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Zhu X, Li C. Information Support or Emotional Support? Social Support in Online Health Information Seeking among Chinese Older Adults. Healthcare (Basel) 2024; 12:1790. [PMID: 39273813 PMCID: PMC11395669 DOI: 10.3390/healthcare12171790] [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: 07/31/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Online Health Information Seeking (OHIS) serves as an alternative form of social capital that can help older adults alleviate offline medical-related stress. This study collected and analyzed user interaction data from Patient-to-Doctor and Patient-to-Peer platforms and compared the roles of social support between them. Significant differences were identified in the dimensions of social support (information, emotional, and companion) on the Patient-to-Peer platforms compared with Patient-to-Doctor platforms (p < 0.05). The overall and core-core network density values for social support on Patient-to-Peer platforms were higher than those on Patient-to-Doctor platforms. Patient-to-Doctor interactions focused on information support, displaying a more centralized and efficient network with structural holes pertaining to treatment effects. By contrast, Patient-to-Peer interactions provided more emotional support, with a dispersed and redundant network containing structural holes related to individual information. Companion support was found to be weaker on both platforms. Additionally, digital literacy, surrogate seeking, and altruistic information significantly explained the variances between the two platforms (p < 0.01), with surrogate seeking playing a crucial role. These findings enhance our understanding of OHIS disparities among older adults and their surrogates, offering valuable insights for developing effective support systems and regulatory frameworks for health information platforms.
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Affiliation(s)
- Xiaowen Zhu
- School of Education, Suzhou University of Science and Technology, Suzhou 215009, China
| | - Chang Li
- School of Architecture and Urban Planning, Suzhou University of Science and Technology, Suzhou 215009, China
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Nishimura A, Masuda C, Murauchi C, Ishii M, Murata Y, Kawasaki T, Azuma M, Arai H, Harashima SI. Regional differences in frailty among older adults with type 2 diabetes: a multicenter cross-sectional study in Japan. BMC Geriatr 2024; 24:688. [PMID: 39154001 PMCID: PMC11330035 DOI: 10.1186/s12877-024-05223-7] [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: 02/28/2024] [Accepted: 07/15/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Social environment may broadly impact multifaceted frailty; however, how environmental differences influence frailty in older adults with diabetes remains unclear. This study aimed to investigate regional differences in frailty in urban and rural areas among older adults with diabetes. METHODS This cross-sectional study was conducted as part of the frailty prevention program for older adults with diabetes study. Older adults aged 60-80 years who could independently perform basic activities of daily living (ADLs) were enrolled sequentially. Trained nurses obtained patient background, complications, body weight, body composition, blood tests, grip strength, frailty assessment, and self-care score results. Regional differences in frailty were evaluated using logistic and multiple linear regression analyses. RESULTS This study included 417 participants (269 urban and 148 rural). The prevalence of robustness was significantly lower in rural areas than in urban areas (29.7% vs. 43.9%, p = 0.018). Living in rural areas was associated with frailty (odds ratio [OR] 2.55, 95% confidence interval [CI] 1.38-4.71) and pre-frailty (OR 2.10, 95%CI 1.30-3.41). Lower instrumental ADL (B 0.28, standard error [SE] 0.073) and social ADL (B 0.265, SE 0.097) were characteristics of rural residents. CONCLUSIONS Regional differences in frailty were observed. Older adults with diabetes living in rural areas have a higher risk of frailty owing to a decline in instrumental and social ADLs. Social environment assessment and intervention programs that include communication strategies to enable care and social participation across environments are crucial to the effective and early prevention of frailty.
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Affiliation(s)
- Akiko Nishimura
- Department of Chronic Care Nursing, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan.
- Department of Internal Medicine and Diabetes, Goshominami Harashima Clinic, 630 Heinouchi-cho, Nakagyo-ku, Kyoto City, Kyoto, 604-0884, Japan.
| | - Chie Masuda
- Department of Nursing, Asahikawa City Hospital, 1-1-65 Kinsei-cho, Asahikawa City, Hokkaido, 070-8610, Japan
| | - Chiyo Murauchi
- Faculty of Nursing and Graduate School of Nursing, Kansai Medical University, 2-3-1 Shinmachi, Hirakata City, Osaka, 573-1010, Japan
| | - Miho Ishii
- Jonan branch, Town Home-visit Medical Care Clinic, Gardenia Kamiikedai 101, 1-40-6 Kamiikedai, Ota-ku, Tokyo, 145-0064, Japan
| | - Yuko Murata
- Department of Nursing, Takashima Municipal Hospital, 1667 Katsuno, Takashima City, Shiga, 520-1121, Japan
| | - Terumi Kawasaki
- Department of Nursing, Sapporo City General Hospital, 1-1 Kita, 11-jo Nishi, 13-chome, Chuo- ku, Sapporo City, Hokkaido, 064-0064, Japan
| | - Mayumi Azuma
- Department of Chronic Care Nursing, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu- cho, Miyazaki City, Miyazaki, 880-8510, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi, 474-8511, Japan
| | - Shin-Ichi Harashima
- Department of Chronic Care Nursing, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan.
- Department of Internal Medicine and Diabetes, Goshominami Harashima Clinic, 630 Heinouchi-cho, Nakagyo-ku, Kyoto City, Kyoto, 604-0884, Japan.
- Clinical Research Planning and Administration Division, National Hospital Organization, Kyoto Medical Center, 1-1 Fukakusa Mukabatake-cho, Fushimi-ku, Kyoto City, Kyoto, 611-8555, Japan.
- Research Center for Healthcare, Nagahama City Hospital, 313 Ohinui-cho, Nagahama City, Shiga, 526-8580, Japan.
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Choe E, Poleon S, Thomas T, Racette L. The association between perceived cause of glaucoma and illness perceptions. Front Med (Lausanne) 2024; 11:1363732. [PMID: 38638934 PMCID: PMC11024309 DOI: 10.3389/fmed.2024.1363732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Purpose The perceived cause of disease is an important factor that has been linked with treatment outcomes but has not been fully assessed in primary open-angle glaucoma (POAG). This study assessed the accuracy of patients' perceived cause of POAG and identified associations between accuracy, illness perceptions, medication adherence, and quality of life (QoL). Methods The Brief Illness Perception Questionnaire (BIPQ) was used to assess illness perceptions and asked patients to rank the three most important causes of their disease in order of importance. POAG risk factors recognized by the American Academy of Ophthalmology were used to code responses as accurate or inaccurate based on the following three methods: (1) coding any reported cause, regardless of rank, (2) coding only the first-ranked cause, and (3) coding and weighting all reported causes. Medication adherence was measured electronically. QoL was measured using the Glaucoma Quality of Life questionnaire. Mann-Whitney U test was used to detect differences in illness perceptions, medication adherence, and QoL between accuracy groups. Results A total of 97 patients identified a cause of their POAG and were included in this analysis. A higher proportion of patients reported an accurate cause (86.6% using method 1, 78.4% using method 2, and 79.4% using method 3; all p < 0.001). Mean medication adherence was 86.0% ± 17.8 and was similar across accuracy groups (all p > 0.05). Using method 2 (p = 0.045) and method 3 (p = 0.028), patients who reported an accurate cause of their POAG believed that their illness would last for a longer time compared to patients who reported an inaccurate cause. Method 3 also revealed that patients who reported an accurate cause of their POAG had lower perceived understanding of their illness (p = 0.048) compared to patients who reported an inaccurate cause. There were no differences in QoL between accuracy groups (all p > 0.05). Conclusion This study highlights the association between perceived cause of POAG and illness perceptions related to knowledge level and POAG duration. Future studies should assess associations between perceived cause of disease and other critical dimensions of illness perception.
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Affiliation(s)
| | | | | | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Ishizuki S, Hirano M. Online health information searching and health literacy among middle-aged and older adults: A cross-sectional study. Nurs Health Sci 2024; 26:e13098. [PMID: 38369320 DOI: 10.1111/nhs.13098] [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: 12/27/2022] [Revised: 12/28/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
Given the rapid increase in health information available, health literacy is now more important than ever when searching for health information online. Furthermore, health literacy and online health information searching are reported to be associated with support from others. In this study, we examined the associations of health literacy and social support with online health information searching among individuals in their 50s and 60s. Between March and May 2022, an anonymous self-administered questionnaire was administered among 750 middle-aged and older adults (age 50-69) living in northern Japan. The questionnaire items included personal characteristics, frequency of online health information searching, health literacy domains, and social support. A total of 237 respondents answered all the items (response rate: 31.6%). Multiple logistic regression analysis revealed that communicative health literacy was significantly associated with searching for information about illnesses and health promotion, while critical health literacy was significantly associated with searching for information about medical institutions. Controlling for personal characteristics, health literacy, was associated with online health information searching, suggesting that improving health literacy is important in a digital and information society.
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Affiliation(s)
- Shiho Ishizuki
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michiyo Hirano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Kılınç A, Çam C, Aydoğan Gedik S, Oktar D, Taşcıoğlu U, Öznur Muz FN, Önsüz MF, Metintaş S. Public health literacy in primary users in western Turkey. Glob Health Promot 2024; 31:45-54. [PMID: 37724844 DOI: 10.1177/17579759231191507] [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] [Indexed: 09/21/2023]
Abstract
BACKGROUND Public health literacy (PHL) is a novel perspective on health literacy (HL). Differing from HL's individualist approach, PHL is concerned with public health events and promoting health in the whole society. OBJECTIVES To evaluate PHL, a newly developed concept, and related factors. METHODS In this cross-sectional study, people who visited primary healthcare centers in urban and rural settings were recruited using a questionnaire that includes Public Health Literacy Knowledge Scale (PHLKS) and Adult Health Literacy Scale (AHLS). Out of four Primary Healthcare Centers (PMCs) in western Turkey selected randomly, one PMC was located in a rural setting, while three PMCs were located in an urban setting. Multiple linear regression was used to determine the predictors for PHL. RESULTS The study group consisted of 1672 people, of which 55.3% were male. The mean age was 40.94 ± 15.22. The median score (min-max) from PHLKS was 13.0 (0-17). Multiple linear regression showed that income level had a negative impact on PHL. Higher education, fondness for reading, hospital admission and HL, however, increased PHL levels. Additionally, living in an urban area and not having auditory problems were positively associated with PHL. CONCLUSIONS Participants had a moderate level of PHL. Improving PHL should be a priority to tackle global and local problems that have an adverse effect on community health. To increase community engagement in public health events, people with low education and HL levels should be targeted in future training programs.
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Affiliation(s)
- Ali Kılınç
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Cüneyt Çam
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Sevil Aydoğan Gedik
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Didem Oktar
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Umur Taşcıoğlu
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Feyza Nehir Öznur Muz
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Muhammed Fatih Önsüz
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Selma Metintaş
- Department of Public Health, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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Zhang X, Li C, Liu M, Sun J, Yue H, Bao H. The mediation effect of health literacy on social support and health lifestyle of patients with chronic diseases. Appl Nurs Res 2024; 75:151763. [PMID: 38490794 DOI: 10.1016/j.apnr.2024.151763] [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: 11/30/2022] [Revised: 08/18/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Previous studies have identified the antecedents of the lifestyle of many patients with chronic diseases. However, the mechanism of social support affecting the lifestyle of patients with chronic diseases is unclear, and the role of health literacy in social support affecting the lifestyle of patients with chronic diseases has not been found. Therefore, this study aims to explore the status quo of social support, health literacy and healthy lifestyle of patients with chronic diseases in China and the relationship among them. METHODS Through convenient sampling, 356 patients with chronic diseases were surveyed using a health promoting lifestyle scale, a chronic disease patients' health literacy scale and a social support scale. RESULTS There was a pairwise positive correlation between social support, health lifestyle and health literacy (R = 0.397,0.356,0.556, P < 0.01). After controlling gender, age and education level, it is found that social support has a positive impact on health lifestyle, and health literacy plays an intermediary role between social support and health lifestyle, accounting for 45.78 % of the total effect. CONCLUSION To promote the healthy lifestyle of patients with chronic diseases and delay the development of the disease, we should strengthen social support for patients with chronic diseases; We should simultaneously take various measures to improve their health literacy.
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Affiliation(s)
- Xuemin Zhang
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China; School of Humanities and International Education, Baotou Medical College, No. 31 Jianshe Road, Donghe District, Inner Mongolia 014040, China.
| | - Cuiyun Li
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Min Liu
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Junfang Sun
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Heng Yue
- School of Psychology, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China
| | - Hugejiletu Bao
- School of Physical Education, Inner Mongolia Normal University, No. 81 Zhaowuda Road, Saihan District, Hohhot 010022, Inner Mongolia, China.
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Egelko A, Kahler D, Donovan B, Gardella R, Reddy S, Jones C. Food Desert Residence Is Not Associated With Dietary Adherence or Complication Rates in Patients With Isolated Mandibular Fractures. J Oral Maxillofac Surg 2024; 82:191-198. [PMID: 37980938 DOI: 10.1016/j.joms.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Mandible fracture management requires postoperative dietary modifications to promote healing. Over 20 million Americans live in food deserts, low-income neighborhoods over one mile from a grocery store. The relationship between food desert residence (FDR) and adherence to postoperative dietary instructions remains unexplored. PURPOSE This study's purpose is to evaluate the relationships between FDR, known risk factors, dietary adherence, and complications among patients with isolated mandible fractures. STUDY DESIGN, SETTING, SAMPLE This retrospective cohort study was conducted at a level 1 trauma center and analyzed patients with mandible fractures between January 2015 and December 2020. Inclusion criteria included operative treatment of adult patients for mandible fractures; pregnant, incarcerated, and patients with incomplete data were excluded. PREDICTOR VARIABLE FDR was the predictor variable of interest. FDR (coded yes or no) was generated by converting patient addresses to census tract GeoIDs and comparing them to the US Department of Agriculture Food Access Research Atlas. MAIN OUTCOME VARIABLES The study examined two outcome variables: dietary adherence and postoperative complications. Dietary adherence was coded as adherent or nonadherent, indicating documented compliance with postoperative dietary modifications. Postoperative complications were coded as present or absent, reflecting infection, hardware failure, and mandible malunion or nonunion. COVARIATES The covariates analyzed included age, sex, ethnicity, mechanism of injury, medical and psychiatric comorbidities (including diagnoses such as diabetes, hypertension, and schizophrenia), and tobacco use. ANALYSES Relative risks (RRs) and multivariate logistic regression models were generated for both outcome variables. Two-tailed P values < 0.05 were considered statistically significant. RESULTS During the study period, 143 patients had complete data allowing for FDR and dietary adherence determination, 124 of whom (86.7%) had complication data recorded. Of the cohort, 51/143 (35.7%) resided within a food desert, 30/143 (21.0%) exhibited dietary nonadherence, and 46/124 (37.1%) experienced complications. FDR was not associated with increased risk of dietary nonadherence (RR 0.92, 95% confidence interval [CI] 0.52 to 1.61, P = .76) or complications (RR 1.19, 95% CI 0.75 to 1.89; P = .46). On multivariate regression, dietary nonadherence was associated with increased complications (odds ratio 2.85, 95% CI 1.01 to 8.09, P = .049). CONCLUSION AND RELEVANCE There was no association between FDR and dietary nonadherence or complications in mandible fracture patients. However, dietary nonadherence was associated with complications, highlighting the need for further research and intervention.
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Affiliation(s)
- Aron Egelko
- Resident Physician, Department of General Surgery, Temple University Hospital, Philadelphia, PA.
| | - Dylan Kahler
- Resident Physician, Department of General Surgery, Temple University Hospital, Philadelphia, PA
| | - Brienne Donovan
- Resident Physician, Department of General Surgery, Temple University Hospital, Philadelphia, PA
| | - Rebecca Gardella
- Medical Student, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Sai Reddy
- Medical Student, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Christine Jones
- Assistant Professor, Division of Plastic and Reconstructive Surgery, Temple University Hospital, Philadelphia, PA
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Tang ZY, Ng KS, Koh YLE, Yeung MT. Study protocol for the validation of a new pictorial functional scale in patients with knee osteoarthritis: the functional activity scoring tool (FAST). BMJ Open 2024; 14:e076947. [PMID: 38191249 PMCID: PMC10806685 DOI: 10.1136/bmjopen-2023-076947] [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: 06/21/2023] [Accepted: 12/10/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are required for patient-centred care. There are limited PROMs with good psychometric properties, and limitations to any language-based scale are often constrained by the written words or numerals used. Therefore, we developed the Functional Activity Scoring Tool (FAST), a self-reporting pictorial scale. FAST measures the impact of knee osteoarthritis on essential activities of daily living (ADL) and the significant changes in the self-perceived functional status over time. OBJECTIVES This study aims to (1) develop FAST with adaptation from the Wong-Baker FACES pain rating scale, (2) validate FAST against the Patient-Specific Functional Scale (PSFS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) and (3) establish the reliability, validity and responsiveness of FAST in individuals with knee osteoarthritis. METHODS AND ANALYSIS The prospective study protocol investigates the validity, responsiveness and reliability of FAST. The PSFS and KOOS will be gold standard comparisons. Participant recruitment will occur at four public polyclinics that offer physiotherapy outpatient services in Singapore. Onsite physiotherapists familiar with the study eligibilities will refer potential participants to the investigators after the routine physiotherapy assessment. After providing written consent, eligible participants will complete outcome measurements with FAST, the PSFS and KOOS during baseline and follow-up assessments. The Global Rating of Change (GROC) scale will determine how the participant's knee status was changed compared with the beginning of the physiotherapy intervention. ETHICS AND DISSEMINATION SingHealth Centralised Institutional Review Board approved the study (CIRB reference number: 2022/2602). The final results will be published via scientific publication. FAST will benefit the evaluation and management of those who suffer knee osteoarthritis regardless of English proficiency or language barriers. TRIAL REGISTRATION NUMBER NCT05590663.
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Affiliation(s)
- Zhi Yin Tang
- Department of Physiotherapy, SingHealth Polyclinics, Singapore
| | - Khim Siong Ng
- Department of Physiotherapy, SingHealth Polyclinics, Singapore
| | | | - Meredith T Yeung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
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Kothari P, Du C, Aalami Harandi A, Hwang K, Griffith S, Kim J. Barriers to Healthcare: Non-English Speaking and Elderly Patients More Likely to Have Retained Ureteral Stents. Urology 2024; 183:46-49. [PMID: 38006956 DOI: 10.1016/j.urology.2023.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE To identify factors for retained ureteral stents in our institution of patients receiving de novo ureteral stents. Ureteral stent placement, a commonly performed urologic procedure, is a temporary measure and requires timely removal. Retained ureteral stents may result in significant morbidities and need for additional procedures. MATERIALS AND METHODS We queried for all de novo ureteral stents indicated for calculi at our institution between July 2019-June 2021. Retained ureteral stents were defined as stents that remained indwelling for a period greater than 90days. Patients with metallic stents, stents on strings, pediatric patients, and planned therapy outside 90days were excluded. Patient demographic information including gender, race, age, insurance status, non-English speaking status as well as clinical data including location of presentation and indication were collected. Characteristics of patients with retained stents were compared to those without. RESULTS Four hundred fifty-seven de novo stent patients meeting study criteria were identified, of which 61 (13%) patients had retained stents. The median duration of retention was 24days +/- 32days (IQR). Patients with retained stents were older than those with stents removed within 90days (62.1 vs 57.2years, P = .03). Retained stents were more common among non-English-speaking patients (13% vs 5%, P = .012). CONCLUSION Stent retention was found to be associated with non-English speaking status and older age. Healthcare barriers in language and age may lead to increased morbidity due to stent retention.
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Affiliation(s)
- Pankti Kothari
- Department of Urology, Stony Brook University Medical Center, Stony Brook, NY.
| | - Chris Du
- Department of Urology, Stony Brook University Medical Center, Stony Brook, NY
| | | | - Kuemin Hwang
- Department of Urology, Stony Brook University Medical Center, Stony Brook, NY
| | - Spencer Griffith
- Department of Urology, Stony Brook University Medical Center, Stony Brook, NY
| | - Jason Kim
- Department of Urology, Stony Brook University Medical Center, Stony Brook, NY
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Lima ACP, Maximiano-Barreto MA, Martins TCR, Luchesi BM. Factors associated with poor health literacy in older adults: A systematic review. Geriatr Nurs 2024; 55:242-254. [PMID: 38070263 DOI: 10.1016/j.gerinurse.2023.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024]
Abstract
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.
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Affiliation(s)
- Ana Caroline Pinto Lima
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | | | - Tatiana Carvalho Reis Martins
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Bruna Moretti Luchesi
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil.
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Davuluru SS, Jess AT, Kim JSB, Yoo K, Nguyen V, Xu BY. Identifying, Understanding, and Addressing Disparities in Glaucoma Care in the United States. Transl Vis Sci Technol 2023; 12:18. [PMID: 37889504 PMCID: PMC10617640 DOI: 10.1167/tvst.12.10.18] [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: 07/16/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide, currently affecting around 80 million people. Glaucoma prevalence is rapidly rising in the United States due to an aging population. Despite recent advances in the diagnosis and treatment of glaucoma, significant disparities persist in disease detection, management, and outcomes among the diverse patient populations of the United States. Research on disparities is critical to identifying, understanding, and addressing societal and healthcare inequalities. Disparities research is especially important and impactful in the context of irreversible diseases such as glaucoma, where earlier detection and intervention are the primary approach to improving patient outcomes. In this article, we first review recent studies identifying disparities in glaucoma care that affect patient populations based on race, age, and gender. We then review studies elucidating and furthering our understanding of modifiable factors that contribute to these inequities, including socioeconomic status (particularly age and education), insurance product, and geographic region. Finally, we present work proposing potential strategies addressing disparities in glaucoma care, including teleophthalmology and artificial intelligence. We also discuss the presence of non-modifiable factors that contribute to differences in glaucoma burden and can confound the detection of glaucoma disparities. Translational Relevance By recognizing underlying causes and proposing potential solutions, healthcare providers, policymakers, and other stakeholders can work collaboratively to reduce the burden of glaucoma and improve visual health and clinical outcomes in vulnerable patient populations.
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Affiliation(s)
- Shaili S. Davuluru
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alison T. Jess
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Kristy Yoo
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Van Nguyen
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Benjamin Y. Xu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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12
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Nag S, Schneider JA. Limbic-predominant age-related TDP43 encephalopathy (LATE) neuropathological change in neurodegenerative diseases. Nat Rev Neurol 2023; 19:525-541. [PMID: 37563264 PMCID: PMC10964248 DOI: 10.1038/s41582-023-00846-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/12/2023]
Abstract
TAR DNA-binding protein 43 (TDP43) is a focus of research in late-onset dementias. TDP43 pathology in the brain was initially identified in amyotrophic lateral sclerosis and frontotemporal lobar degeneration, and later in Alzheimer disease (AD), other neurodegenerative diseases and ageing. Limbic-predominant age-related TDP43 encephalopathy (LATE), recognized as a clinical entity in 2019, is characterized by amnestic dementia resembling AD dementia and occurring most commonly in adults over 80 years of age. Neuropathological findings in LATE, referred to as LATE neuropathological change (LATE-NC), consist of neuronal and glial cytoplasmic TDP43 localized predominantly in limbic areas with or without coexisting hippocampal sclerosis and/or AD neuropathological change and without frontotemporal lobar degeneration or amyotrophic lateral sclerosis pathology. LATE-NC is frequently associated with one or more coexisting pathologies, mainly AD neuropathological change. The focus of this Review is the pathology, genetic risk factors and nature of the cognitive impairments and dementia in pure LATE-NC and in LATE-NC associated with coexisting pathologies. As the clinical and cognitive profile of LATE is currently not easily distinguishable from AD dementia, it is important to develop biomarkers to aid in the diagnosis of this condition in the clinic. The pathogenesis of LATE-NC should be a focus of future research to form the basis for the development of preventive and therapeutic strategies.
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Affiliation(s)
- Sukriti Nag
- Rush Alzheimer's Disease Center, Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, IL, USA.
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, IL, USA.
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13
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Stewart TA, Perrin EM, Yin HS. Addressing Health Literacy in Pediatric Practice: A Health Equity Lens. Pediatr Clin North Am 2023; 70:745-760. [PMID: 37422312 DOI: 10.1016/j.pcl.2023.03.007] [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] [Indexed: 07/10/2023]
Abstract
Low health literacy has been linked to worse child health-related knowledge, behaviors, and outcomes across multiple health domains. As low health literacy is highly prevalent and an important mediator of income- and race/ethnicity-associated disparities, provider adoption of health literacy best practices advances health equity. A multidisciplinary effort involving all providers engaged in communication with families should include a universal precautions approach, with clear communication strategies employed with all patients, and advocacy for health system change.
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Affiliation(s)
- Tiffany A Stewart
- Department of Pediatrics, New York University Grossman School of Medicine / Bellevue Hospital Center, 550 First Avenue, NBV 8S4-11, New York, NY 10016, USA
| | - Eliana M Perrin
- Department of Pediatrics, Johns Hopkins School of Medicine / School of Nursing, 200 North Wolfe Street, Rubenstein Building 2071, Baltimore, MD 21287, USA
| | - Hsiang Shonna Yin
- Department of Pediatrics, New York University Grossman School of Medicine / Bellevue Hospital Center, 550 First Avenue, NBV 8S4-11, New York, NY 10016, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
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14
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Shan Y, Ji M, Xing Z, Dong Z, Xu X. Susceptibility to Breast Cancer Misinformation Among Chinese Patients: Cross-sectional Study. JMIR Form Res 2023; 7:e42782. [PMID: 37018020 PMCID: PMC10131805 DOI: 10.2196/42782] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Currently, breast cancer is the most commonly diagnosed cancer and the sixth-leading cause of cancer-related deaths among Chinese women. Worse still, misinformation contributes to the aggravation of the breast cancer burden in China. There is a pressing need to investigate the susceptibility to breast cancer misinformation among Chinese patients. However, no study has been performed in this respect. OBJECTIVE This study aims to ascertain whether some demographics (age, gender, and education), some health literacy skills, and the internal locus of control are significantly associated with the susceptibility to misinformation about all types of breast cancers among randomly sampled Chinese patients of both genders in order to provide insightful implications for clinical practice, health education, medical research, and health policy making. METHODS We first designed a questionnaire comprising 4 sections of information: age, gender, and education (section 1); self-assessed disease knowledge (section 2); the All Aspects of Health Literacy Scale (AAHLS), the eHealth Literacy Scale (eHEALS), the 6-item General Health Numeracy Test (GHNT-6), and the "Internal" subscale of the Multidimensional Health Locus of Control (MHLC) scales (section 3); and 10 breast cancer myths collected from some officially registered and authenticated websites (section 4). Subsequently, we recruited patients from Qilu Hospital of Shandong University, China, using randomized sampling. The questionnaire was administered via wenjuanxing, the most popular online survey platform in China. The collected data were manipulated in a Microsoft Excel file. We manually checked the validity of each questionnaire using the predefined validity criterion. After that, we coded all valid questionnaires according to the predefined coding scheme, based on Likert scales of different point (score) ranges for different sections of the questionnaire. In the subsequent step, we calculated the sums of the subsections of the AAHLS and the sums of the 2 health literacy scales (the eHEALS and GHNT-6) and the 10 breast cancer myths. Finally, we applied logistic regression modeling to relate the scores in section 4 to the scores in sections 1-3 of the questionnaire to identify what significantly contributes to the susceptibility to breast cancer misinformation among Chinese patients. RESULTS All 447 questionnaires collected were valid according to the validity criterion. The participants were aged 38.29 (SD 11.52) years on average. The mean score for their education was 3.68 (SD 1.46), implying that their average educational attainment was between year 12 and a diploma (junior college). Of the 447 participants, 348 (77.85%) were women. The mean score for their self-assessed disease knowledge was 2.50 (SD 0.92), indicating that their self-assessed disease knowledge status was between "knowing a lot" and "knowing some." The mean scores of the subconstructs in the AAHLS were 6.22 (SD 1.34) for functional health literacy, 5.22 (SD 1.54) for communicative health literacy, and 11.19 (SD 1.99) for critical health literacy. The mean score for eHealth literacy was 24.21 (SD 5.49). The mean score for the 6 questions in the GHNT-6 was 1.57 (SD 0.49), 1.21 (SD 0.41), 1.24 (SD 0.43), 1.90 (SD 0.30), 1.82 (SD 0.39), and 1.73 (SD 0.44), respectively. The mean score for the patients' health beliefs and self-confidence was 21.19 (SD 5.63). The mean score for their response to each myth ranged from 1.24 (SD 0.43) to 1.67 (SD 0.47), and the mean score for responses to the 10 myths was 14.03 (SD 1.78). Through interpreting these descriptive statistics, we found that Chinese female patients' limited ability to rebut breast cancer misinformation is mainly attributed to 5 factors: (1) lower communicative health literacy, (2) certainty about self-assessed eHealth literacy skills, (3) lower general health numeracy, (4) positive self-assessment of general disease knowledge, and (5) more negative health beliefs and lower levels of self-confidence. CONCLUSIONS Drawing on logistic regression modeling, we studied the susceptibility to breast cancer misinformation among Chinese patients. The predicting factors of the susceptibility to breast cancer misinformation identified in this study can provide insightful implications for clinical practice, health education, medical research, and health policy making.
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Affiliation(s)
- Yi Shan
- School of Foreign Studies, Nantong University, Nantong, China
| | - Meng Ji
- School of Languages and Cultures, The University of Sydney, Sydney, Australia
| | - Zhaoquan Xing
- Department of Urology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Zhaogang Dong
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Ji'nan, China
| | - Xiaofei Xu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Qilu Hospital of Shandong University, Ji'nan, China
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15
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Lalor JP, Wu H, Mazor KM, Yu H. Evaluating the efficacy of NoteAid on EHR note comprehension among US Veterans through Amazon Mechanical Turk. Int J Med Inform 2023; 172:105006. [PMID: 36780789 PMCID: PMC9992155 DOI: 10.1016/j.ijmedinf.2023.105006] [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: 11/01/2022] [Revised: 12/23/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Low health literacy is a concern among US Veterans. In this study, we evaluated NoteAid, a system that provides lay definitions to medical jargon terms in EHR notes to help Veterans comprehend EHR notes. We expected that low initial scores for Veterans would be improved by using NoteAid. MATERIALS AND METHODS We recruited Veterans from the Amazon Mechanical Turk crowd work platform (MTurk). We also recruited non-Veterans from MTurk as a control group for comparison. We randomly split recruited MTurk Veteran participants into control and intervention groups. We recruited non-Veteran participants into mutually exclusive control or intervention tasks on the MTurk platform. We showed participants de-identified EHR notes and asked them to answer comprehension questions related to the notes. We provided participants in the intervention group with EHR note content processed with NoteAid, while NoteAid was not available for participants in the control group. RESULTS We recruited 94 Veterans and 181 non-Veterans. NoteAid leads to a significant improvement for non-Veterans but not for Veterans. Comparing Veterans recruited via MTurk with non-Veterans recruited via MTurk, we found that without NoteAid, Veterans have significantly higher raw scores than non-Veterans. This difference is not significant with NoteAid. DISCUSSION That Veterans outperform a comparable population of non-Veterans is a surprising outcome. Without NoteAid, scores on the test are already high for Veterans, therefore, minimizing the ability of an intervention such as NoteAid to improve performance. With regards to Veterans, understanding the health literacy of Veterans has been an open question. We show here that Veterans score higher than a comparable, non-Veteran population. CONCLUSION Veterans on MTurk do not see improved scores when using NoteAid, but they already score high on the test, significantly higher than non-Veterans. When evaluating NoteAid, population specifics need to be considered, as performance may vary across groups. Future work investigating the effectiveness of NoteAid on improving comprehension with local Veterans and developing a more difficult test to assess groups with higher health literacy is needed.
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Affiliation(s)
- John P Lalor
- Department of Information Technology, Analytics, and Operations, Mendoza College of Business, University of Notre Dame, Notre Dame, IN, US
| | - Hao Wu
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, US
| | - Kathleen M Mazor
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, US; Meyers Primary Care Institute, University of Massachusetts Medical School/Reliant Medical Group/Fallon Health, Worcester, MA, US
| | - Hong Yu
- Department of Computer Science, University of Massachusetts Lowell, Lowell, MA, US; College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, MA, US; Center for Healthcare Organization and Implementation Research, Bedford Veterans Affairs Medical Center, Bedford, MA, US.
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16
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Wang J, Guan J, Wang G. Impact of long-term care insurance on the health status of middle-aged and older adults. HEALTH ECONOMICS 2023; 32:558-573. [PMID: 36403228 DOI: 10.1002/hec.4634] [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: 07/20/2021] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
With the increase of aging population, long-term care insurance (LTCI) systems have become important for improving individuals' health. However, the effect of LTCI on health is unclear, especially in developing countries, owing to the lack of random policy shocks and comprehensive databases. This study investigates the Chinese LTCI pilot program, using four waves of the China Health and Retirement Longitudinal Study database (sample aged ≥45 years) from 2011 to 2018. The recent difference-in-differences approaches for staggered design, which are capable of dealing with the negative weights issue, are used to investigate changes in health status, measured by self-rated health (SRH), (instrumental) activities of daily living, self-rated depression, and cognition, in pilot and non-pilot cities before and after LTCI implementation. Long-term care insurance has a significant average effect on SRH improvement and a long-term positive effect on cognition for middle-aged and older populations. This study provides the first evaluation of LTCI policy on health outcomes using the recent difference-in-differences approaches. It provides evidence for the overall health improvement achieved through the LTCI and offers positive reinforcement and potential areas for improvement in establishing LTCI worldwide.
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Affiliation(s)
- Jingyi Wang
- School of Insurance and Economics, University of International Business and Economics, Beijing, China
| | - Jing Guan
- School of Economics, Beijing Technology and Business University, Beijing, China
| | - Guojun Wang
- School of Insurance and Economics, University of International Business and Economics, Beijing, China
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Tian CY, Mo PKH, Dong D, Cheung AWL, Wong ELY. Development and validation of a comprehensive health literacy tool for adults in Hong Kong. Front Public Health 2023; 10:1043197. [PMID: 36703842 PMCID: PMC9871493 DOI: 10.3389/fpubh.2022.1043197] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Health literacy (HL) refers to an individual's ability to process and use health information to make health-related decisions. However, previous HL scales did not fully cover all aspects of this concept. This study aimed to develop a comprehensive Hong Kong HL scale (HLS-HK) and evaluate its psychometric properties among Chinese adults. Methods A scale of 31-item covering Nutbeam's framework, namely functional and interactive HL (FHL and IHL), and critical HL (CHL) within three subdomains: critical appraisal of information, understanding of social determinants of health, and actions to address social determinants of health, was developed based on previous literature review and Delphi survey. Cognitive interviews were performed to examine all items' face validity in terms of three aspects: comprehensiveness, clarity, and acceptability. A cross-sectional survey was conducted to investigate the scale's psychometric properties, including its internal consistency reliability, factorial structure validity, convergent validity, and predictive validity. Results Nine interviewees participated in the cognitive interviews in October 2021. Based on the input from respondents, two items were deleted, two items were combined, and several items' wording was revised. The other items were clear and readable. Finally, 28 items remained. A total of 433 adults completed the questionnaire survey between December 2021 and February 2022. After excluding one item with low inter-item correlations, the scale's internal consistency reliability was acceptable, with a Cronbach's alpha of 0.89. Exploratory factor analysis produced a five-factor model, as shown in the original theoretical framework. These factors accounted for 53% of the total variance. Confirmatory factor analysis confirmed that the fit indices for this model were acceptable (comparative fit index = 0.91, root mean square error of approximation = 0.06, and root mean square residual = 0.06). The scale is also significantly correlated with theoretically selected variables, including education and self-rated health. Conclusion The HLS-HK is a valid and reliable tool for evaluating HL. Compared with existing tools, this scale extended the operationalization of FHL, IHL, and CHL and fully operationalized the CHL via three subdomains. It can be used to understand the difficulties and barriers that people may encounter when they use health-related information and services.
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Affiliation(s)
- Cindy Yue Tian
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Phoenix Kit-Han Mo
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Annie Wai-ling Cheung
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Eliza Lai-Yi Wong ✉
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Klokgieters SS, Picavet HSJ, Huisman M, Monique Verschuren WM, Uiters EAH, Kok AA. Differences in the Mediating Role of HL in Socioeconomic Inequalities in Health Across Age Groups: Results from the Dutch Doetinchem Cohort Study. Health Lit Res Pract 2023; 7:e26-e38. [PMID: 36779930 PMCID: PMC9918305 DOI: 10.3928/24748307-20230124-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Although it is known that health literacy (HL) plays an explanatory role in educational inequalities in health, it is unknown whether this role varies across age groups. OBJECTIVE The purpose of this study was to investigate whether the mediating role of HL in educational inequalities in four health outcomes varies across age groups: age 46 to 58 years, age 59 to 71 years, and age 72 to 84 years. METHODS We used data from the Dutch Doetinchem Cohort Study, which included 3,448 participants. We included years of education as predictor, chronic illness prevalence and incidence, mental and self-perceived health as outcomes, and HL, based on self-report, as mediator. We used multiple-group mediation models to compare indirect effects across age groups. KEY RESULTS In the complete sample without age stratification, HL partly mediated the effect of education on all health outcomes except for incidence of chronic diseases. These indirect effect estimates were larger for subjective (self-perceived health, proportion mediated [PM] = 37%, and mental health, PM = 37%) than for objective health outcomes (prevalence of chronic disease, PM = 17%). For the prevalence of chronic disease, the indirect effect estimate was significantly larger among individuals age 46 to 58 years compared to individuals age 59 to 71 years and for incidence of chronic disease also compared to individuals age 72 to 84 years. All other indirect effect estimates did not differ significantly between age groups. Using an alternative cut-off point for HL or adjusting for cognitive functioning did not meaningfully change the results. CONCLUSIONS Overall, we found that the explanatory role of HL in educational inequalities in mental and subjective health was stable but that it varied across age groups for chronic diseases, where it was largest among individuals age 46 to 58 years. Future studies may investigate the benefits of starting to intervene on HL from a younger age but means to improve HL may also benefit the subjective health of older adults with lower education. [HLRP: HL Research and Practice. 2023;7(1):e26-e38.] Plain Language Summary: This study examined age-group differences in the mediating role of HL in the relationship between education and health. Overall, we found that the explanatory role of HL in educational inequalities in mental and subjective health was stable but that it varied across age groups for chronic diseases, where it was largest among individuals age 46 to 58 years compared to individuals age 59 to 71 years and individuals age 72 to 84 years.
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Affiliation(s)
- Silvia S. Klokgieters
- Address correspondence Silvia S. Klokgieters, PhD, Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands;
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Zurynski Y, Ellis LA, Pomare C, Meulenbroeks I, Gillespie J, Root J, Ansell J, Holt J, Wells L, Braithwaite J. Engagement with healthcare providers and healthcare system navigation among Australians with chronic conditions: a descriptive survey study. BMJ Open 2022; 12:e061623. [PMID: 36600342 PMCID: PMC9743284 DOI: 10.1136/bmjopen-2022-061623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES With the rate of chronic conditions increasing globally, it is important to understand whether people with chronic conditions have the capacity to find the right care and to effectively engage with healthcare providers to optimise health outcomes.We aimed to examine associations between care navigation, engagement with health providers and having a chronic health condition among Australian adults. DESIGN AND SETTING This is a cross-sectional, 39-item online survey including the navigation and engagement subscales of the Health Literacy Questionnaire, completed in December 2018, in Australia. Binary variables (low/high health literacy) were created for each item and navigation and engagement subscale scores. Logistic regression analyses (estimating ORs) determined the associations between having a chronic condition and the navigation and engagement scores, while controlling for age, gender, level of education and income. PARTICIPANTS 1024 Australians aged 18-88 years (mean=46.6 years; 51% female) recruited from the general population. RESULTS Over half (n=605, 59.0%) of the respondents had a chronic condition, mostly back pain, mental disorders, arthritis and asthma. A greater proportion of respondents with chronic conditions had difficulty ensuring that healthcare providers understood their problems (32.2% vs 23.8%, p=0.003), having good discussions with their doctors (29.1% vs 23.5%, p=0.05), discussing things with healthcare providers until they understand all they needed (30.5% vs 24.5%, p=0.04), accessing needed healthcare providers (35.7% vs 29.7%, p=0.05), finding the right place to get healthcare services (36.3% vs 29.2%, p=0.02) and services they were entitled to (48.3% vs 40.6%, p=0.02), and working out what is the best healthcare for themselves (34.2% vs 27.7%, p=0.03). Participants with chronic conditions were 1.5 times more likely to have low scores on the engagement (adjusted OR=1.48, p=0.03, 95% CI 1.05 to 2.08) and navigation (adjusted OR=1.43, p=0.026, 95% CI 1.043 to 1.970) subscales after adjusting for age, gender, income and education. CONCLUSION Upskilling in engagement and communication for healthcare providers and people with chronic conditions is needed. Codesigned, clearly articulated and accessible information about service entitlements and pathways through care should be made available to people with chronic conditions. Greater integration across health services, accessible shared health records and access to care coordinators may improve navigation and engagement.
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Affiliation(s)
- Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Chiara Pomare
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Isabelle Meulenbroeks
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - James Gillespie
- Menzies Centre for Health Policy and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jo Root
- Consumers Health Forum of Australia, Canberra, Australian Capital Territory, Australia
| | - James Ansell
- Consumers Health Forum of Australia, Canberra, Australian Capital Territory, Australia
| | - Joanna Holt
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Leanne Wells
- Consumers Health Forum of Australia, Canberra, Australian Capital Territory, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Leung T, Victorino A, Lemos M, Porojan L, Costa A, Arriaga M, Gregório MJ, de Sousa RD, Rodrigues AM, Canhão H. A Video-Based Mobile App as a Health Literacy Tool for Older Adults Living at Home: Protocol for a Utility Study. JMIR Res Protoc 2022; 11:e29675. [PMID: 36476754 PMCID: PMC9773022 DOI: 10.2196/29675] [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: 04/16/2021] [Revised: 11/25/2021] [Accepted: 05/26/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND People aged ≥65 years are more likely to have health problems related to aging, polypharmacy, and low treatment adherence. Moreover, health literacy levels decrease with increasing age. OBJECTIVE The aim of this study is to assess an app's utility in promoting health-related knowledge in people aged ≥65 years. METHODS We developed a simple, intuitive, and video-based app (DigiAdherence) that presents a recipe, nutritional counseling, and content on physical activity, cognitive exercise, motivation to adhere to treatment, fall prevention, and health literacy. A convenience sample of 25 older adults attending the Personalized Health Care Unit of Portimão or the Family Health Unit of Portas do Arade (ACeS Algarve II - Barlavento, ARS Algarve, Portugal) will be recruited. Subjects must be aged ≥65 years, own a smartphone or tablet, be willing to participate, and consent to participate. Those who do not know how to use or do not have a smartphone/tablet will be excluded. Likewise, people with major cognitive or physical impairment as well as those living in a long-term care center will not be included in this study. Participants will have access to the app for 4 weeks and will be evaluated at 3 different timepoints (V0, before they start using the app; V1, after using it for 30 days; and V2, 60 days after stopping using it). After using the app for 30 days, using a 7-point Likert scale, participants will be asked to score the mobile tool's utility in encouraging them to take their medications correctly, improving quality of life, increasing their health-related knowledge, and preventing falls. They will also be asked to assess the app's ease of use and visual esthetics, their motivation to use the app, and their satisfaction with the app. Subjects will be assessed in a clinical interview with a semistructured questionnaire, including questions regarding user experience, satisfaction, the utility of the app, quality of life (EQ-5D-3L instrument), and treatment adherence (Morisky scale). The proportion of participants who considered the app useful for their health at V1 and V2 will be analyzed. Regarding quality of life and treatment adherence perceptions, comparisons will be made between V0 and V1, using the t test for dependent samples. The same comparisons will be made between V0 and V2. RESULTS This study was funded in December 2019 and authorized by the Executive Board of ACeS Algarve II - Barlavento and by the Ethics Committee of NOVA Medical School (99/2019/CEFCM, June 2020). This protocol was also approved by the Ethics Committee for Health (16/2020, September 2020) and the Executive Board (December 2020) of the Regional Health Administration of the Algarve, IP (Instituto Público). Recruitment was completed in June 2021. CONCLUSIONS Since the next generation of older adults may have higher digital literacy, information and communication technologies could potentially be used to deliver health-related content to improve lifestyles among older adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/29675.
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Affiliation(s)
| | - André Victorino
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Costa da Caparica, Portugal
| | - Marta Lemos
- Unidade de Saúde Pública Algarve II - Barlavento, Centro de Saúde de Portimão, Portimão, Portugal
| | - Ludmila Porojan
- Unidade de Saúde Pública Algarve II - Barlavento, Centro de Saúde de Portimão, Portimão, Portugal
| | - Andreia Costa
- Direção-Geral da Saúde, Lisbon, Portugal.,Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Escola Superior de Enfermagem de Lisboa, Lisbon, Portugal.,Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisbon, Portugal
| | - Miguel Arriaga
- Direção-Geral da Saúde, Lisbon, Portugal.,Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisbon, Portugal
| | - Maria João Gregório
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisbon, Portugal
| | - Rute Dinis de Sousa
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Episaúde - Associação Científica, Évora, Portugal
| | - Ana Maria Rodrigues
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Episaúde - Associação Científica, Évora, Portugal
| | - Helena Canhão
- Comprehensive Health Research Center, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,EpiDoC Unit, NOVA Medical School
- Faculdade de Ciências Médicas, NMS
- FCM, Universidade Nova de Lisboa, Lisbon, Portugal.,Episaúde - Associação Científica, Évora, Portugal
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21
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Gatulytė I, Verdiņa V, Vārpiņa Z, Lublóy Á. Level of health literacy in Latvia and Lithuania: a population-based study. Arch Public Health 2022; 80:166. [PMID: 35820958 PMCID: PMC9275389 DOI: 10.1186/s13690-022-00886-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background Measuring and understanding the level of health literacy serves as a starting point for developing various policies in health care. The consequences of weak health literacy competencies are severe; they result in riskier health behaviour, poorer health status, more frequent emergency visits and hospitalizations. This research has three aims: i) measure the level of health literacy in the populations of Latvia and Lithuania; ii) investigate which demographic and socioeconomic determinants are associated with it; and iii) discuss the means of improving its current level. Methods We employ a validated survey tool, the 47-item European Health Literacy Questionnaire (HLS-EU-Q). In addition to the 47 questions in the domains of health care, disease prevention, and health promotion, the participants’ demographic and socioeconomic characteristics are assessed. Face-to-face paper-assisted surveys are conducted with randomly selected residents from Latvia and Lithuania. The level of health literacy is measured by the health literacy index. Spearman correlation analyses and multiple regressions models are employed for investigating the association between the health literacy level and its determinants. The survey tool is complemented with in-depth interviews with six healthcare industry experts in order to assess the most promising ways to improve the level of health literacy. Results The stratified random sampling with quota elements assured a representative sample in terms of gender, urban/rural distribution and regions. In Latvia, 79% of the population possesses weak health literacy competencies. In Lithuania, 73% of the population can be characterized with inadequate or problematic level of health literacy. The most important determinants of the health literacy level include age, financial situation, social status, and ethnicity. In particular, elderly (aged 76 and over) and the Latvian-speaking population are less health literate, while those having better financial situation and higher social status are more health literate. The three most promising ways to improve the level of health literacy, as suggested by the healthcare industry experts, include health education in schools, provision of structured health-related information in Latvian and Lithuanian, and guidelines for the most common health problems. Conclusions The proportion of population with inadequate or problematic level of health literacy is higher in Latvia and Lithuania than in several other European countries. There is an urgent need to develop policies to improve it. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00886-3.
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22
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Coleshill MJ, Day RO, Tam K, Kouhkamari M, Caillet V, Aung E, Kannangara DRW, Cronin P, Rodgers A, Stocker SL. Persistence with urate-lowering therapy in Australia: A longitudinal analysis of allopurinol prescriptions. Br J Clin Pharmacol 2022; 88:4894-4901. [PMID: 35675118 PMCID: PMC9795926 DOI: 10.1111/bcp.15435] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/12/2022] [Accepted: 05/27/2022] [Indexed: 12/30/2022] Open
Abstract
AIM Gout is the most common form of inflammatory arthritis in men. Despite the availability of effective urate-lowering therapies (ULT), the management of gout is suboptimal due to poor persistence with ULT. This study examined national prescribing patterns of ULT to determine persistence with allopurinol in Australia. METHODS A 10% sample of the Australian Pharmaceutical Benefits Scheme dispensing claims database was used to identify individuals initiated on allopurinol between April 2014 and December 2019. The number of allopurinol scripts dispensed was used to estimate persistence with allopurinol. Persistence was defined as the number of months from initiation until discontinuation (last prescription with no further scripts acquired for a period thereafter). Kaplan-Meier curves were used to examine persistence, while Cox regression analysis was used to examine the influence of gender, concomitant colchicine and age. RESULTS The largest drop in persistence occurred immediately after initiation, with 34% of patients discontinuing allopurinol 300-mg therapy in the first month. Median persistence with allopurinol 300 mg was 5 months (95% confidence interval 4.76-5.24), with around 63% of individuals not persisting with this therapy for more than 12 months. Concomitant prescription of colchicine on the day of allopurinol initiation only occurred in 7% of allopurinol initiations. No increase in persistence was observed for those co-prescribed colchicine. CONCLUSION Persistence with allopurinol was poor. More effective methods targeting prescribers, patients and systems are required to promote persistence with allopurinol. Improving persistence to allopurinol is an important public health goal given the proven potential of this medication to eliminate gout.
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Affiliation(s)
- Matthew J. Coleshill
- Department of Clinical Pharmacology & ToxicologySt Vincent's HospitalSydneyAustralia,St Vincent's Clinical SchoolUniversity of New South WalesSydneyAustralia
| | - Richard O. Day
- Department of Clinical Pharmacology & ToxicologySt Vincent's HospitalSydneyAustralia,St Vincent's Clinical SchoolUniversity of New South WalesSydneyAustralia
| | - Karson Tam
- Department of Clinical Pharmacology & ToxicologySt Vincent's HospitalSydneyAustralia
| | | | | | - Eindra Aung
- Department of Clinical Pharmacology & ToxicologySt Vincent's HospitalSydneyAustralia,St Vincent's Clinical SchoolUniversity of New South WalesSydneyAustralia
| | - Diluk R. W. Kannangara
- Department of Clinical Pharmacology & ToxicologySt Vincent's HospitalSydneyAustralia,Notre Dame Medical SchoolSydneyAustralia
| | | | - Anthony Rodgers
- George Institute for Global StudiesUniversity of New South WalesSydneyAustralia
| | - Sophie L. Stocker
- Department of Clinical Pharmacology & ToxicologySt Vincent's HospitalSydneyAustralia,St Vincent's Clinical SchoolUniversity of New South WalesSydneyAustralia,Sydney Pharmacy School, Faculty of Medicine & HealthThe University of SydneySydneyAustralia
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23
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Roble S, Wångdahl J, Warner G. COVID-19 Information in Sweden: Opinions of Immigrants with Limited Proficiency in Swedish. HEALTH COMMUNICATION 2022; 37:1510-1519. [PMID: 35287507 DOI: 10.1080/10410236.2022.2050005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 has highlighted the importance of health information for prevention of communicable disease. Knowledge about groups that have high risk is important to prevent disease transmission. In Sweden, immigrants have been identified as one such group. Yet, little is known about where they have sourced information about COVID-19 and their opinions toward it. The aim of this study was to describe the COVID-19 information sources used by immigrants with limited proficiency in Swedish as well as their opinions on how comprehensive the information has been, the importance of the recommendations and their possibility to follow them. A cross-sectional survey was conducted via introductory Swedish language classes in Region Uppsala (n = 855). The results showed the immigrants were using different information sources, with the majority using school, media and social media. The immigrants' opinions about COVID-19 information differed. Most reported they knew where to find information; however, over two-fifths reported the recommendations from the authorities should be more extensive. The majority reported it is important to follow the recommendations, whereas the possibility to follow the recommendations was more mixed. Age differences in opinions toward COVID-19 information were detected. Although the results were largely positive, there still appears to be a need for improvement in how immigrant groups with limited ability in the host country´s language are reached. Effective health communication that engages the whole nation is an important factor authorities should commit to as we face the current pandemic. This research suggests that an approach tailored by age could be helpful.
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Affiliation(s)
- Sagal Roble
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University
| | - Josefin Wångdahl
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University
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Fung MY, Lee YH, Lee YTA, Wong ML, Li JTS, Nok Ng EE, Lee VWY. Feasibility of a telephone-delivered educational intervention for knowledge transfer of COVID-19-related information to older adults in Hong Kong: a pre-post-pilot study. Pilot Feasibility Stud 2022; 8:228. [PMID: 36203186 PMCID: PMC9535844 DOI: 10.1186/s40814-022-01169-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background During the COVID-19 pandemic, educational interventions have become necessary to prevent the spread of health-related misinformation among Hong Kong older adults. The primary objective of this study was to assess the feasibility of a student-led, telephone-delivered intervention to improve COVID-19-related health knowledge among Hong Kong older adults. The secondary objective was to evaluate the impact of the intervention on the student volunteers. Methods Twenty-five participants aged 65 or above who were able to communicate in Cantonese and had no hearing or cognitive impairments were recruited for this longitudinal pre–post-study from a community center in Hong Kong. The pilot telephone-delivered intervention consisted of five telephone call sessions conducted by 25 student volunteers. Each participant was paired with the same volunteer throughout the intervention. The first four sessions included pre-tests that assessed the participants’ understanding of three COVID-19-related themes: medication safety, healthcare voucher scheme, and COVID-19 myth-busting. Standardized explanations of the pre-test questions were offered to participants during the phone calls. In the last session, a post-test on all the themes was conducted. The intervention’s feasibility was assessed based on (a) percentage changes in the participants’ test scores, (b) attrition rate, and (c) the acceptability of the intervention by the participants. The impact of the intervention on the student volunteers was evaluated based on a student feedback survey. There was no control group. Results Significant improvements in the participants’ test scores (out of 100%) for all themes were observed after the intervention: from 76 to 95.2% for medication safety, from 64.0 to 88.8% for the healthcare voucher scheme, and from 78.0 to 93.2% for COVID-19 myth-busting. The average improvement in test scores of the three themes was 18.4% (95% CI 12.2 to 24.6%). Most participants were satisfied with the program. The student feedback survey suggested that the intervention enhanced students’ communication skills and understanding of Hong Kong older adults. Conclusion This pilot study offers initial evidence of the potential and feasibility of student-led, telephone-delivered educational interventions for the transfer of COVID-19-related knowledge to older adults and their benefits for the student volunteers. Future studies should include larger samples and a control group. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01169-y.
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Affiliation(s)
- Mong Yung Fung
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yu Hong Lee
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yan Tung Astor Lee
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mei Ling Wong
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joyce Tik Sze Li
- Center for Learning Enhancement and Research, The Chinese University of Hong Kong, 5/F, Hui Yeung Shing Building, Hong Kong, Hong Kong
| | - Enoch E Nok Ng
- Center for Learning Enhancement and Research, The Chinese University of Hong Kong, 5/F, Hui Yeung Shing Building, Hong Kong, Hong Kong
| | - Vivian Wing Yan Lee
- Center for Learning Enhancement and Research, The Chinese University of Hong Kong, 5/F, Hui Yeung Shing Building, Hong Kong, Hong Kong.
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25
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Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Serv Res 2022; 22:1148. [PMID: 36096793 PMCID: PMC9465902 DOI: 10.1186/s12913-022-08527-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background This study aims to assess the health literacy of medical patients admitted to hospitals and examine its correlation with patients’ emergency department visits, hospital readmissions, and durations of hospital stay. Methods This prospective cohort study recruited patients admitted to the general internal medicine units at the two urban tertiary care hospitals. Health literacy was measured using the full-length Test of Functional Health Literacy in Adults. Logistic regression analyses were performed to examine the correlation between health literacy and the desired outcomes. The primary outcome of interest of this study was to determine the correlation between health literacy and emergency department revisit within 90 days of discharge. The secondary outcomes of interest were to assess the correlation between health literacy and length of stay and hospital readmission within 90 days of discharge. Results We found that 50% had adequate health literacy, 32% had inadequate, and 18% of patients had marginal health literacy. Patients with inadequate health literacy were more likely to revisit the emergency department as compared to patients with adequate health literacy (odds ratio: 3.0; 95% Confidence Interval: 1.3–6.9, p = 0.01). In patients with inadequate health literacy, the mean predicted probability of emergency department revisits was 0.22 ± 0.11 if their education level was some high school or less and 0.57 ± 0.18 if they had completed college. No significant correlation was noted between health literacy and duration of hospital stay or readmission. Conclusions Only half of the patients admitted to the general internal medicine unit had adequate health literacy. Patients with low health literacy, but high education, had a higher probability of emergency department revisits.
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Affiliation(s)
- Rabia Shahid
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK7N OW8, Canada.
| | - Muhammad Shoker
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Luan Manh Chu
- Provincial Research Data Services, Alberta Health Services, Edmonton, Canada
| | - Ryan Frehlick
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Heather Ward
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK7N OW8, Canada
| | - Punam Pahwa
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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Lee HG, Kwon S, Jang BH, Jeon JP, Lee YS, Jung WS, Moon SK, Cho KH. A Study on the Perceptions of Korean Older Adult Patients and Caregivers about Polypharmacy and Deprescribing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11446. [PMID: 36141719 PMCID: PMC9517474 DOI: 10.3390/ijerph191811446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Polypharmacy is continuously increasing among older adults. The resultant potentially inappropriate medications (PIMs) can be harmful to patient health. Deprescribing refers to stopping or reducing PIMs. In this study, the current status of polypharmacy and willingness of older adults to deprescribe were investigated among patients and caregivers who are not associated with one another. The survey used the Korean translated version of the revised Patients' Attitude Towards Deprescribing (rPATD) Scale. Data were collected through an online survey of 500 participants (250 patients and caregivers each) in this study. The following results were found for patients and caregivers, respectively: 74.8% and 63.6% felt their number of medications was high, 64.4% and 55.6% desired to reduce their medications, 70.4% and 60.8% were concerned about medication discontinuation, 63.2% and 61.2% had a good understanding of their medications, 77.6% and 76.4% were willing to be well informed, and 79.6% and 72% wanted to reduce the number of medications if medically feasible. Patients and caregivers commonly agreed to the burden of the number of medications they were taking, and were willing to reduce the number of medications if the doctor said it was possible. Doctors should consider this information during the deprescribing process, and promote deprescription while involving patients and caregivers in the decision-making process.
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Affiliation(s)
- Han-Gyul Lee
- Kyung Hee University Medical Center, Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Seungwon Kwon
- Kyung Hee University Medical Center, Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Jin Pyeong Jeon
- Department of Neurosurgery, Hallym University College of Medicine, Chuncheon 24253, Korea
| | - Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Korea
| | - Woo-Sang Jung
- Kyung Hee University Medical Center, Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Sang-Kwan Moon
- Kyung Hee University Medical Center, Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Ki-Ho Cho
- Kyung Hee University Medical Center, Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
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Abstract
OBJECTIVE To evaluate the baseline level and demographic predictors of statistical literacy in orthopaedic patients who sustained traumatic injuries. DESIGN Prospective observational. SETTING Level 1 trauma center. PATIENTS One hundred ninety-eight patients presenting to the orthopaedic trauma clinic. INTERVENTION Berlin Numeracy Test (BNT) and General Health Numeracy Test-6 (GHNT-6). RESULTS When assessed using the BNT, 67% of patients had results that placed them into the lowest quartile of objective numeracy skills. Only 3.5% of patients had results that scored in the top quartile. Our multivariate ordinal regression model demonstrated lower education level ( P = 0.01), and older age ( P = 0.03) were significant predictors of poor performance on the BNT. The mean score on the GHNT-6 was 36% (SD 30%). CONCLUSIONS In a cohort of traumatically injured patients, poor statistical literacy was common, occurring in more than two-thirds of patient surveyed. Older age and lower levels of education were predictive of poor BNT performance and should be considered when discussing surgical options, associated risks, and likelihood of potential complications.
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Chiou SJ, Chang YJ, Liao K, Chen CD. Modest association between health literacy and risk for peripheral vascular disease in patients with type 2 diabetes. Front Public Health 2022; 10:946889. [PMID: 36091498 PMCID: PMC9448987 DOI: 10.3389/fpubh.2022.946889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
Objective Health literacy plays a crucial role in managing chronic health conditions. Previous studies have revealed the positive relationship between health literacy and diabetes knowledge but few studies have focused on peripheral vascular disease (PVD) in diabetes in relation to health literacy in diabetes management. This study investigated the relationship between the risk for PVD and health literacy level with other determining factors among patients with type 2 diabetes. Method We conducted a survey on health literacy using the Mandarin Multidimensional Health Literacy Questionnaire in the department of metabolism and endocrine systems at a regional hospital in northern Taiwan from December 2021 to May 2022 and obtained data from the hospital's health information system (HIS) from 2013 to 2020 to identify occurrences of PVD (n = 429). We performed logistic regression analysis to identify the relationship between PVD events and health literacy levels (overall and in five separate subdimensions) adjusted with other variables. Results A longer duration of diabetes increased the risk for PVD events (P = 0.044 and 0.028). In terms of health literacy, the overall level was not significant; however, the dimension of higher levels of health literacy in acquiring health information increased the risk for PVD events (P = 0.034). Other variables were not significantly associated with the risk for PVD events. Conclusion This study examined the risk for PVD events in terms of the duration of diabetes and provided evidence across the range of dimensions of health literacy concerning the ability to control diabetes. Those with a higher level of health literacy may be more aware of their disease situation, seek and cooperate with their healthcare providers earlier, and have more opportunities to be made aware of their health status from regular checkups than those with inadequate health literacy. These results may help providers make available more self-management tools that are adequate and sustainable for diabetes patients with poor health literacy.
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Affiliation(s)
- Shang-Jyh Chiou
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan,*Correspondence: Shang-Jyh Chiou
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei City, Taiwan
| | - Kuomeng Liao
- Department of Endocrinology and Metabolism, Zhongxiao Branch, Taipei City Hospital, Taipei City, Taiwan
| | - Chih-Dao Chen
- Department of Family Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
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Trela KC, Zajac P, Zhu M, Press VG. Health literacy and type of education intervention predicting post-education metered-dose inhaler misuse. Respir Med 2022; 200:106930. [PMID: 35870435 DOI: 10.1016/j.rmed.2022.106930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/23/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asthma and chronic obstructive pulmonary disease (COPD) guidelines recommend self-management assessment and inhaler education at all care-visits. Assessment is vital for identifying inhaler misuse. Whether age-related factors impede the efficacy of educational interventions for inhaler technique among older patients is unknown. We aimed to study factors associated with metered-dose inhaler (MDI) misuse pre/post-inhaler education among younger (< 65) and older inpatient populations (≥ 65). METHODS Adult inpatients with asthma or COPD enrolled across five studies between 2007 and 2017, who were eligible for, consented, and assigned to one of three education interventions (Brief Intervention [BI], Teach-to-Goal [TTG], Virtual Teach-to-Goal [V-TTG]) were included. Participants' visual acuity, health literacy, and MDI technique pre/post education were assessed using validated assessments. Binary logistic regression was used to investigate factors that increased odds of inhaler misuse. RESULTS Across the five studies, 394 unique participants were enrolled with a mean age of 51.9 years (SD±15). There was no significant difference in baseline MDI misuse by age, vision, or health literacy levels. Post-education misuse use was lower among patients with better baseline MDI technique, those who received TTG or V-TTG education, and those with high health literacy. Neither age nor visual acuity were significantly associated with increased rates of misuse, although age was correlated with low health literacy. CONCLUSION MDI education with teach-to-goal modalities is more effective than brief intervention; however, patients with low health literacy (disproportionately affecting older patients) may benefit less from these interventions. Further investigation into tailored inhaler education is needed.
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Affiliation(s)
- Kristin C Trela
- University of Chicago Medicine, Department of Anesthesiology and Critical Care, USA
| | - Paulina Zajac
- University of Chicago, Harris School of Public Policy, USA
| | - Mengqi Zhu
- University of Chicago Medicine, Section of General Internal Medicine, USA
| | - Valerie G Press
- University of Chicago Medicine, Section of General Internal Medicine, USA.
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Raddadi Y, Adib-Hajbaghery M. Health literacy and quality of life in Iranian persons with COPD. Heart Lung 2022; 54:61-67. [PMID: 35349857 DOI: 10.1016/j.hrtlng.2022.02.009] [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: 08/22/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease is a progressive disorder with significant physical, psychological, and social consequences and adversely affects the persons' quality of life (QOL). OBJECTIVES This study aimed to determine the health literacy (HL) and QOL of persons with COPD and some of the contributing factors. METHODS A cross-sectional study was conducted from May to December 2019 on 270 persons with COPD referring to Shahid-Beheshti Hospital of Kashan, Iran. Data were collected using a demographic questionnaire, the 33-item Health Literacy Questionnaire of the Urban Population of Iran (with a total score ranging from 33 to 165, higher score indicates higher HL) and the 50-item St. George's Respiratory Questionnaire for assessing the QOL (with a total score ranging from zero to 100, greater score means lower QOL). Descriptive statistics, Pearson and Spearman correlation coefficient, Chi-square test, t-test, analysis of variance, and linear regression analysis were used to analyze the data. RESULTS The mean age and the mean duration of COPD were 59.48±13.31 and 3.85±3.47 years, respectively. The mean HL score and the mean QOL were 81.44±23.89 and 57.41±10.70, respectively. A significant correlation was found between HL and QOL (r=-0.21, p<0.001). CONCLUSION Participants had moderate levels of HL and QOL. There was a significant correlation between HL and QOL. Health care providers are recommended to take effective steps to improve the HL of persons with COPD by developing comprehensive educational programs for them.
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Affiliation(s)
- Yasaman Raddadi
- Medical Surgical Nursing Department, Faculty of Nursing, Kashan University of Medical Sciences, Kashan, Iran
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Health Information Sources Influencing Health Literacy in Different Social Contexts across Age Groups in Northern Thailand Citizens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106051. [PMID: 35627585 PMCID: PMC9141654 DOI: 10.3390/ijerph19106051] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 01/13/2023]
Abstract
Health literacy is an essential social determinant of health and has been associated with positive health outcomes. While many sources of health information are widely available, people of different ages also have diverse social contexts and preferences for health information sources. This study aimed to identify health information sources and socio-demographics influencing health literacy in different social contexts across age groups: 15–29 years (young), 30–59 years (middle-age), and ≥60 years (elderly). We obtained secondary data from a cross-sectional study in northern Thailand from March to August 2019. Multivariate linear regression with age group subgroup analysis was used to determine factors associated with general health literacy by the Thai version of the health literacy questionnaire. Receiving health information from physicians was significantly associated with higher general health literacy in young (β 6.45, 95%CI 0.44–12.45; p = 0.035) and elderly (β 5.18, 95%CI 1.84–8.52; p = 0.002) groups, while receiving health information from health volunteers was significantly associated with a higher general health literacy in the middle-aged (β 2.89, 95%CI 0.38–5.39; p = 0.024) group. Although younger participants showed more frequent access to health information via the media than the other age groups, there were no media sources significantly linked with their general health literacy. Health information from physicians is a vital source of health information.
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Stock S, Isselhard A, Jünger S, Peters S, Schneider G, Haarig F, Halbach S, Okan O, Fischer F, Bollweg TM, Bauer U, Schaeffer D, Vogt D, Berens EM, Ernstmann N, Bitzer EM. [DNVF Memorandum Health Literacy (Part 2) - Operationalisation and Measuring of Health Literacy from a Health Services Research Perspective]. DAS GESUNDHEITSWESEN 2022; 84:e26-e41. [PMID: 35472769 PMCID: PMC9050455 DOI: 10.1055/a-1807-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Das vorliegende „DNVF Memorandum Gesundheitskompetenz (Teil 2) –
Operationalisierung und Messung von Gesundheitskompetenz aus Sicht der
Versorgungsforschung“ des Deutschen Netzwerks Versorgungsforschung e.V.
(DNVF) stellt die Fortführung des Memorandums „DNVF Memorandum
Gesundheitskompetenz (Teil 1) – Hintergrund, Gegenstand und
Fragestellungen in der Versorgungsforschung“ dar. Neben den allgemeinen
Anforderungen an die Messung der Gesundheitskompetenz, beschäftigt sich
dieses Memorandum auch mit den speziellen Anforderungen, wie die Abgrenzung zu
verwandten Konstrukten, den Unterschieden zwischen performanzbasierten und
Selbsteinschätzungsverfahren, den Unterschieden zwischen generischen und
spezifischen Instrumenten, dem Einsatz von Screeninginstrumenten sowie der
Messung der Gesundheitskompetenz bei speziellen Personengruppen. Weiterhin
werden Besonderheiten bei der Messung der digitalen Gesundheitskompetenz,
Potenziale qualitativer und partizipativer Forschungszugänge sowie
forschungsethische Gesichtspunkte bei der Messung der Gesundheitskompetenz
erarbeitet. Ein besonderer Wert wird auf den Praxisbezug gelegt, der am Ende der
jeweiligen Abschnitte mit einem Fazit für die Versorgungsforschung
aufgegriffen wird. Abschließend wird einen Blick auf Herausforderungen
und Forschungsdesiderate im Zusammenhang mit der Messung von
Gesundheitskompetenz im Rahmen der Versorgungsforschung geworfen.
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Affiliation(s)
- Stephanie Stock
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln, Cologne, Germany
| | - Anna Isselhard
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln, Cologne, Germany
| | - Saskia Jünger
- Department of Community Health, Hochschule für Gesundheit, Bochum, Germany
| | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Hürth Efferen, Germany
| | - Gundolf Schneider
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Standort Berlin, Berlin, Germany
| | - Frederik Haarig
- Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Carl Gustav Carus der Technischen Universität Dresden, Dresden, Germany
| | - Sarah Halbach
- Bundeszentrale für gesundheitliche Aufklärung (BzgA), Köln, Germany.,Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn
| | - Orkan Okan
- Fakutät für Sport- und Gesundheitswissenschaften, Technische Universität München, München, Germany
| | - Florian Fischer
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten, Weingarten, Germany
| | - Torsten Michael Bollweg
- Fakultät für Erziehungswissenschaft, AG 2 Sozialisation, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Bielefeld, Germany
| | - Ullrich Bauer
- Fakultät für Erziehungswissenschaft, AG 2 Sozialisation, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Bielefeld, Germany
| | - Doris Schaeffer
- Interdisziplinäres Zentrum für Gesundheitskompetenzforschung, Universität Bielefeld, Bielefeld, Germany
| | - Dominique Vogt
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Eva-Maria Berens
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Nicole Ernstmann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn
| | - Eva Maria Bitzer
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Germany
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Singh S, Polavarapu M, Arsene C. Changes in patient portal adoption due to the emergence of COVID-19 pandemic. Inform Health Soc Care 2022; 48:125-138. [PMID: 35473512 DOI: 10.1080/17538157.2022.2070069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Even though patient portals are recognized as a promising mechanism to support greater patient engagement, questions remain about access and utilization. This study aims to identify factors related to portal adoption in 2019 and 2020 (before and during the COVID-19). Cross-sectional data from the Health Information National Trends Survey (HINTS) cycles- 2019 HINTS 5 cycle 3 (N = 5,438) and 2020 HINTS 5 cycle 4 (N = 3,865) were analyzed using STATA-SE version 17 to factors predicting portal adoption. Next, HINTS 5 cycles 3 and 4 were pooled to identify changes in portal feature use and ease of usage among portal users, and barrier to portal use among non-users. Respondents who were college graduates, high income, and married were more likely to adopt patient portals during 2019 and 2020. Aged 75+ and Hispanic respondents reported less frequency of portal access in 2020 versus 2019. Men were more likely to adopt patient portals in 2019 versus women in 2020. Portal users were more likely to use the portal-system features in 2019 versus 2020. Portal non-users reported having multiple-health records as less of a barrier in 2020 compared to 2019. Patient engagement needs heightened attention during the COVID-19 pandemic.
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Affiliation(s)
- Shipra Singh
- in Health Education, School for the Advancement of Interprofessional Education (Ipe), School of Population Health, College of Health & Human Services, University of ToledoHealth Education & Public Health, Health Equity Research Center (Herc), Doctoral Program, Toledo, Ohio, USA
| | | | - Camelia Arsene
- ProMedica Cancer Institute, Sylvania, Ohio, USA.,College of Medicine and Life Sciences, Department of Medicine, College of Health & Human Services, School of Population Health, University of Toledo, Toledo, Ohio, USA
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Yılmaz NG, Timmermans DRM, Portielje J, Van Weert JCM, Damman OC. Testing the effects on information use by older versus younger women of modality and narration style in a hospital report card. Health Expect 2022; 25:567-578. [PMID: 34953006 PMCID: PMC8957735 DOI: 10.1111/hex.13389] [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] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/28/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hospital report cards (HRCs) are usually presented in a textual and factual format, likely hampering information processing. OBJECTIVE This study aimed to investigate the effects of audiovisual and narrative information in HRCs on user responses, and to test differences between older and younger women. DESIGN A 2 (modality [textual vs. audiovisual]) × 3 (narration style [factual vs. process narrative vs. experience narrative]) online experiment was conducted. Information about breast cancer care was used as a case example. Age (younger [<65] vs. older [≥65]) was included as a potential effect modifier. SETTING AND PARTICIPANTS A total of 631 disease-naïve women (Mage = 56.06) completed an online survey. The outcomes were perceived cognitive load, satisfaction, comprehension, information recall and decisional conflict. Data were analysed using AN(C)OVAs. RESULTS Audiovisual (vs. textual) information resulted in higher information satisfaction across age groups, but was associated with lower comprehension in older women. An experience narrative (vs. factual information) increased satisfaction with attractiveness and emotional support of the information only in older women. A three-way interaction effect was found, suggesting that older women were most satisfied with the comprehensibility of audiovisual factual or textual process narrative information. Younger women were most satisfied with the comprehensibility of audiovisual process narrative or textual factual information. DISCUSSION AND CONCLUSION Audiovisual and narrative information in an HRC showed beneficial effects on satisfaction measures. In particular, audiovisual information could be incorporated into HRCs to increase satisfaction with information. PUBLIC CONTRIBUTION Lay persons helped in optimizing the visuals used in the stimulus materials by checking for clarity.
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Affiliation(s)
- Nida Gizem Yılmaz
- Department of Public and Occupational HealthAmsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Communication ScienceAmsterdam School of Communication Research/ASCoR, University of AmsterdamAmsterdamThe Netherlands
| | - Danielle R. M. Timmermans
- Department of Public and Occupational HealthAmsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Johanneke Portielje
- Department of Medical OncologyLeiden University Medical CenterLeidenThe Netherlands
| | - Julia C. M. Van Weert
- Department of Communication ScienceAmsterdam School of Communication Research/ASCoR, University of AmsterdamAmsterdamThe Netherlands
| | - Olga C. Damman
- Department of Public and Occupational HealthAmsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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PALA E. Evaluation of the health literacy level of the patients who applied to a tertiary hospital family medicine clinic. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1073138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Farrell TW, Towsley GL, Eaton J, Butler JM, Supiano KP, Stephens C, Witt C, Nelson NM, Edelman LS. The Development and Validation of a Communication Survey Instrument for Long-term Care Staff. J Contin Educ Nurs 2022; 53:123-130. [PMID: 35244460 DOI: 10.3928/00220124-20220210-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Information transfers in long-term care (LTC) settings between and among providers, staff, residents, and family caregivers are often fragmented. In order to identify training needs to improve communication, a survey instrument was developed and refined to assess the self-efficacy of LTC staff in communicating with staff, providers, residents, and caregivers. This 11-item survey instrument, based on a literature review, covered four key concepts (mutual respect, recognizing and responding to sensory deficits, limited health literacy, and changes in condition) relevant to communicating health information in LTC settings. Ten content experts evaluated each survey item using a 4-point scale. The content validity of the survey was established by using the content validity index to assess results at the item and scale levels. All items scored 0.90 or greater and were retained. Future work should entail broad-scale validation and testing of this survey across the United States. By assessing the self-efficacy of LTC staff in communicating with the interprofessional team, leadership teams can design personalized interprofessional continuing education activities aimed at improving communication skills. [J Contin Educ Nurs. 2022;53(3):123-130.].
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Dai Minh L, Quang BV, Ngoc Le Mai D, Quyen LL, Gia NH, Hang NT, Giang KB. Health Literacy of Newly-Admitted Cancer Patients in Vietnam: Difficulties Understanding Treatment Options and Processing Health-Related Information. Health Serv Insights 2022; 15:11786329211067325. [PMID: 35035220 PMCID: PMC8753245 DOI: 10.1177/11786329211067325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Having a good understanding of cancer patients' health literacy in the early stage of diagnosis can help to implement strategies to improve the management process and overall health outcomes. The study aims to describe health literacy and its association with socio-demographic characteristics among newly admitted cancer patients. A cross-sectional study was conducted on 262 newly admitted patients of a cancer hospital in Vietnam using the Vietnamese version of the HLS-SF12 questionnaire. Descriptive analytics and regression analysis were used to describe health literacy and examine associated factors. Older age, lower level of education, and living in rural areas were associated with lower health literacy while there was no significant relationship between gender and health literacy among newly admitted cancer patients. Many newly admitted patients, especially the older patients have difficulties understanding the different treatment options (54%) and evaluating the reliability of health information on the internet (43%). During the early stage of treatment, strategies should be implemented with regards to patients' health literacy, to properly educate patients and their caregivers to improve communication, adherence to medication, lifestyle, and overall better quality of life and treatment outcome.
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Affiliation(s)
| | | | | | | | | | | | - Kim Bao Giang
- School of Preventive Medicine and Public Health, Hanoi Medical University, Vietnam
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You X, Liu Y, Zhang M, Zhang M, Yu Y, Sang C. Modeling on Social Health Literacy Level Prediction. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2021; 2021:7049997. [PMID: 34917138 PMCID: PMC8670972 DOI: 10.1155/2021/7049997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
Nowadays, the health level of residents has become the focus of people's attention. Under the background of the development of health service from "disease-centered" to "health-centered," it is very important to improve the level of urban health and clarify the factors affecting urban health. Therefore, this paper quantifies the relationship between residents' health literacy level and environment, average life expectancy, infectious disease mortality, and other indicators by selecting appropriate indicators and establishing a mathematical model. Based on the reciprocal linear combination of the collected index data and the corresponding health level value, the prediction model of social health literacy level (SPM) was established, and the qualitative prediction and quantitative analysis of citizens' health literacy level were studied in depth. Based on the SPM model, we can roughly predict the level of health literacy in a region only based on the main variables identified in this paper. The consistency of the experiment shows that the model is effective and robust, and it reveals that environmental factors are the most important factors affecting residents' health literacy level. The actual data show that THE SPM model is a timely and reasonable framework to measure the health literacy level of residents.
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Affiliation(s)
- Xuemei You
- Business School, Shandong Normal University, Jinan, Shandong 250014, China
| | - Yongdong Liu
- Business School, Shandong Normal University, Jinan, Shandong 250014, China
| | - Mingming Zhang
- Business School, Shandong Normal University, Jinan, Shandong 250014, China
| | - Man Zhang
- Business School, Shandong Normal University, Jinan, Shandong 250014, China
| | - Yangli Yu
- Business School, Shandong Normal University, Jinan, Shandong 250014, China
| | - Chengge Sang
- Business School, Shandong Normal University, Jinan, Shandong 250014, China
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Determinants of rating of the seriousness of health issues facing Americans. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312432. [PMID: 34886157 PMCID: PMC8656600 DOI: 10.3390/ijerph182312432] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
Background: Health Literacy (HL) is one of the main determinants of health and is crucial for the prevention of noncommunicable diseases, by influencing key health-related behaviours. The aim of the present study was to assess the role of HL and sociodemographic factors in predicting the adoption of two healthy behaviours—physical activity and fruits and vegetables consumption. Methods: This study was conducted on the Tuscan population subsample of the Italian Behavioral Risk Factor Surveillance System in 2017–2018. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results: About 40% of the 7157 interviewees reported an inadequate or problematic HL level. Female sex, poor financial status, foreign nationality, and low education were associated with a problematic HL level, while an inadequate HL level was associated with being 50–69 years old, low education level, foreign nationality, poor financial status and unemployment or inactive status. Inadequate HL level was a strong predictor of both eating less than three portions of fruits/vegetables per day and not engaging in sufficient PA during leisure times. Conclusions: Our findings showed that an inadequate level of HL could negatively affect physical activity and diet, independently from the other sociodemographic conditions, confirming the role of HL as a relevant social determinant of health.
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The Role of Health Literacy among Outpatient Caregivers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211743. [PMID: 34831499 PMCID: PMC8624592 DOI: 10.3390/ijerph182211743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 12/14/2022]
Abstract
Health literacy became an important competence during the COVID-19 pandemic. Despite outpatient caregivers being a particularly vulnerable occupational group, their health literacy has hardly been examined yet, especially during the pandemic. Hence, this study aimed to explore this field and provide first empirical insights. Data were collected based on a cross-sectional online survey among 155 outpatient caregivers. In particular, health literacy (HLS-EU-Q16), diet and physical activity, pandemic-related worries, perceived information sufficiency and stress perception were examined. Descriptive and ordinal logistic regression analyses were run to test explorative assumptions. The majority of outpatient caregivers reported high values of health literacy (69% on a sufficient level). Although no significant associations between health literacy and health behaviours or perceived information sufficiency were found, perceived information sufficiency and perceived stress (OR = 3.194; 95% CI: 1.542-6.614), and pandemic-related worries (OR = 3.073; 95% CI: 1.471-6.421; OR = 4.243; 95% CI: 2.027-8.884) seem to be related. Therefore, dissemination of reliable information and resource-building measures to reduce worries may be important parameters for improving outpatient caregivers' health. Our results provide first explorative insights, representing a starting point for further research. Considering outpatient caregivers' mobile work setting, they need to be provided with adequate equipment and comprehensible information to ensure physically and mentally healthy working conditions.
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Yu L, Mottola G, Bennett DA, Boyle PA. Adverse Impacts of Declining Financial and Health Literacy in Old Age. Am J Geriatr Psychiatry 2021; 29:1129-1139. [PMID: 33676832 PMCID: PMC8357843 DOI: 10.1016/j.jagp.2021.02.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Inadequate financial and health literacy presents a formidable public health and economic challenge in old age. This study investigated declining financial and health literacy in relation to decision making performance, scam susceptibility and psychological wellbeing. DESIGN Longitudinal study. SETTING A community-based cohort in Northeastern Illinois, USA. PARTICIPANTS One thousand fourty-six older adults who were free of dementia at baseline and underwent annual clinical and literacy assessments. MEASUREMENTS Financial and health literacy, decision making, scam susceptibility, and psychological wellbeing were assessed using validated instruments. Linear mixed effects models estimated person-specific rates of change in financial and health literacy, and multivariable regression analyses examined the associations of declining literacy with subsequent levels of decision making, scam susceptibility, and psychological wellbeing. RESULTS The mean age was 81 years and 76% were female. Over up to 10 years of annual follow-ups, the average financial and health literacy score dropped 1 percentage point a year. Substantial variability in decline was observed between participants. Faster decline in financial and health literacy was associated with poorer decision making, higher scam susceptibility, and lower psychological wellbeing. Notably, these associations were above and beyond the baseline literacy level and persisted even after controlling for cognition. CONCLUSIONS Most community-dwelling older adults experience decline in financial and health literacy over time, but decline is not inevitable. Declining literacy is related to poorer decision making, greater scam susceptibility and lower wellbeing. These findings suggest that efforts to mitigate declining financial and health literacy may promote independence and wellbeing in old age.
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Affiliation(s)
- Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center (LY, DAB, PAB), Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center (LY, DAB), Chicago, IL, USA.
| | - Gary Mottola
- FINRA Investor Education Foundation (GM), Washington DC, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center (LY, DAB, PAB), Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center (LY, DAB), Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center (LY, DAB, PAB), Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center (PAB), Chicago, IL, USA
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How doctors make themselves understood in primary care consultations: A mixed methods analysis of video data applying health literacy universal precautions. PLoS One 2021; 16:e0257312. [PMID: 34547015 PMCID: PMC8454934 DOI: 10.1371/journal.pone.0257312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To mitigate the health risks that result from low health literacy and difficulty identifying patients with insufficient health literacy, health organizations recommend physicians apply health literacy universal precaution communication skills when communicating with all patients. Our aim was to assess how health literacy universal precautions are delivered in routine GP consultations, and explore whether there were differences in how GPs used universal precaution approaches according to areas of deprivation in England. METHODS This was a mixed methods study using video and interview data. Ten physicians conducted 217 consultations in primary care settings with adults over 50 years old between July 2017 and March 2018 in England. Eighty consultations (N = 80) met the inclusion criteria of new or persisting problems. Descriptive quantitative analysis of video-recorded consultations using an observation tool and qualitative thematic analysis of transcribed scripts. Meta-themes explored differences in physicians' communication by areas of deprivation. RESULTS Descriptive statistics showed physicians used a caring tone of voice and attitude (n = 73, 91.3%) and displayed comfortable body language (n = 69, 86.3%) but infrequently demonstrated profession-specific health literacy universal precaution communication skills, such as the teach-back technique (n = 3, 3.8%). Inferences about physicians' communication from qualitative analysis converged with the quantitative findings. Differences in physicians' communication varied according to areas of deprivation. CONCLUSIONS Physicians need health literacy universal precautions communication skills to improve population health.
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Does Health Literacy Reinforce Disease Knowledge Gain? A Prospective Observational Study of Hungarian COPD Patients. J Clin Med 2021; 10:jcm10173990. [PMID: 34501438 PMCID: PMC8432554 DOI: 10.3390/jcm10173990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
We set out to measure the health literacy (HL) of COPD patients using the Short Test of Functional Health Literacy (S-TOFHLA), perception-based screening questions (BHLS), and a specific disease knowledge test (COPD-Q). Our main focus is the relationship between functional HL and patients' disease-knowledge, which contributes to the clarification of the relationship between the different kinds of HL. In two prospective observational studies, 151 COPD patients (80 males, mean age: 62 ± 9 years) completed a questionnaire containing HL measurements, psychological tests (e.g., the Self-Control and Self-Management Scale), and questions regarding subjective health status. Medical data of the patients from the MedSole system were added. The HL scores of the COPD patients were compared to a representative sample using a t-test. Furthermore, correlations of HL with demographic, psychological, and medical variables were calculated within the patient group. The relations among the different HL measurements were tested by chi-square trials. COPD patients had significantly lower HL, as measured by S-TOFHLA. Younger and higher educated patients possessed higher S-TOFHLA scores. Unlike the demographic variables, general self-management showed significant correlations with both BHLS and with COPD-Q. Out of the medical variables, objective health status was associated with BHLS and COPD-Q. Neither BHLS nor S-TOFHLA had a correlation with COPD-Q, but they correlated with each other. We found S-TOFHLA to be a better tool in the medical context. There is a clear gap between self-perceived/functional HL and the necessary disease knowledge. Rehabilitation care for patients with lower HL was more advantageous.
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Zachariou A, Filiponi M, Kaltsas A, Dimitriadis F, Sapouna V, Giannakis I, Mamoulakis C, Karagiannis A, Zikopoulos A, Paschopoulos M, Takenaka A, Sofikitis N. Translation and Validation of the TANGO Nocturia Screening Tool into Greek. J Multidiscip Healthc 2021; 14:1883-1891. [PMID: 34321885 PMCID: PMC8309650 DOI: 10.2147/jmdh.s312393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The present study aimed to translate the Targeting the individual's Aetiology of Nocturia to Guide Outcomes Questionnaire (TANGO) into the Greek language to create TANGO-Gr. A relative reliability study in prospective samples of community dwellers and rehabilitation centre residents was undertaken in order to validate the translation. In terms of nocturia severity, these groups were considered to be representative of patients at both ends of the scale, and therefore suitable validation purposes. Patients and Methods The prospective descriptive study took place between 07 and 09/2020. Fifty residents in a rehabilitation centre and thirty-seven community dwellers were included in the study. All participants had more than one episode of nocturia per night. They were asked to complete the newly translated TANGO-Gr Questionnaire twice (test-retest procedure). TANGO-Gr includes three possible answers ("yes", "no", and "DK/NA") to facilitate increased validity. The study group evaluated the socio and demographic characteristics, the level of independence and the comprehensive frailty of all participants. Results Both groups satisfactorily completed questionnaire responses. The overall Cronbach's alpha coefficient was 0.753 (community-dwelling people: 0.776; rehabilitation centre residents: 0.531). A test-retest statistical analysis to determine reliability found an overall median Kappa of 0.88 (IQR: 0.79-0.94) in community dwellers and 0.91 (IQR: 0.84-1.00) in rehabilitation centre residents, thereby confirming an almost perfect respective agreement. Conclusion The validity of the newly translated TANGO-Gr Questionnaire was proven. It should be considered to be a reliable, self-administered screening tool suitable for clinical practice, and therefore invaluable for Greek-speaking people. The study also determined that certain environment-related variables may contribute to nocturia in rehabilitation centre populations, which is a finding which invites further study.
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Affiliation(s)
- Athanasios Zachariou
- Urology Department, Ioannina University, Ioannina, Greece.,Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Maria Filiponi
- Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Aris Kaltsas
- Urology Department, Ioannina University, Ioannina, Greece
| | - Fotios Dimitriadis
- 1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Vagia Sapouna
- Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | | | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Crete, Greece
| | | | | | - Minas Paschopoulos
- Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, Ioannina, Greece
| | - Atsushi Takenaka
- Urology Department, School of Medicine, Tottori University, Yonago, Japan
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Sponselee HCS, Kroeze W, Poelman MP, Renders CM, