three themes: 1. Methods of estimating health literacy; 2. GPs' perceptions about the impact of health literacy on CVD prevention including risk factor knowledge and behaviours; and 3. Strategies for communicating with patients experiencing health literacy challenges. The findings show that while no formal tools were used to assess health literacy in this sample, perceived health literacy can change GPs' communication and prevention strategies. CONCLUSION The findings raise concerns about the equity of choices made available to patients, based on subjective perceptions of their health literacy level. PRACTICE IMPLICATION GPs could be better supported to assess and address patient health literacy needs in CVD prevention consultations.
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Affiliation(s)
- Shannon McKinn
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia
| | - Niamh Chapman
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Rosie Nash
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Laura Sutton
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Cassia Yung
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia
| | - Jenny Doust
- Australian Women and Girls' Health Research (AWaGHR) Centre, University of Queensland, Queensland, Australia
| | - Anna L Hawkes
- School of Public Health, University of Queensland, Queensland, Australia
| | - Carissa Bonner
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia; Menzies Centre for Health Policy & Economics, University of Sydney, Sydney, Australia.
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Yardimci Gürel T, Güner Ö. Health literacy as a predictor of cardiovascular disease risk factor knowledge level among women in Turkey: A community-based cross-sectional study. Medicine (Baltimore) 2024; 103:e38994. [PMID: 39029038 PMCID: PMC11398776 DOI: 10.1097/md.0000000000038994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
While more common in men globally, heart diseases also rank as the leading cause of death among women. This study aimed to examine the relationship between Turkish women's level of knowledge about cardiovascular disease (CVD) risk factors and their health literacy. Data for this descriptive and cross-sectional study were collected online by using Health Literacy Scale and CVD risk factor knowledge level scale from October 2022, to May 2023. The study sample consisted of 409 women. It was found that the total score average of the women on the CVD risk factor knowledge level was 20.65 ± 4.72 and the Health Literacy Scale was 107.06 ± 16.01. There was a moderate, significantly positive correlation between CVD knowledge levels and health literacy (r = .548, P = .000). It was found that women with high health literacy also had increased knowledge levels. Furthermore, all health literacy dimensions of access to information (P < .001), understanding information (P < .001), appraisal/evaluation (P < .001), and implementation (P < .001) were detected as the predictors of CVD risk factor knowledge levels. Factors such as educational level and economic status significantly influenced scores on both scales (P < .05). The study's findings highlight the challenges encountered by women with low socioeconomic status in accessing accurate information. It may be recommended that nurses provide health education and consultancy services to these women on the prevention and management of cardiovascular diseases. Also, public education programs should consider socioeconomic and educational levels, focusing on women who encounter difficulties accessing information.
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Affiliation(s)
- Tuğba Yardimci Gürel
- Department of Nursing, Sinop University Faculty of Health Sciences, Sinop, Turkey
| | - Özlem Güner
- Department of Midwifery, Sinop University Faculty of Health Sciences, Sinop, Turkey
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Rahmawati BA, Rochmawati E. Trying to understand the illness: A qualitative investigation of health literacy of patients undergoing maintenance hemodialysis. Nurs Health Sci 2024; 26:e13120. [PMID: 38605631 DOI: 10.1111/nhs.13120] [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: 08/17/2023] [Revised: 12/19/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
Limited health literacy is high among patients with chronic kidney disease, which can pose challenges in health care. Evidence of health literacy in Indonesia, particularly regarding patients undergoing hemodialysis, is lacking. In this study, we aimed to explore health literacy in adult patients undergoing maintenance hemodialysis. An inductive qualitative study was conducted. Individual semi-structured interviews were conducted with 10 adult patients undergoing hemodialysis, four family caregivers, and four healthcare professionals. Interviews were transcribed verbatim and analyzed thematically. Three themes emerged from the data: "Trying to understand the illness," "searching and obtaining health information," and "applying health information." Understanding and accepting the illness included raising awareness of the changes in their lives and accepting these changes. Participants actively sought information from healthcare professionals and other sources and used it carefully. Behavioral changes included patients' adherence to therapy, although participants often felt bored during the illness trajectory. Understanding the illness and being willing to seek and critically evaluate health information before implementing it are important. These aspects may affect patient outcomes and require further intervention and research.
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Affiliation(s)
- Berlian Ayu Rahmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Muhammadiyah Siti Aminah Bumiayu Hospital, Brebes, Indonesia
| | - Erna Rochmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
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Taylor LL, Hong AS, Hahm K, Kim D, Smith-Morris C, Zaha VG. Health Literacy, Individual and Community Engagement, and Cardiovascular Risks and Disparities: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2024; 6:363-380. [PMID: 38983375 PMCID: PMC11229558 DOI: 10.1016/j.jaccao.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/13/2024] [Indexed: 07/11/2024] Open
Abstract
Cardiovascular and cancer outcomes intersect within the realm of cardio-oncology survivorship care, marked by disparities across ethnic, racial, social, and geographical landscapes. Although the clinical community is increasingly aware of this complex issue, effective solutions are trailing. To attain substantial public health impact, examinations of cancer types and cardiovascular risk mitigation require complementary approaches that elicit the patient's perspective, scale it to a population level, and focus on actionable population health interventions. Adopting such a multidisciplinary approach will deepen our understanding of patient awareness, motivation, health literacy, and community resources for addressing the unique challenges of cardio-oncology. Geospatial analysis aids in identifying key communities in need within both granular and broader contexts. In this review, we delineate a pathway that navigates barriers from individual to community levels. Data gleaned from these perspectives are critical in informing interventions that empower individuals within diverse communities and improve cardio-oncology survivorship.
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Affiliation(s)
| | - Arthur S Hong
- UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA
- UT Southwestern O'Donnell School of Public Health, Dallas, Texas, USA
| | - Kristine Hahm
- University of Texas at Dallas, Richardson, Texas, USA
| | - Dohyeong Kim
- University of Texas at Dallas, Richardson, Texas, USA
| | | | - Vlad G Zaha
- UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA
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Uğurlu Z, Kav S, Eler ÇÖ, Kaya S, Korkmaz Y. Health literacy in older adults receiving hemodialysis in Turkey: A cross-sectional study. Ther Apher Dial 2024; 28:380-389. [PMID: 38163856 DOI: 10.1111/1744-9987.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/10/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION This study aimed to determine the health literacy level and related factors of older adults receiving hemodialysis treatment. METHODS A cross-sectional study was conducted at the five dialysis centers, using the information form and Turkish Health Literacy Survey-32 (THLS-32). A total of 336 older adults receiving hemodialysis treatment participated. RESULTS The general health literacy score was found to be 25.69 ± 14.47. Based on the health literacy assessment scores, 62.5% of the participants were in the category of inadequate and limited level of health literacy. The lower level of education, perceived health status, income, and getting help in reading and writing were statistically significant predictors of the health literacy score. CONCLUSION The health literacy of older adults receiving hemodialysis treatment was inadequate and limited. Findings of this study emphasize the importance of integrating health literacy assessment in clinical care settings and supporting the health literacy of older adults receiving hemodialysis treatment.
