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Stege H, Schneider S, Forschner A, Eigentler T, Nashan D, Huening S, Meiss F, Lehr S, Kaatz M, Kuchen R, Kaehler KC, Haist M, Huebner J, Loquai C. eHealth Literacy in German Skin Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148365. [PMID: 35886215 PMCID: PMC9320579 DOI: 10.3390/ijerph19148365] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 11/30/2022]
Abstract
The global incidence of skin cancer has steadily increased in recent years, and malignant melanoma still has one of the fastest-growing incidence rates among all malignant tumors in the western world. Thus, newly diagnosed patients have an increased need for health information concerning their disease. Using a standardized questionnaire, our study aims to investigate our patients’ primary sources of health-related information as well as their self-proclaimed eHealth literacy. We received 714 questionnaires. Regardless of age, the primary source of information was the treating dermato-oncologist, followed by the treating general practitioner and the Internet. However, with increasing age, the usage of the Internet decreased. Hence, younger participants were better equipped to find health-related information while using the Internet. Additionally, comprehending health-related information and gaining medical knowledge was significantly increased in better-educated participants. Overall, our study shows that with increased use of eHealth services, accessing web-based information increased, correlating with a better eHealth literacy of our patients. eHealth technologies are increasingly becoming more prevalent as a primary source of information in our modern health care system. Thus, it is crucial to educate cancer patients in eHealth literacy to make autonomous, informed decisions and gain more confidence in dealing with their disease.
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Affiliation(s)
- Henner Stege
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany; (S.S.); (M.H.); (C.L.)
- Correspondence:
| | - Sara Schneider
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany; (S.S.); (M.H.); (C.L.)
| | - Andrea Forschner
- Department of Dermatology, University Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Thomas Eigentler
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität, 10117 Berlin, Germany;
| | - Dorothée Nashan
- Department of Dermatology, Hospital Dortmund, 44137 Dortmund, Germany; (D.N.); (S.H.)
| | - Svea Huening
- Department of Dermatology, Hospital Dortmund, 44137 Dortmund, Germany; (D.N.); (S.H.)
| | - Frank Meiss
- Department of Dermatology, Medical Center—University of Freiburg, 79104 Freiburg, Germany; (F.M.); (S.L.)
| | - Saskia Lehr
- Department of Dermatology, Medical Center—University of Freiburg, 79104 Freiburg, Germany; (F.M.); (S.L.)
| | - Martin Kaatz
- Department of Dermatology, Wald-Klinikum Gera, 07546 Gera, Germany;
| | - Robert Kuchen
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, 55131 Mainz, Germany;
| | - Katharina C. Kaehler
- Department of Dermatology, Venerology and Allergology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, Germany;
| | - Maximilian Haist
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany; (S.S.); (M.H.); (C.L.)
| | - Jutta Huebner
- Klinik für Innere Medizin II, Hämatologie und Onkologie, Universitätsklinikum Jena, 07747 Jena, Germany;
| | - Carmen Loquai
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany; (S.S.); (M.H.); (C.L.)
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Mackey LM, Blake C, Casey MB, Power CK, Victory R, Hearty C, Fullen BM. The impact of health literacy on health outcomes in individuals with chronic pain: a cross-sectional study. Physiotherapy 2019; 105:346-353. [PMID: 30878145 DOI: 10.1016/j.physio.2018.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/04/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To establish if health literacy (HL) is linked to poorer outcomes and behaviours in patients with chronic pain. DESIGN A prospective cross-sectional observational study. SETTING Multidisciplinary out-patient pain clinics in three university teaching hospitals. PATIENTS New patients (n=131) referred to the pain clinic with a history of chronic pain (>12 weeks). METHODS A questionnaire was distributed to chronic pain patients attending their first appointment. Those eligible for inclusion were newly referred patients who had pain lasting longer than three months. The questionnaire comprised the following sections: demographics, chronic pain status and disease-related knowledge, quality of life (SF-36), beliefs (Beliefs About Pain Control Questionnaire), and a validated HL tool (Newest Vital Sign). RESULTS Of the 131 participants recruited, 54% had inadequate HL. The group was subsequently stratified according to HL level. In bivariate analysis, inadequate HL was associated with older age (p<0.001), being unemployed or retired (p=0.005), less education (p<0.001), lower income, increased comorbidities (p=0.038), being less likely to utilise allied health services (p=0.001), poorer disease-related knowledge (p=0.002), and poorer beliefs about pain (p<0.05). In multivariate analysis, disease-related knowledge (OR 2.5, 95%CI 1.0 to 6.3, p=0.05) and beliefs about pain (B=-2.3, S.E=0.9, p=0.01) remained independently associated with HL. CONCLUSION Inadequate HL is prevalent in chronic pain patients, and may impact on the development of certain characteristics necessary for effective self-management.
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Affiliation(s)
- Laura M Mackey
- School of Public Health, Physiotherapy and Sports Science, University College Dublin 4, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin 4, Ireland
| | - Maire-Brid Casey
- Pain Service Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Camillus K Power
- Pain Service, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
| | - Ray Victory
- Pain Service St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Conor Hearty
- Pain Service Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Brona M Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin 4, Ireland; UCD Centre for Translational Pain Research, University College Dublin, Ireland.
