Health literacy, health-related quality of life, and atrial fbrillation

Factors associated with poor health literacy in older adults: A systematic review

OBJECTIVES

To identify factors associated with poor health literacy in older adults.

METHODS

A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy".

PROSPERO - CRD

42022350140.

RESULTS

Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others).

CONCLUSIONS

The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies.

Coping with identity threat and health literacy on the quality of life and mental health in students: Structural equation modeling

AIM

Adolescents face many challenges when entering university. The aim of this study was determined predictor role of coping with identity threat and health literacy on the quality of life and mental health of students.

METHODS

This is a descriptive-analytical study of the structural equation study. Random sampling was performed on 300 students of Alborz University of medical science who were eligible to enter the study. The link of the questionnaires was provided to the students through social networks. The questionnaires were used to study identity threat, mental health, health literacy, and quality of life.

RESULTS

The results of structural equations showed that health literacy has a negative and significant effect (β = -0.22) and identity threat strategy has a negative and significant effect on students' mental health disorder (β = -0.53). Mental health disorders have a negative and significant effect on the quality of life in students (β = -0.49), and health literacy has a positive and significant effect on the quality of life (β = 0.35). Based on Sobel criterion, mental health disorder was a partial mediator for the indirect effect of coping threat strategy on quality of life.

CONCLUSIONS

Considering the effect of mental health and health literacy on the quality of life and the effectiveness of coping strategies, it is recommended to evaluate the mental health and health literacy of students in universities and provide educational programs for identity coping in the early years after entering the university.

Surgeon compassion may mitigate quality of life disparities associated with health literacy

Objectives

Patients with health literacy (HL) disparities are less likely to comprehend hospital discharge instructions and less satisfied with physician communication. In this prospective cohort study, we sought to examine the interaction of HL, physician communication, and quality of life after hospital discharge among postoperative emergency surgery and trauma patients.

Methods

Emergency surgery and trauma surgery patients were prospectively enrolled between December 2020 and December 2021 at an urban level 1 trauma center. Newest Vital Sign (NVS) instrument was used to measure HL during hospitalization. After discharge, patients were administered Revised Trauma Quality of Life (RT-QOL) and Interpersonal Processes of Care (IPC) instruments. An adjusted regression model was used to determine associations among NVS the emotional well-being subscale on the RT-QOL, and patient perception of physician compassion and respect on the IPC.

Results

94 patients completed all instruments. HL was proficient (high HL) in 59.6% and less than proficient (low HL) in 40.4%. HL was positively associated with RT-QOL emotional well-being, r(94)=0.212, p=0.040. However, higher rating of surgeon compassion and respect on IPC moderated the relationship between HL and emotional well-being such that patients with low HL and high perception of physician compassion and respect had similar emotional well-being as the high HL group (p=0.042).

Conclusion

Favorable patient perception of surgeon compassion and respect was correlated with higher emotional well-being, independent of HL proficiency. Although the allocation of resources toward improving HL disparities remains warranted, improving patient perception of caregiver compassion during hospitalization may be a target of opportunity with respect to improving quality of life after hospital discharge.

Level of evidence

Level III.

Investigation of health literacy level and its effect on quality of life in patients with spinal cord injury

OBJECTIVES

To determine the health literacy (HL) level in patients with traumatic spinal cord injury (SCI) and evaluate the relationship between HL and the quality of life (QoL).

STUDY DESIGN

Cross-sectional study.

SETTING

Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Turkey.

PARTICIPANTS

A total of 77 patients with traumatic SCI aged 15-65 years where the trauma had occurred at least a month ago before data collection and who were attending the rehabilitation program at the hospital as inpatients we included in the study.

OUTCOME MEASURES

The European Health Literacy Questionnaire Turkish Adaptation (HLS-TR) was used for the evaluation of the HL level, and the Short Form-36 was used for the evaluation of the QoL.

RESULTS

The HL level was inadequate in 32.5%, problematic-limited in 40.3%, sufficient in 19.5%, and excellent in 7.8% of the patients. The vitality and mental health subdimensions of the QoL were found to be statistically significantly better in participants with excellent, sufficient or problematic-limited HL compared to those with an inadequate level.

CONCLUSIONS

According to our results, the HL level of the majority of patients with SCI who are hospitalized in our hospital is low, and there is a relationship between HL and QoL. In conclusion, steps need to be taken to increase the HL levels of patients to improve their QoL, taking into account the important effect of HL on the QoL.