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Affiliation(s)
- Ziyafet Uğurlu
- Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey
| | - Sultan Kav
- Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey
| | - Çiğdem Özdemir Eler
- Vocational Health School, Dialysis Program, Baskent University, Ankara, Turkey
| | - Semiha Kaya
- Umitkoy Dialysis Center Director, Baskent University, Ankara, Turkey
| | - Yasemin Korkmaz
- Cigdem Dialysis Center, Baskent University Hospital, Ankara, Turkey
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Reading Turchioe M, Mangal S. Health literacy, numeracy, graph literacy, and digital literacy: an overview of definitions, evaluation methods, and best practices. Eur J Cardiovasc Nurs 2024; 23:423-428. [PMID: 37590968 PMCID: PMC11129894 DOI: 10.1093/eurjcn/zvad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023]
Abstract
Health literacy is an important skill for people receiving care. Those with limited literacy face disparities in their care and health outcomes when strategies for addressing literacy are not used when delivering health information. In this article, we introduce the importance of considering health literacy, defining it and related concepts including numeracy, graph literacy, and digital literacy, and discuss open questions about measuring health literacy in clinical care. Finally, we present best practices, including assuming 'universal precautions', carefully considering wording, leveraging visualizations, recognizing cultural differences in interpretation, providing guidance on pilot testing, and considering digital literacy when developing electronic materials.
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Affiliation(s)
| | - Sabrina Mangal
- University of Washington School of Nursing, Seattle, WA, USA
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Pan X, Hu W, Wang Z, Fang Q, Xu L, Shen Y. Effect of self-regulating fatigue on health-related quality of life of middle-aged and elderly patients with recurrent stroke: a moderated sequential mediation model. PSYCHOL HEALTH MED 2024; 29:778-790. [PMID: 37455376 DOI: 10.1080/13548506.2023.2235739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Although the association between self-regulation of fatigue and health-related quality of life (HRQoL) has been confirmed, the potential mechanism remains unclear. This study aimed to explore the role of health literacy, health behavior, and exercise frequency in the relationship among middle-aged and elderly patients with recurrent stroke. A cross-sectional survey was conducted. A total of 176 patients completed the survey, in which self-regulation of fatigue, HRQoL, health literacy and health behavior were measured by questionnaires. Based on Bootstrap analyses, a moderating sequential mediation model using PROCESS software was constructed with health literacy and health behavior as mediators and exercise frequency as the moderator. Of the participants, the mean age was 65.44 ± 12.43 years. Self-regulation of fatigue was found to affect HRQoL indirectly through two significant mediation pathways: (1) health literacy (β=-0.11, 95%CI = -0.20, -0.03), which accounted for 28.79% of the total effect, and (2) health literacy and health behavior (β=-0.02, 95%CI = -0.05, -0.00), which accounted for 4.80% of the total effect. Exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Specifically, the interaction term between self-regulating fatigue and exercise frequency significantly predicted HRQoL (β = 0. 25, t = 2.55, p < 0.05). These findings highlight the role of health literacy and health behavior as sequential mediators of the relationship between self-regulating fatigue and HRQoL. Moreover, exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Encouraging patients with recurrent stroke to increase exercise frequency appropriately might improve HRQoL for patients with poor health literacy and health behavior.
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Affiliation(s)
- Xi Pan
- Departments of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Wei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, P. R. China
| | - Zhi Wang
- Departments of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Qi Fang
- Departments of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lan Xu
- Nursing Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, P. R. China
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Kirchberger I, Fischer S, Raake P, Linseisen J, Meisinger C, Schmitz T. Depression mediates the association between health literacy and health-related quality of life after myocardial infarction. Front Psychiatry 2024; 15:1341392. [PMID: 38419900 PMCID: PMC10899501 DOI: 10.3389/fpsyt.2024.1341392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction So far, health literacy (HL) and its related factors in patients with acute myocardial infarction received little attention. Thus, the objective of this study was to investigate the associations between the different dimensions of HL and disease-specific health-related quality of life (HRQOL), and factors that may affect these relations in patients after acute myocardial infarction (AMI). Methods All survivors of AMI between June 2020 and September 2021, from the Myocardial Infarction Registry Augsburg (n=882) received a postal questionnaire on HL [Health Literacy Questionnaire (HLQ)], HRQOL (MacNew Heart Disease HRQOL questionnaire) and depression (Patient Health Questionnaire). From the 592 respondents, 546 could be included in the analysis. Multivariable linear regression models were performed to investigate the associations between the nine subscales of the HLQ and the total score and three subscales of the MacNew questionnaire. A mediation analysis was performed to estimate direct and indirect effects of HL on HRQOL taking into account the mediating effect of depression. Results In the sample of 546 patients (72.5% male, mean age 68.5 ± 12.2 years), patients with poor education showed significantly lower HLQ scores. Significant associations between the subscales of the HLQ and the MacNew were found, which remained significant after adjustment for sociodemographic variables with few exceptions. More than 50% of the association between HL and HRQOL was mediated by depression in seven HLQ subscales and a complete mediating effect was found for the HLQ subscales 'Actively managing my health' and 'Appraisal of health information'. Discussion Depression mediates the associations between HL and disease-specific HRQOL in patients with myocardial infarction.