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Ansari H, Almasi Z, Ansari-Moghaddam A, Mohammadi M, Peyvand M, Hajmohammadi M, Bagheri F. Health Literacy in Older Adults and Its Related Factors: A Cross-Sectional Study in Southeast Iran. HEALTH SCOPE 2016. [DOI: 10.17795/jhealthscope-37453] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gardiner P, Filippelli AC, Sadikova E, White LF, Jack BW. Medication and Dietary Supplement Interactions among a Low-Income, Hospitalized Patient Population Who Take Cardiac Medications. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:429826. [PMID: 25949262 PMCID: PMC4407526 DOI: 10.1155/2015/429826] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 03/07/2015] [Accepted: 03/24/2015] [Indexed: 02/06/2023]
Abstract
Purpose. To identify characteristics associated with the use of potentially harmful combinations of dietary supplements (DS) and cardiac prescription medications in an urban, underserved, inpatient population. Methods. Cardiac prescription medication users were identified to assess the prevalence and risk factors of potentially harmful dietary supplement-prescription medication interactions (PHDS-PMI). We examined sociodemographic and clinical characteristics for crude (χ (2) or t-tests) and adjusted multivariable logistic regression associations with the outcome. Results. Among 558 patients, there were 121 who also used a DS. Of the 110 participants having a PHDS-PMI, 25% were asked about their DS use at admission, 75% had documentation of DS in their chart, and 21% reported the intention to continue DS use after discharge. A multivariable logistic regression model noted that for every additional medication or DS taken the odds of having a PHDS-PMI increase and that those with a high school education are significantly less likely to have a PHDS-PMI than those with a college education. Conclusion. Inpatients at an urban safety net hospital taking a combination of cardiac prescription medications and DS are at a high risk of harmful supplement-drug interactions. Providers must ask about DS use and should consider the potential for interactions when having patient discussions about cardiac medications and DS.
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Affiliation(s)
- Paula Gardiner
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
| | - Amanda C. Filippelli
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
| | - Ekaterina Sadikova
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
| | - Laura F. White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Brian W. Jack
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
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Gardiner P, Mitchell S, Filippelli AC, Sadikova E, White LF, Paasche-Orlow MK, Jack BW. Health literacy and complementary and alternative medicine use among underserved inpatients in a safety net hospital. JOURNAL OF HEALTH COMMUNICATION 2013; 18 Suppl 1:290-7. [PMID: 24093362 PMCID: PMC3814611 DOI: 10.1080/10810730.2013.830663] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Little is known about the relationship between health literacy and complementary and alternative medicine (CAM) use in low-income racially diverse patients. The authors conducted a secondary analysis of baseline data from 581 participants enrolled in the Re-Engineered Discharge clinical trial. The authors assessed sociodemographic characteristics, CAM use, and health literacy. They used bivariate and multivariate logistic regression to test the association of health literacy with four patterns of CAM use. Of the 581 participants, 50% reported using any CAM, 28% used provider-delivered CAM therapies, 27% used relaxation techniques, and 21% used herbal medicine. Of those with higher health literacy, 55% used CAM. Although there was no association between health literacy and CAM use for non-Hispanic Black participants, non-Hispanic White (OR = 3.68, 95% CI [1.27, 9.99]) and Hispanic/other race (OR = 3.40, 95% CI [1.46, 7.91]) participants were significantly more likely to use CAM if they had higher health literacy. For each racial/ethnic group, there were higher odds of using relaxation techniques among those with higher health literacy. Underserved hospitalized patients use CAM. Regardless of race, patients with high health literacy make greater use of relaxation techniques.
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Affiliation(s)
- Paula Gardiner
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
- Address correspondence to Paula Gardiner, Department of Family Medicine, Boston University Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA. E-mail:
| | - Suzanne Mitchell
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Amanda C. Filippelli
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Ekaterina Sadikova
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Laura F. White
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Michael K. Paasche-Orlow
- Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Brian W. Jack
- Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
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Loke YK, Hinz I, Wang X, Rowlands G, Scott D, Salter C. Impact of health literacy in patients with chronic musculoskeletal disease--systematic review. PLoS One 2012; 7:e40210. [PMID: 22792242 PMCID: PMC3391211 DOI: 10.1371/journal.pone.0040210] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 06/04/2012] [Indexed: 01/10/2023] Open
Abstract
Objectives To estimate the prevalence of low health literacy, and evaluate the impact of low health literacy on outcomes in patients with chronic musculoskeletal conditions. Data Sources We searched Embase, Pubmed, PsycInfo, and CINAHL in January 2011 for relevant studies, restricted to English-language articles. Study Selection and Data Extraction Studies were included if they measured health literacy and/or reported on the link between outcomes and health literacy levels in patients with osteoporosis, osteoarthritis, or rheumatoid arthritis. We assessed risk of bias from participant selection, methods of measuring health literacy and functional outcomes, missing data, and potential for confounding. Data Synthesis We reviewed 1863 citations and judged 8 studies to be relevant. Most were cross-sectional in nature, and five were based in the United States. Diversity in measurements, participant characteristics, and settings meant that results had to be synthesized narratively. Prevalence of low health literacy varied from 7% to 42%. Of the five studies that reported on musculoskeletal outcomes, only one showed an association (unadjusted) between low health literacy and greater pain and limitations in physical functioning. However, other studies, including those with multivariate analyses, found no significant relationship between health literacy and measures of pain or disease specific questionnaires. One clinical trial found short-term improvements in the mental health of patients with musculoskeletal conditions after an intervention to improve health literacy. Limitations Most of the studies were cross-sectional in nature, which precludes interpretation of a causal relationship. The sample sizes may not have been sufficiently large to enable detection of significant associations. Conclusions The current evidence does not show a consistent association between low health literacy and poorer functional outcomes in patients with chronic musculoskeletal conditions. In the absence of a definite link, efforts to develop interventions to improve health literacy would not necessarily improve health service or patient-related outcomes.
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Affiliation(s)
- Yoon K Loke
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom.
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