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Kor PPK, Yu CTK, Li Y, Tsang APL, Tan LHZ, Lam SC, Lee PH, Liu JYW, Leung AYM, Lee KC. Development and validation of a health literacy scale for family caregivers of older people with chronic illness. BMC Nurs 2024; 23:447. [PMID: 38951836 PMCID: PMC11218080 DOI: 10.1186/s12912-024-02057-x] [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: 03/31/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Family caregivers (FCs) encounter a variety of health problems in older people with chronic illness, necessitating a certain level of health literacy to access, understand, appraise and apply health information and services. This study aimed to develop and validate a scale for measuring health literacy among FCs of older people with chronic illness. METHODS Concept mapping was first employed to develop a conceptual model of health literacy of FCs. Scale domains were derived from the conceptual model, and item generation was performed using deductive and inductive methods. Quantitative methods, including merging scale dimensions and items, expert reviews, cognitive interviews, and item reduction analysis, were used to refine the scale. Confirmatory factor analysis was employed to validate the scale's structure. Concurrent validity, internal consistency, and test-retest reliability were also examined. RESULTS A 20-dimension conceptual model was developed, and 60 items were generated for the scale. Expert review (content validity index > 0.85) and cognitive interview with FCs confirmed the relevance and clarity of the majority of the generated scale items. Confirmatory factor analysis with 451 FCs of older people with chronic illness supported a 5-factor structure (symptom management, daily personal care and household tasks, care coordination, communication and relationship with the care recipient, and self-care of caregivers) with 42 finalized scale items, including four levels of health literacy skills (accessing, understanding, appraising and applying health information). Concurrent validity with the European Health Literacy Questionnaire (HLS-EU-Q47) was satisfactory (r = 0.67, p < 0.01). The Cronbach's α coefficient of the scale was 0.96, with subscales ranging from 0.84 to 0.91. The two-week test-retest reliability was 0.77 (p < 0.01). CONCLUSION This study developed a conceptual model explaining the concept and factors of health literacy among FCs of older people with chronic illness that could provide the groundwork for future studies in developing relevant evidence-based interventions. A new Health Literacy Scale-Family Caregiver (HLS-FC) with satisfactory psychometric properties was developed in this study, which can be utilized to identify caregivers with insufficient health literacy and facilitate timely interventions by healthcare professionals.
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Affiliation(s)
| | - Clare Tsz Kiu Yu
- Division of Psychiatry, University of College London, London, UK
| | - Yaqin Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Alex Pak Lik Tsang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lexi Han Zhi Tan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Paul Hong Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Dijkman EM, ter Brake WWM, Drossaert CHC, Doggen CJM. Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review. Healthcare (Basel) 2023; 12:11. [PMID: 38200917 PMCID: PMC10778720 DOI: 10.3390/healthcare12010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Assessment of (digital) health literacy in the hospital can raise staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools should ideally address multiple domains of health literacy, fit to the complex hospital context and have a short administration time, to enable routine assessment. This review aims to create an overview of tools for measuring (digital) health literacy in hospitals. A search in Scopus, PubMed, WoS and CINAHL, following PRISMA guidelines, generated 7252 hits; 251 studies were included in which 44 assessment tools were used. Most tools (57%) were self-reported and 27% reported an administration time of <5 min. Almost all tools addressed the domain 'understanding' (98%), followed by 'access' (52%), 'apply' (50%), 'appraise' (32%), 'numeracy' (18%), and 'digital' (18%). Only four tools were frequently used: the Newest Vital Sign (NVS), the Short Test of Functional Health Literacy for Adults ((S)TOFHLA), the Brief Health Literacy Screener (BHLS), and the Health Literacy Questionnaire (HLQ). While the NVS and BHLS have a low administration time, they cover only two domains. HLQ covers the most domains: access, understanding, appraise, and apply. None of these four most frequently used tools measured digital skills. This review can guide health professionals in choosing an instrument that is feasible in their daily practice, and measures the required domains.