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Affiliation(s)
- Inge Kirchberger
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Simone Fischer
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Philip Raake
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - Jakob Linseisen
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Christine Meisinger
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Timo Schmitz
- Epidemiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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Verstraeten LM, Mashni A, van Wijngaarden JP, Meskers CG, Maier AB. Sarcopenia knowledge of geriatric rehabilitation patients is low while they are willing to start sarcopenia treatment: EMPOWER-GR. J Cachexia Sarcopenia Muscle 2024; 15:352-360. [PMID: 38124340 PMCID: PMC10834324 DOI: 10.1002/jcsm.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/08/2023] [Accepted: 10/18/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sarcopenia is prevalent in 20-50% of geriatric rehabilitation inpatients and is associated with functional dependence and mortality. The aim is to assess knowledge of geriatric rehabilitation inpatients on sarcopenia and their willingness and perceived barriers to start treatment. METHODS Enhancing Muscle POWER in Geriatric Rehabilitation (EMPOWER-GR) is an observational cohort of geriatric rehabilitation inpatients in Amsterdam, the Netherlands. Knowledge of sarcopenia, willingness and perceived barriers to treatment were assessed with a survey among inpatients. Importance of and self-perceived muscle health were rated using a visual analogue scale from 0 to 10. Descriptive statistics were used. RESULTS Inpatients' (n = 157, 59.9% female) mean age was 80.5 years (SD 7.3). Sarcopenia (European Working Group on Sarcopenia in Older People 2) prevalence was 21.7%. Five inpatients (3.2%) had heard of sarcopenia and had knowledge of its definition. Median muscle health was rated as 6 (interquartile range: 4-7). After explanation of treatment options, 67.1% were willing to start resistance exercise training (RET), 61.1% a high-protein diet and 55.7% oral nutritional supplements (ONS). Inpatients with sarcopenia were less willing (51.6%) to start a high-protein diet compared with inpatients without sarcopenia (77.8%) (P = 0.002); there was no difference for RET and ONS. Most reported barriers to treatment were ONS dislike (17.0%), too many other health issues (13.6%), doubts about treatment effectiveness/importance (12.9%) and RET intensity/difficulty (10.2%). CONCLUSIONS Knowledge of sarcopenia was low, while the majority of inpatients showed willingness to start treatment. A dislike of ONS, RET difficulty and too many other health issues may reduce willingness to start treatment. Education is important to increase sarcopenia-related health issues in geriatric rehabilitation inpatients.
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Affiliation(s)
- Laure M.G. Verstraeten
- Department of Human Movement Sciences@AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciencesvan der Boechorststraat 7Amsterdam1081 BTThe Netherlands
| | - Amir Mashni
- Department of Human Movement Sciences@AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciencesvan der Boechorststraat 7Amsterdam1081 BTThe Netherlands
| | | | - Carel G.M. Meskers
- Department of Rehabilitation MedicineAmsterdam University Medical Centre, Amsterdam Movement SciencesAmsterdamThe Netherlands
| | - Andrea B. Maier
- Department of Human Movement Sciences@AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciencesvan der Boechorststraat 7Amsterdam1081 BTThe Netherlands
- Department of Medicine and Aged Care@AgeMelbourne, The Royal Melbourne Hospital, The University of MelbourneParkvilleVictoriaAustralia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Centre for Healthy Longevity@AgeSingapore, National University Health SystemSingapore
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Cocchieri A, Pezzullo AM, Cesare M, De Rinaldis M, Cristofori E, D'Agostino F. Association between health literacy and nursing care in hospital: A retrospective study. J Clin Nurs 2024; 33:642-652. [PMID: 37807642 DOI: 10.1111/jocn.16899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/31/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
AIMS To describe the health literacy (HL) levels of hospitalised patients and their relationship with nursing diagnoses (NDs), nursing interventions and nursing measures for clinical risks. DESIGN Retrospective study. METHODS The study was conducted from December 2020 to December 2021 in an Italian university hospital. From 146 wards, 1067 electronic nursing records were randomly selected. The Single-Item Literacy Screener was used to measure HL. Measures for clinical risks were systematically assessed by nurses using Conley Index score, the Blaylock Risk Assessment Screening Score, Braden score, and the Barthel Index. A univariable linear regression model was used to assess the associations of HL with NDs. RESULTS Patients with low HL reported a higher number of NDs, interventions and higher clinical risks. HL can be considered a predictor of complexity of care. CONCLUSIONS The inclusion of standardised terms in nursing records can describe the complexity of care and facilitate the predictive ability on hospital outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE HL evaluation during the first 24 h. From hospital admission could help to intercept patients at risk of higher complexity of care. These results can guide the development of interventions to minimise needs after discharge. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection.
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Affiliation(s)
- Antonello Cocchieri
- Section of Hygiene, Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Angelo Maria Pezzullo
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Manuele Cesare
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Miriam De Rinaldis
- Section of Hygiene, Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Elena Cristofori
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Fabio D'Agostino
- Saint Camillus International University of Health Sciences, Rome, Italy
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Bulto LN, Roseleur J, Noonan S, Pinero de Plaza MA, Champion S, Dafny HA, Pearson V, Nesbitt K, Gebremichael LG, Beleigoli A, Gulyani A, Schultz T, Hines S, Clark RA, Hendriks JM. Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2024; 23:21-32. [PMID: 37130339 DOI: 10.1093/eurjcn/zvad040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/04/2023]
Abstract
AIMS This review aimed to investigate the effectiveness of nurse-led interventions vs. usual care on hypertension management, lifestyle behaviour, and patients' knowledge of hypertension and associated risk factors. METHODS A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), EmCare (Ovid), CINAHL (EBSCO), Cochrane library, and ProQuest (Ovid) were searched from inception to 15 February 2022. Randomized controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. RESULTS A total of 37 RCTs and 9731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (mean difference -4.66; 95% CI -6.69, -2.64; I2 = 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (mean difference -1.91; 95% CI -3.06, -0.76; I2 = 79.35; 29 RCTs; low certainty evidence) compared with usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. CONCLUSION This review revealed the beneficial effects of nurse-led interventions in hypertension management compared with usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. REGISTRATION PROSPERO: CRD42021274900.
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Affiliation(s)
- Lemma N Bulto
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Jacqueline Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Sara Noonan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, 5005, SA, Australia
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Hila Ariela Dafny
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Vincent Pearson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Katie Nesbitt
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Lemlem G Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Aarti Gulyani
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Timothy Schultz
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, 5005, SA, Australia
| | - Sonia Hines
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- Flinders Rural and Remote Health, NT. College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, 5001, SA, Australia
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Elbarazi I, Aziz F, Ahmed LA, Abdullahi AS, Al-Maskari F. Cancer Health Literacy and Its Correlated Factors in the United Arab Emirates-A Cross Sectional Study. Cancer Control 2024; 31:10732748241248032. [PMID: 38717601 PMCID: PMC11146015 DOI: 10.1177/10732748241248032] [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: 03/09/2023] [Revised: 03/15/2024] [Accepted: 04/01/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Cancer Health literacy (CHL) is the health literacy related to cancer knowledge, prevention, treatment, screening, and access to services. It is an important indicator of people's adherence to screening and preventive measures, which helps to reduce the incidence and prevalence of cancer. The study assessed the CHL level and its association with relevant socio-demographic characteristics and sources of information among primary health care patients and visitors in the United Arab Emirates (UAE). METHODS A cross-sectional study recruited survey participants who consented to respond to an interviewer-administered questionnaire. The assessment of CHL was done by using 15 questions. CHL level was measured as a median score and also categorized as poor/inadequate, moderate, good/excellent. Nominal logistic regression was used to analyze the relationship between CHL categories and participants' sociodemographic characteristics and CHL sources of information. RESULTS Of the total 492 participants, 45.5% were young adults (30-39 years old), 32.9% were males, and 70.8% were UAE nationals. The overall median CHL score was 8.0 (IQR = 5.0-10). 33.7% of the participants had a poor/inadequate level of CHL, 49.6% had a moderate level and 16.7% had a good to excellent level of CHL. 76.9% of the participants knew the importance of early cancer screening tests, 72.7% acknowledged the metastatic capacity of cancer, and the protective factors of cancer, especially, in colon cancer (71.7%). A high proportion of participants received health information about cancer via the internet (50.7%), television (45.3%), social media (40.2%), and doctors (43.6%). Nationality other than UAE (aOR = 1.62, 95% CI = 1.03-2.56, P = .038), having university education (aOR = 2.20, 95% CI = 1.21-3.99, P = .010) compared to those with lower than high school, and having a family history of cancer (aOR = 2.42, 95% CI = 1.33-4.41, P = .004) were positively associated with CHL. Older age (aOR = .36, 95% CI = .17-.75, P = .007 for 50-59 years, and aOR = .29, 95% CI = .11-.82, P = .019) for 60-69 years, higher-income (aOR = .57, 95% CI = .33-.99, P = .047 for 10,000-19,999 AED; aOR = .53, 95% CI = .33-.88, P = .013 for ≥20,000) compared with those earning <10,000 AED were negatively associated with CHL. CONCLUSIONS CHL among the resident UAE population was moderately adequate, therefore implementation of awareness campaigns seems to be warranted. Moreover, evaluation research targeting the CHL impact on cancer prevention practices and screening is also advocated.
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Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Faisal Aziz
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Aminu S. Abdullahi
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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16
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Cheong KY, Syed Mahmud SMB, Chng NW, Kwek GJ, Yan CC, Yeung MT. Cross-sectional survey of health literacy among health science students in Singapore. THE JOURNAL OF MEDICINE ACCESS 2024; 8:27550834231222382. [PMID: 38306366 PMCID: PMC10822080 DOI: 10.1177/27550834231222382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/07/2023] [Indexed: 02/04/2024]
Abstract
Background Health literacy proficiency is essential for health care professionals to provide quality patient care. There is limited research exploring health literacy proficiency among undergraduate health science students. Objectives To determine health literacy among health science students in Singapore using the electronic Health Literacy Questionnaire (HLQ). Design A cross-sectional survey using purposive sampling was conducted among undergraduate health science students. Methodology This study hypothesises that health literacy is influenced by gender, and it increases with the level of health science education, attributed to the increased exposure to the health care system and health care education as undergraduates progress through the years of study. Eligible students from the 4-year entry-level programmes of diagnostic radiography, dietetics, occupational therapy, physiotherapy, radiation therapy and speech and language therapy, aged from 21 to 50, were invited. Exclusion criteria were students who were no longer studying due to dropping out or having immediately graduated from these programmes and students in the accelerated programmes whose studies would be completed in less than 4 years. Results In total, 111 respondents (72 females and 37 males) completed surveys (response rate, 7.7%) returned from physiotherapy (n = 69), occupational therapy (n = 25), diagnostic radiography (n = 12) and dietetics (n = 5), with nil from radiation therapy and speech and language therapy. All participants were English literate. Female participants demonstrated higher HLQ with a mean total score of 30.67 (standard deviation (SD) = 0.61) versus male participants 29.83 (SD = 0.53). Year 2, 3 and 4 students generally scored higher than Year 1 across all nine HLQ scales. Overall, dietetics students had the highest total score on the HLQ, while the diagnostic radiography students had the lowest scores for all the nine HLQ scales. Conclusion This study established the health literacy level of health science students in Singapore. Gender and years of study influenced health literacy levels, supporting the hypothesis.
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Affiliation(s)
- Kenrick Y Cheong
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Department of Physiotherapy, Singhealth Polyclinics, Singapore
| | | | - Nicole W Chng
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Geralyn J Kwek
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Clement C Yan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Meredith T Yeung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
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17
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Datta BK, Ansa BE, Saucier A, Pandey A, Haider MR, Puranda R, Adams M, Coffin J. Child Marriage and Cardiovascular Risk: An Application of the Non-laboratory Framingham Risk Score. High Blood Press Cardiovasc Prev 2024; 31:55-63. [PMID: 38285323 DOI: 10.1007/s40292-023-00620-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
INTRODUCTION Child marriage, defined as marriage before the age of 18 years, is a precocious transition from adolescence to adulthood, which may take a long-term toll on health. AIM This study aims to assess whether child marriage was associated with added risk of adverse cardiovascular outcomes in a nationally representative sample of Indian adults. METHODS Applying the non-laboratory-based Framingham algorithm to data on 336,953 women aged 30-49 years and 49,617 men aged 30-54 years, we estimated individual's predicted heart age (PHA). Comparing the PHA with chronological age (CA), we categorized individuals in four groups: (i) low PHA: PHA < CA, (ii) equal PHA: PHA = CA (reference category), (iii) high PHA: PHA > CA by at most 4 years, and (iv) very high PHA: PHA > CA by 5 + years. We estimated multivariable multinomial logistic regressions to obtain relative risks of respective categories for the child marriage indicator. RESULTS We found that women who were married in childhood had 1.06 (95% CI 1.01-1.10) and 1.22 (95% CI 1.16-1.27) times higher adjusted risks of having high and very high PHA, respectively, compared to women who were married as adults. For men, no differential risks were found between those who were married as children and as adults. These results were generally robust across various socioeconomic sub-groups. CONCLUSIONS These findings add to the relatively new and evolving strand of literature that examines the role of child marriage on later life chronic health outcomes and provide important insights for public health policies aimed at improving women's health and wellbeing.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, 1120 15th St., CJ 2300, Augusta, GA, 30912, USA.
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA.
| | - Benjamin E Ansa
- Institute of Public and Preventive Health, Augusta University, 1120 15th St., CJ 2300, Augusta, GA, 30912, USA
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA
| | - Ashley Saucier
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ajay Pandey
- Department of Biological Sciences, Augusta University, Augusta, GA, USA
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Racquel Puranda
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Malika Adams
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Janis Coffin
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Franzoi MA, Bayle A, Vaz-Luis I. Changing cancer representations toward comprehensive portraits to empower patients in their care journey. Ann Oncol 2023; 34:1082-1087. [PMID: 37816461 DOI: 10.1016/j.annonc.2023.09.3117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Affiliation(s)
- M A Franzoi
- Cancer Survivorship Group, Inserm U981, Gustave Roussy, Villejuif.
| | - A Bayle
- Bureau Biostatistique et Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM, Université Paris-Saclay, CESP U1018 Oncostat, labelisé Ligue contre le cancer, Villejuif, France
| | - I Vaz-Luis
- Cancer Survivorship Group, Inserm U981, Gustave Roussy, Villejuif
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Svavarsdóttir MH, Halapi E, Ketilsdóttir A, Ólafsdóttir IV, Ingadottir B. Changes in disease-related knowledge and educational needs of patients with coronary heart disease over a six-month period between hospital discharge and follow-up. PATIENT EDUCATION AND COUNSELING 2023; 117:107972. [PMID: 37703621 DOI: 10.1016/j.pec.2023.107972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To describe changes in the disease-related knowledge and educational needs of individuals with coronary heart disease (CHD). METHODS Patients hospitalized for CHD answered questionnaires about disease-related knowledge (Coronary Artery Disease Education Questionnaire-short version (CADE-Q-SV), score 0-20), educational needs (investigator-designed questions), health literacy (Short version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16)), self-care (Self-Care of Coronary Heart Disease Inventory version (SC-CHDI)), and physical activity (Leisure-time Physical Activity Questionnaire) at discharge (T1) and six months later (T2). RESULTS Participants' (N = 308; mean [M] age=65.5 years [SD=8.7]; 81.5% male) knowledge scores increased from M= 13.8 (SD=3.2) to M= 14.8 (SD=2.8) (p < 0.001). At T1, educational level, age, health literacy, smoking, and self-care maintenance explained 14.5% of knowledge variability. At T2, these variables plus lack of awareness of CHD diagnosis explained 20.3% of the variability. Substantial educational needs were reported at both time points, although 89% received predischarge education. CONCLUSION The patients' educational needs were unfulfilled despite an increase in disease-related knowledge over time. Improved evidence-based patient education and follow-ups that address diagnosis, treatment, and self-care are needed. PRACTICE IMPLICATIONS Healthcare professionals can improve care of patients with CHD by providing focused patient education, prioritizing "need-to-know" topics and considering patients' health literacy.
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Affiliation(s)
| | - Eva Halapi
- University of Akureyri, Faculty of Nursing, Nordurslod 2, 600 Akureyri, Iceland
| | - Auður Ketilsdóttir
- Landspitali University Hospital, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Faculty of Nursing and Midwifery, Eiríksgata 34, 101 Reykjavik, Iceland
| | | | - Brynja Ingadottir
- Landspitali University Hospital, Hringbraut, 101 Reykjavik, Iceland; University of Iceland, Faculty of Nursing and Midwifery, Eiríksgata 34, 101 Reykjavik, Iceland
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Shim SY, Lee H. Sex and Age Differences in the Association Between Social Determinants of Health and Cardiovascular Health According to Household Income Among Mongolian Adults: Cross-Sectional Study. JMIR Public Health Surveill 2023; 9:e44569. [PMID: 38039072 PMCID: PMC10724809 DOI: 10.2196/44569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/11/2023] [Accepted: 10/03/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Although social determinants of health (SDH) are an underlying cause of poor cardiovascular health (CVH), there is insufficient evidence for the association between SDH and CVH, which varies by sex and age among Mongolian adults. OBJECTIVE We aimed to explore whether education, household income, and health insurance were associated with CVH according to sex and age among Mongolian adults. METHODS The final sample included data on 5691 participants (male: n=2521. 44.3% and female: n=3170, 55.7%) aged 18-69 years from the 2019 World Health Organization STEPwise approach to noncommunicable disease risk-factor surveillance. CVH was measured using a modified version of Life's Simple 7 with 4 health behaviors (cigarette smoking, BMI, physical activity, and a healthy diet) and 3 biological factors (blood pressure, fasting glucose, and total cholesterol blood levels) and classified into poor, intermediate, and ideal levels as recommended by the American Heart Association. Multinomial logistic regression analyses examined the associations between SDH and CVH by monthly equivalized household income after adjusting for age, sex, work status, area, history of myocardial infarction or stroke, use of aspirin, and use of statin. Subgroup analyses were conducted to examine the associations between SDH and CVH based on sex and age, considering monthly equivalized household income as a key variable. RESULTS Using the ideal level of CVH as a reference, among those with the lowest household income, having less than 12 years of education, and not having health insurance were associated with poor CVH (education level: odds ratio [OR] 2.42, 95% CI 1.30-4.51; P=.006; health insurance: OR 2.17, 95% CI 1.13-4.18; P=.02). These associations were more profound among female individuals (education level: OR 2.99, 95% CI 1.35-6.63; P=.007; health insurance: OR 2.54, 95% CI 1.09-5.90; P=.03) and those aged 18-44 years (education level: OR 3.22, 95% CI 1.54-6.72; P=.002; health insurance: OR 2.03, 95% CI 0.98-4.18; P=.06). CONCLUSIONS Participants in the lowest household income group with lower educational levels and without health insurance were more likely to have poor CVH, and these results were more pronounced in female individuals and young adults. These findings suggest the need to develop strategies for CVH equity in Mongolian female individuals and young adults that consider income levels, education levels, and health insurance.
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Affiliation(s)
- Sun Young Shim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
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Liu S, Xiong XY, Chen H, Liu MD, Wang Y, Yang Y, Zhang MJ, Xiang Q. Transitional Care in Patients with Heart Failure: A Concept Analysis Using Rogers' Evolutionary Approach. Risk Manag Healthc Policy 2023; 16:2063-2076. [PMID: 37822727 PMCID: PMC10563773 DOI: 10.2147/rmhp.s427495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
Objective The purpose of this study was to clarify the concept of transitional care in patients with heart failure. Background Transitional care is increasingly being applied in patients with heart failure, but the concept of transitional care in heart failure patients is not uniform and confused with other definitions, which limits further research and practice on transitional care for these patients. Design Rodgers' evolutionary concept analysis. Methods A comprehensive literature search was conducted using the PUBMED, EMBASE, EBSCO, Chinese Biological Medicine (CBM), CNKI, and WANFANG databases (up to January 26, 2023). We used Rodgers' evolutionary concept analysis method to identify related concepts, attributes, antecedents, and consequences of transitional care in patients with heart failure. Results A total of 33 articles were included. The following attributes belonging to transitional care in patients with heart failure were extracted from the literature: self-care, multidisciplinary collaboration, and information transmission. The antecedents were patients' health status, the health literacy of patients and caregivers, the role functions of the main implementer and social and medical resources. Consequences were separated into two categories: patient-centered health outcomes (all-cause mortality, health-related quality of life, discharge preparedness, self-care behaviors, satisfaction of patients) and healthcare utilization outcomes (hospital readmission, length of hospital stay, emergency department visits). Conclusion This study found that transitional care in heart failure patients is a systemic care process during a vulnerable period that improves patient self-management and coordination between hospital resources and social support systems for continuous management to promote smooth patient transitions between different locations. This concept analysis will inform healthcare providers in designing evidence-based interventions and quality improvement strategies to ensure that transition processes lead to desired outcomes. In addition, this study will also be helpful for developing specific assessment tools to identify patients with HF who need transitional care.
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Affiliation(s)
- Si Liu
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
- Nursing Department, the Second Affiliated Hospital of Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Xiao-yun Xiong
- Nursing Department, the Second Affiliated Hospital of Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Hua Chen
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Meng-die Liu
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Ying Wang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Ying Yang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Mei-jun Zhang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
| | - Qin Xiang
- School of Nursing, Nan Chang University, Nan Chang, Jiang Xi, People’s Republic of China
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22
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Nair SC, Sreedharan J, Vijayan K, Ibrahim H. Estimation of health literacy levels in patients with cardiovascular diseases in a Gulf country. BMC Health Serv Res 2023; 23:518. [PMID: 37221529 DOI: 10.1186/s12913-023-09364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/04/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. In the United Arab Emirates (UAE), the prevalence of deaths associated with CVD is higher than the global average, and the incidence of premature coronary heart disease is 10-15 years earlier than in Western nations. In patients with CVD, inadequate health literacy (HL) is significantly associated with poor health outcomes. The goal of this study is to assess HL levels among patients with CVD in the UAE to develop effective health system strategies for disease prevention and management. METHODS A nationwide cross-sectional survey to assess HL levels in patients with CVD was conducted between January 2019 and May 2020 in the UAE. The association between health literacy level with patient age, gender, nationality, and education was determined using the Chi-Square test. The significant variables were further analyzed by ordinal regression. RESULTS Of 336 participants (86.5% response rate), approximately half 51.5% (173/336) of the respondents were women, and 46% (146/336) of them attained high school level of education. More than 75% (268/336) of the participants were above the age of 50 years. Overall, 39.3% (132/336) of respondents possessed inadequate HL, and 46.4% (156/336) and 14.3% (48/336) demonstrated marginal and adequate HL, respectively. Inadequate health literacy was more prevalent among women, as compared to men. Age was significantly associated with HL levels. Participants under age 50 had higher adequate HL levels 45.6% (31/68), (95% CI (3.8-57.4), P < 0.001). There was no correlation between education and health literacy levels. CONCLUSION The inadequate HL levels found in outpatients with CVD is a major health concern in the UAE. To improve population health outcomes, health system interventions, including targeted educational and behavioral programs for the older population are necessary.
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Affiliation(s)
- Satish Chandrasekhar Nair
- Department of Academic Affairs, Tawam Hospital, Al Ain, United Arab Emirates.
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
| | - Jayadevan Sreedharan
- Department of Community Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - Karthik Vijayan
- School of Medicine, Shri Satya Sai Medical College and Research Institute, Nellikuppam, India
| | - Halah Ibrahim
- Department of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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23
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Bourdache LR, Ould Brahim L, Wasserman S, Nicolas-Joseph M, Frati FYE, Belzile E, Lambert SD. Evaluation of quality, readability, suitability, and usefulness of online resources available to cancer survivors. J Cancer Surviv 2023; 17:544-555. [PMID: 36626094 DOI: 10.1007/s11764-022-01318-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of this study was to evaluate the quality, readability, suitability, and usefulness of resources publicly available to adult cancer survivors (aged 18 +) who have completed primary treatment. METHODS Resources were identified in July 2021 through Google. Search completeness was verified using Yahoo, Bing, and MedlinePlus. Retrieved resources were assessed for quality using the DISCERN, readability, suitability using the Suitability Assessment Measure (SAM), and usefulness based on a list of unmet needs and self-management skills derived from the literature. Descriptive analyses were conducted, and a cluster analysis identified the highest-scoring resources. RESULTS Forty-five resources were included. The mean DISCERN score was fair at 63.3% (SD 13.7%) with low-rated items being sources, publication date, and risks and mechanisms of treatment. The mean reading grade level was 11.19 (SD 1.61, range 8-16) with only one resource scoring an 8. The mean SAM score was in the adequate range at 48.2% (SD 10.6%), with graphics being the lowest-rated section. On average, included resources addressed 57.7% (SD 27.3%) of the unmet needs and 48.4% (SD 20.9%) of the self-management skills, the least addressed being problem-solving. CONCLUSION Quality and suitability were fair, whereas readability exceeded recommended levels. Only one resource had a superior score in both quality and suitability. IMPLICATIONS FOR CANCER SURVIVORS The most pressing need is to develop resources for cancer survivors that address their unmet needs and are accessible in terms of literacy. Study findings outline the highest-scoring resources currently available to survivors, families, and clinicians.
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Affiliation(s)
- Lydia Rosa Bourdache
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de La Montagne, Montreal, QC, H3G 2M1, Canada
| | - Lydia Ould Brahim
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Sydney Wasserman
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Marrah Nicolas-Joseph
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada
| | - Francesca Y E Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, 809 Sherbrooke West, QC, H3A 0C1, Montreal, Canada
| | - Eric Belzile
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, QC, H3A 2M7, Canada.
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada.
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24
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Kanejima Y, Izawa KP, Kitamura M, Ishihara K, Ogura A, Kubo I, Nagashima H, Tawa H, Matsumoto D, Shimizu I. Relationship between health literacy and physical function of patients participating in phase I cardiac rehabilitation: a multicenter clinical study. Heart Vessels 2023. [PMID: 36864154 DOI: 10.1007/s00380-023-02255-8] [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] [Indexed: 03/04/2023]
Abstract
Health literacy (HL) is an important decision factor for health. Both low HL and low physical function cause adverse events in cardiovascular disease patients, but their relationship is not well documented. To clarify the relationship between HL and physical function of patients participating in cardiac rehabilitation and calculate the cutoff value of the 14-item HL scale (HLS) for low handgrip strength, this multicenter clinical study named the Kobe-Cardiac Rehabilitation project for people around the World (K-CREW) was conducted among four affiliated hospitals with patients who underwent cardiac rehabilitation. We used the 14-item HLS to assess HL, and the main outcomes were handgrip strength and Short Physical Performance Battery (SPPB) score. The study included 167 cardiac rehabilitation patients with a mean age of 70.5 ± 12.8 years, and the ratio of males was 74%. Among them, 90 patients (53.9%) had low HL and scored significantly lower in both handgrip strength and SPPB. Multiple linear regression analysis revealed that HL was a determinant factor (β = 0.118, p = 0.04) for handgrip strength. Receiver operating characteristic analysis revealed the cutoff value of the 14-item HLS for screening for low handgrip strength was 47.0 points, and the area under the curve was 0.73. This study showed that HL was significantly associated with handgrip strength and SPPB in cardiac rehabilitation patients and suggests the possibility of early screening for low HL to improve physical function in cardiac rehabilitation patients with low HL.
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Affiliation(s)
- Yuji Kanejima
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-Ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-Ku, Kobe, 654-0142, Japan.
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan.
| | - Masahiro Kitamura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-Ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
- School of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Fukuoka, Japan
| | - Kodai Ishihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-Ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
- Department of Rehabilitation, Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Asami Ogura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-Ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
| | - Ikko Kubo
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-Chome, Suma-Ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe, Japan
- Department of Rehabilitation, Yodogawa Christian Hospital, Osaka, Japan
| | - Hitomi Nagashima
- Department of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi, Japan
| | - Hideto Tawa
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Daisuke Matsumoto
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan
| | - Ikki Shimizu
- Department of Diabetes, Sakakibara Heart Institute of Okayama, Okayama, Japan
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25
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Oh S, Choi H, Oh EG, Lee JY. Effectiveness of discharge education using teach-back method on readmission among heart failure patients: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2023; 107:107559. [PMID: 36411152 DOI: 10.1016/j.pec.2022.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study aims to review and evaluate the effectiveness of discharge education using the teach-back method (TBM) on readmission rates among patients with heart failure (HF). METHODS Searches were conducted in five electronic databases (PubMed, CINAHL, Embase, Cochrane Library, and Web of Science) published until May 2022, followed by a manual search of reference lists. The risk of bias in the studies was assessed using the Cochrane Risk of Bias and Joanna Briggs Institute quasi-experimental critical appraisal tool, and meta-analysis was conducted using Cochrane Review Manager 5. RESULTS Seven studies were included in the review, and the quality of the studies varied, with two studies scoring low on the overall risk of bias. Meta-analysis was conducted using six studies, demonstrating that discharge education using TBM significantly reduced the overall readmission rates (odds ratio = 0.40, 95% confidence interval 0.17-0.94). CONCLUSIONS TBM is an effective educational strategy for reducing the readmission rate in discharged patients with HF. More rigorously designed studies evaluating the effectiveness of education using TBM in patients with HF are needed. PRACTICE IMPLICATIONS Nurses in clinical settings can use TBM in their discharge education to improve HF patients' understanding of the illness and impact long-term outcomes, such as readmission rates.
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Affiliation(s)
- Sunyoung Oh
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea; College of Nursing, Yonsei University, Seoul, South Korea
| | - Hannah Choi
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Eui Geum Oh
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea; College of Nursing, Yonsei University, Seoul, South Korea; Mo-IM KIM Nursing Research Institute College of Nursing, Yonsei University, Seoul, South Korea
| | - Ji Yea Lee
- College of Nursing, Yonsei University, Seoul, South Korea.
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26
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Baltazar AO, Popejoy L. Health Literacy of Surrogates and Communication Issues in Palliative Care Conversations in Critical Care: An Integrative Review. J Hosp Palliat Nurs 2023; 25:39-44. [PMID: 36622313 DOI: 10.1097/njh.0000000000000921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Worldwide, 56.8 million persons are estimated to require palliative care. Critically ill patients benefit from palliative care by improving their quality of life through symptom management. Resistance to palliative care exists from surrogate decision-makers because of low health literacy and communication issues with providers. This research reviewed the literature to identify how health literacy and health care communication influenced palliative care conversations with decision-making surrogates and health outcomes of critically ill patients. The review included articles between 2011 and 2022 using the terms communication, health literacy, palliative care, critical care, intensive care, ICU, surrogate decision maker, family, and caregiver in PubMed, CINAHL, and Google Scholar. Fourteen articles were included. Quality was assessed through Joanna Briggs Institute appraisal tools. Health literacy of surrogates was not found to be significant for patient outcomes. However, there were significant differences between clinician and surrogate communication influenced by surrogates' previous health care experiences. Early communication about prognosis was important for surrogates. Structured communication approaches were preferred by surrogates. Limitations of the review included primarily White participants, small variability of research sites, and a few number of articles. Future research needs to study the effects of surrogate health literacy of critically ill patients on willingness to accept palliative care.
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27
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Kanejima Y, Izawa KP, Kitamura M, Ishihara K, Ogura A, Kubo I, Nagashima H, Tawa H, Matsumoto D, Shimizu I. Health Literacy Is Associated with Activities of Daily Living of Patients Participating in Cardiac Rehabilitation: A Multicenter Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416550. [PMID: 36554430 PMCID: PMC9779210 DOI: 10.3390/ijerph192416550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 06/12/2023]
Abstract
The activities of daily living (ADL) in patients with cardiac disease tend to decline. A previous study revealed that ADL relates to physical and cognitive functions associated with health literacy (HL). However, the relationship between HL and ADL is not well documented. This study aimed to clarify this relationship among patients participating in cardiac rehabilitation. This multicenter study, the Kobe-Cardiac Rehabilitation project for people around the World (K-CREW), included patients who participated in cardiac rehabilitation from October 2020 to December 2021. Patients with probable dementia and difficulty walking alone were excluded. We used the 14-item Health Literacy Scale (HLS-14) to assess HL and the Functional Independence Measure (FIM) to assess ADL at discharge. Patients were divided by their HLS-14 score into the low HL group (<50 points) or the high HL group (≥50 points). We analyzed the relationship between the HLS-14 and FIM scores. We investigated 268 cardiac rehabilitation patients (median age, 71.0 years; male ratio, 76.9%). Low HL patients accounted for 51.1% of all patients and had significantly lower motor and cognitive FIM scores. Functional HL related better to the FIM scores (r = 0.28-0.36) than did other HL subclasses. Multiple regression analysis identified HLS-14 as an explanatory variable (p = 0.002) for the total FIM score. Patients with low HL had significantly lower ADL than those with high HL. These findings underscore the importance of considering HL in cardiac rehabilitation.
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Affiliation(s)
- Yuji Kanejima
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan
| | - Kazuhiro P. Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
| | - Masahiro Kitamura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Fukuoka 811-0213, Japan
| | - Kodai Ishihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Rehabilitation, Sakakibara Heart Institute of Okayama, Okayama 700-0804, Japan
| | - Asami Ogura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Rehabilitation, Sanda City Hospital, Sanda 669-1311, Japan
| | - Ikko Kubo
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Rehabilitation, Yodogawa Christian Hospital, Osaka 533-0024, Japan
| | - Hitomi Nagashima
- Department of Rehabilitation, Shinyukuhashi Hospital, Yukuhashi 824-0026, Japan
| | - Hideto Tawa
- Department of Cardiology, Sanda City Hospital, Sanda 669-1311, Japan
| | - Daisuke Matsumoto
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka 533-0024, Japan
| | - Ikki Shimizu
- Department of Diabetes, Sakakibara Heart Institute of Okayama, Okayama 700-0804, Japan
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28
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Huy LD, Truong NLT, Hoang NY, Nguyen NTH, Nguyen TTP, Dang LT, Hsu YHE, Huang CC, Chang YM, Shih CL, Carbone ET, Yang SH, Duong TV. Insight into global research on health literacy and heart diseases: A bibliometric analysis. Front Cardiovasc Med 2022; 9:1012531. [PMID: 36505390 PMCID: PMC9729531 DOI: 10.3389/fcvm.2022.1012531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Health literacy (HL) has shown its important role on reducing the burden of heart diseases. However, no study has provided a comprehensive worldwide view of the data regarding HL and heart diseases. The study aimed to provide insight into: (1) the intellectual structure, (2) research trends, and (3) research gaps on HL and heart diseases; and (4) to explore HL scales commonly utilized in heart studies. Materials and methods Studies related to HL and heart diseases were retrieved from Web of Science, Scopus, and PubMed. All publications published between 2000 and 2021 were included after conducting keyword searches on "heart diseases" in general or on specific types of heart diseases (e.g., "heart failure") and "health literacy". Bibliometric analyses were carried out using the Bibliometrix R package and VOSviewer 1.6.14. Findings A total of 388 original research articles and reviews on HL and heart diseases were included in our study. The studies were primarily conducted in the United States and developed countries. A total of 337 studies (86.9%) focused on heart failure (200 studies, 51.5%) and ischemic heart diseases (137 studies, 35.3%). Sixty-two studies (16.0%) focused on other heart diseases (e.g., valvular diseases and rheumatic heart diseases). The number of interventional studies was limited (52 studies, 13.4%) and fluctuated from 2000 to 2021. The most common questionnaires measuring health literacy among patients with heart diseases were the Test of Functional Health Literacy in Adults (TOFHLA), Short Test of Functional Health Literacy in Adults (STOFHLA), and Brief Health Literacy Screen (BHLS). Use of the eHealth Literacy Scale (eHEALS) has become the latest trend among patients with heart diseases. Conclusion Health literacy and heart diseases were most often studied in the United States and developed countries. Several HL tools were used; eHEALS has been lately used in this field. These findings suggest the need to conduct more empirical studies on HL and heart diseases in different settings (e.g., developing or poor countries) and with different types of heart diseases (e.g., valvular and rheumatic disorders). Additionally, it is necessary to develop heart disease-specified HL scales for research and practice.
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Affiliation(s)
- Le Duc Huy
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Nguyen L. T. Truong
- School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam,Pharmacy Department, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Nhi Y. Hoang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Nhi Thi Hong Nguyen
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam,School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Thao T. P. Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Loan T. Dang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan,Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
| | - Yi-Hsin Elsa Hsu
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan,Executive Master Program of Business Administration in Biotechnology, College of Management, Taipei Medical University, Taipei, Taiwan,International Ph.D. Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Chung-Chien Huang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan,International Ph.D. Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan,Department of Long-Term Care and School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan,School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Yao-Mao Chang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan,Research Center of Health and Welfare Policy, Taipei Medical University, Taipei, Taiwan
| | | | - Elena T. Carbone
- Department of Nutrition, University of Massachusetts, Amherst, MA, United States
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan,Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan,Research Center of Geriatric Nutrition, Taipei Medical University, Taipei, Taiwan,*Correspondence: Shwu-Huey Yang,
| | - Tuyen V. Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan,International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Tuyen V. Duong,
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29
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Beasant B, Lee G, Vaughan V, Lotfaliany M, Hosking S. Health literacy and cardiovascular disease prevention: a systematic scoping review protocol. BMJ Open 2022; 12:e054977. [PMID: 35676010 PMCID: PMC9185497 DOI: 10.1136/bmjopen-2021-054977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Health literacy is 'The skills and resources of a person to access, understand and use information to make decisions, and take action on their own health and healthcare'. Literature investigating cardiovascular disease (CVD) prevention and health literacy often exist in silos, only exploring one element of prevention. This protocol aims to establish a scoping method of articles investigating health literacy and CVD preventive practices or knowledge in lay populations. METHODS AND ANALYSIS A scoping review was deemed the most appropriate study design. The topic was conceptualised, with preliminary searching informing subsequent development of search strings. A search of the following databases will be conducted on 31 January 2022: MEDLINE, Global Health, PubMed, Embase, PsycINFO and CINAHL. Studies included will be published in English, of appropriate design, measuring health literacy and some aspect of primary CVD prevention in lay-populations. These criteria will be tested against 25 'pilot' articles from the results, undergoing necessary review before screening commences. A secondary author will screen 10% of abstracts, with a third subject-matter expert reviewing conflicts. ETHICS AND DISSEMINATION This review will be disseminated through peer-reviewed scholarly networks, most likely including journal publication and conference presentation. ARTICLE SUMMARY CVD is the leading cause of death around the world. This paper proposes an exploration of health literacy's relationship with CVD prevention as a whole, contrasting with the more segmented reviews currently published.
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Affiliation(s)
- Bonnie Beasant
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Georgie Lee
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Vanessa Vaughan
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Mojtaba Lotfaliany
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Sarah Hosking
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
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