Investigating the feasibility of recruitment to an observational, quality-of-life study of patients diagnosed with atrial fibrillation (AF) who have experienced a bleed while anticoagulated: EQUAL-AF feasibility study protocol

Background

Oral anticoagulation therapies (OATs) are often prescribed in conjunction with medications to restore normal heart rate rhythm which can limit the risk of an atrial fibrillation (AF) related stroke and systemic thromboembolism. However, they are associated with the serious side effect of bleeding. Both clinically relevant nonmajor bleeding (CRNMB) and major bleeding while anticoagulated are believed to have a significant impact on patient quality of life (QoL). There is currently limited research into the effect bleeding has on QoL. The aim of this study is to evaluate the feasibility of identifying and recruiting patients diagnosed with AF, who are taking OATs and have recently experienced a bleed and collecting information on their QoL.

Methods

We will recruit a minimum of 50 patients to this cross-sectional, observational study. We will recruit from general practices, secondary care, and through an online AF forum. We will ask participants to complete three validated patient-reported outcome measures (PROMs), EQ5D, AFEQT, and PACT-Q, approximately 4 weeks following a bleed and again 3 months later. We will randomly select a subset of 10 participants (of those who agree to be interviewed) to undergo a structured interview with a member of the research team to explore the impact of bleeding on their QoL and to gain feedback on the three PROMs used. We will undertake a descriptive analysis of the PROMs and demographic data. We will analyse the qualitative interviews thematically to identify key themes.

Discussion

We aim to establish if it is possible to recruit patients and use PROMs to collect information regarding how patient QoL is affected when they experience either a clinically relevant non-major bleed (CRNMB) or major bleed while taking OATs for the management of AF. We will also explore the appropriateness, or otherwise, of the three identified PROMs for assessing quality of life following a bleed.

PROMs

Three PROMs were selected following a literature review of similar QoL studies and using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for comparison. A review of the current literature produced no suitable validated PROM to record QoL experiences in patients who have been diagnosed with AF and have experienced a bleed while anticoagulated. As such, the EQ5D, AFEQT, and PACT-Q (part 2) were deemed most appropriate for use in this feasibility study.

Trial registration

The trial has been adopted onto the NIHR Portfolio (ID no. 47771) and registered with www.ClinicalTrials.gov (no. NCT04921176) retrospectively registered in June 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01135-8.

The Relationship Between Health Literacy and Quality of Life, Attitudes and Perceptions of Covid-19 and Vaccination Among Patients with Systemic Autoimmune Diseases

We aimed to evaluate health literacy in a population of patients with systemic autoimmune diseases (SAD), and to analyze their potential relationships with health-related quality of life (HRQoL), attitudes and beliefs of Covid-19 and vaccination, and perceptions of changes in medical care during the pandemic. A cross-sectional study was conducted among 395 patients (81.1% were living in Spain). An anonymous online survey was distributed to an online SAD association. Health literacy was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the SF-36 tool was used to assess HRQoL. More than half of patients (57.7%) have inadequate health literacy and the mean health literacy level was 9.63(5.66). Patients with inadequate health literacy levels presented the lowest HRQoL scores in all SF-36 domains (p < .001). Health literacy scores were positively correlated with all SF-36 domains (p < .001). The reservations to get vaccinated against Covid-19 were linked to health literacy level (p = 0.024). There are high levels of inadequate health literacy among patients with SAD and it is associated with worse HRQoL and risk attitudes about Covid-19 vaccination and medical care during the pandemic.

Health literacy and quality of life in hospitalized heart failure patients: a cross-sectional study

INTRODUCTION

Heart Failure (HF) treatment may be improved by good knowledge of the disease (Health Literacy) that, despite the well-established role on improving self-care, preventing complications and avoiding worse outcomes, has little evidence on affecting QoL of HF patients. Therefore, the objective of the present study was to evaluate the impact of Health Literacy on QoL in hospitalized HF patients.

METHODOLOGY

A cross-sectional exploratory study was conducted with HF patients hospitalized at a public cardiological hospital. Health Literacy was assessed using the "Questionnaire about Heart Failure Patients' Knowledge of Disease" and QoL using the "Minnesota Living with Heart Failure Questionnaire" (MLHFQ). The association between Health Literacy and QoL was assessed by linear regression (P<0.05).

RESULTS

50 patients were included in the study; the mean Health Literacy score was 34.2 ± 15.1 (the majority presenting acceptable or better knowledge). The mean MLHFQ score was 73.5 ± 19.8. The one-year hospital readmission rate (β=+3.8; P=0.009) and the patients' Health Literacy score (β=-0.4; P=0.024) or good knowledge category (β=-20.2; P=0.016) were independently associated with QoL.

CONCLUSION

While the readmission rate was inversely associated with QoL, the better the HF knowledge the better QoL in hospitalized HF patients.

Health literacy, health outcomes, and the caregiver role in traumatic brain injury

Purpose/Objective: The purpose of this study is to estimate the occurrence of low health literacy among caregivers of people with traumatic brain injury (TBI), and to evaluate associations of health literacy with caregiver health-related quality of life (HRQOL) and perceptions of the caregiving role. Research Method/Design: The TBI-CareQOL measurement system assesses important self-reported outcomes for caregivers of civilians or service members/veterans (SMVs) with TBI. The validation phase included the Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT) measure. Multivariable regression evaluated the impact of low health literacy on generic and TBI-specific HRQOL and appraisals of the caregiving role, adjusted for caregiver gender, race/ethnicity and education, and the functional status of the TBI care recipient. Results: Among 131 caregivers, 28 (21%) had low health literacy. Compared with the high health literacy group, the group with low health literacy had fewer women, more racial/ethnic minorities, and lower education (all p < .05). The low health literacy group reported more subjective caregiving burden, less satisfaction with their relationship with the TBI recipient, less caregiving mastery, and poorer physical health (all p < .05). There were no differences between health literacy groups in caregiving ideology, caregiver-specific HRQOL or general mental health. Conclusions/Implications: A better understanding of the links between health literacy and caregiver HRQOL and the caregiving role can help identify strategies to meet the needs of this underserved population. Tailored interventions for caregivers with low health literacy could improve outcomes for both the caregiver and the care recipient. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Association between diabetes-specific health literacy and health-related quality of life among elderly individuals with pre-diabetes in rural Hunan Province, China: a cross-sectional study

OBJECTIVES

To examine the association between diabetes-specific health literacy (DSHL) and health-related quality of life (HRQoL) among elderly individuals with pre-diabetes in rural China.

DESIGN, SETTING AND PARTICIPANTS

This cross-sectional study included 434 elderly individuals with pre-diabetes from 42 villages in rural China.

MAIN OUTCOME MEASURES

HRQoL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. DSHL was measured by a validated questionnaire in China. Differences in HRQoL between groups with and without high DSHL were tested by multivariate analysis of covariance (MANCOVA).

RESULTS

The prevalence of pre-diabetes was 21.5%. The average age of participants (n=434) was 69.4±6.4 years, and 58.5% were female. Bivariate analysis showed that those with high DSHL had increases of 2.9 points in the physical health component score and 4.4 points in the mental health component score (MCS) compared with those without. After adjustment for potential confounders, a significant MANCOVA model (Wilks' λ=0.974, F=5.63, p=0.004) indicated that individuals with pre-diabetes who had high DSHL reported higher MCS (M_diff=3.5, 95% CI 1.8 to 6.3, effect size=0.38). This remained significant across subscales: general health (p=0.028), vitality (p=0.014), social functioning (p=0.017) and mental health (p=0.005).

CONCLUSIONS

Low DSHL was associated with worsening HRQoL among elderly individuals with pre-diabetes in rural China, particularly in the mental health components.

TRIAL REGISTRATION NUMBER

ChiCTR-IOR-15007033.

The relationship between health literacy and quality of life: a systematic review and meta-analysis

Background

Low health literacy often has an association with poor health outcomes such as low levels of self-efficacy, increased mortality, poor health status and reduced quality of life (QOL). The aim of the study was to quantitatively evaluate the relationship between health literacy (HL) and QOL based on a systematic review and meta-analysis.

Methods

EMBASE, PubMed, Web of Science, Elsevier, Cochrane Library, and Chinese electronic databases such as CNKI, and Wanfang were searched from 1970 until February 1, 2018. The pooled correlation coefficient (PCOR) and its 95% confidence interval (CI) between HL and QOL were estimated using R software. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression.

Results

Twenty-three studies, with a total of 12,303 subjects,were included. The PCOR between HL and QOL was 0.35 (95%CI: 0.25–0.44). Considering different dimensions of HL, the PCOR between QOL and health knowledge, health behavior, health belief, and health skill were 0.36 (95% CI: 0.04–0.61), 0.36 (95%CI: 0.13–0.55), 0.39 (95%CI: 0.10–0.62), and 0.42 (95%CI: 0.03–0.69), respectively. The PCOR between HL and the two dimensions of QOL was lower than the total PCOR between HL and QOL. In subgroup analysis, the PCOR between HL and QOL was 0.46 (95%CI: 0.13, 0.69) among community residents, 0.45 (95%CI: 0.27, 0.61) in China, and 0.45 (95%CI: 0.24, 0.62) based on cohort studies. Sensitivity analyses showed that the stability of results had no significant after excluding the study (p < 0.001). Meta-regression showed that cohort study design, studies conducted in China, and publication before 2012 may be important influencing factors.

Conclusions

Health literacy was moderately correlated with quality of life, but this finding needs to be supported by more evidence.

Electronic supplementary material

The online version of this article (10.1186/s12955-018-1031-7) contains supplementary material, which is available to authorized users.