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Affiliation(s)
- Eline M. Dijkman
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Department of Surgery, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Wouter W. M. ter Brake
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
| | | | - Carine J. M. Doggen
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
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Ezeoke OM, Williams J, Ogueri V, Hills BK. The Heart of the Matter: A Path to Building Diversity in Pediatric Cardiology. Pediatr Cardiol 2023:10.1007/s00246-023-03144-7. [PMID: 36961540 DOI: 10.1007/s00246-023-03144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
Our essay discusses the impact of underrepresentation in medical training, with a focus on pediatric cardiology. We use the perspective of a physician who is underrepresented in medicine (URiM), and has chosen to pursue a career in pediatric cardiology, to initiate an analysis of the current path toward pediatric cardiology and the factors in undergraduate and graduate medical education which could currently be optimized to improve diversity in training. We argue that a lack of diversity among physicians leads to worse patient outcomes, and we describe steps to improve representation in the field. In order to improve representation in pediatric cardiology, we must reflect upon our current practices and implement systemic changes within cardiology training program recruitment and retention practices. These changes should include continuous mentorship of URiM trainees interested in cardiology and prioritization of research that investigates social determinants of health which may disproportionally affect minority patients.
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Affiliation(s)
- Ogochukwu M Ezeoke
- Division of Pediatric Cardiology, Congenital Heart Center - C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA.
| | - Jason Williams
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Vanessa Ogueri
- Division of Pediatric Cardiology, Children's National Hospital, Washington, DC, USA
| | - Brittney K Hills
- Department of Pediatric Cardiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
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Lorini C, Buscemi P, Mossello E, Schirripa A, Giammarco B, Rigon L, Albora G, Giorgetti D, Biamonte MA, Fattorini L, Bruno RM, Giusti G, Longobucco Y, Ungar A, Bonaccorsi G. Health literacy of informal caregivers of older adults with dementia: results from a cross-sectional study conducted in Florence (Italy). Aging Clin Exp Res 2023; 35:61-71. [PMID: 36260214 PMCID: PMC9580430 DOI: 10.1007/s40520-022-02271-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/02/2022] [Indexed: 01/11/2023]
Abstract
AIM The aim of this study was to measure the prevalence of inadequate health literacy (HL) in a sample of family caregivers of older adults with dementia, and to assess the relationship of HL with characteristics of caregiver and persons with dementia. METHODS The study followed a cross-sectional design. Persons with dementia and their family caregivers were enrolled in an outpatients' geriatric memory clinic. For the caregivers, the following information was collected: socio-demographic data, level of HL, cognitive impairment (using the Mini-Cog). For persons with dementia, the following data were collected: socio-demographic data, functional status (using the Basic and Instrumental Activities of Daily Living), cognitive impairment (using the Mini Mental State Evaluation, and the Global Deterioration Scale) behavioral and psychological symptoms associated with dementia (assessed using the Neuropsychiatric Inventory). RESULTS A total of 174 person with dementia/caregiver dyads were enrolled. About 45% of the caregivers presented a possibility or a high likelihood of inadequate HL. The percentage of caregivers with inadequate HL was higher among spousal caregivers than in offspring. Female gender, higher age and lower education were independent predictors of low HL. On multiple logistic regression analysis, persons with dementia assisted by caregivers with a high likelihood of limited HL presented higher risk of a more severe disease. CONCLUSION The results of this study suggest that the HL of dementia caregivers has to be included in the comprehensive geriatric assessment, to develop an appropriate individualized care plan. Moreover, public health interventions are needed to increase the HL of dementia caregivers.
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Affiliation(s)
- Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy ,Health Literacy Laboratory, Department of Health Science, University of Florence, Florence, Italy
| | - Primo Buscemi
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Enrico Mossello
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, Firenze, Italy ,School of Geriatric Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Annamaria Schirripa
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Barbara Giammarco
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Lisa Rigon
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Giuseppe Albora
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Duccio Giorgetti
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Massimiliano Alberto Biamonte
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Letizia Fattorini
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Rita Manuela Bruno
- School of Geriatric Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gemma Giusti
- Department of Health Science, University of Florence, Florence, Italy
| | - Yari Longobucco
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Ungar
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, Firenze, Italy ,School of Geriatric Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Guglielmo Bonaccorsi
- Department of Health Science, University of Florence, Florence, Italy ,Health Literacy Laboratory, Department of Health Science, University of Florence, Florence, Italy
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Burns J, Higgins C, Ganigara M, Kalivas B, Basken A. Health literacy in CHD. Cardiol Young 2022; 32:1-4. [PMID: 35611812 DOI: 10.1017/s1047951122001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Joseph Burns
- Cohen Children's Medical Center, Queens, NY 11040, USA
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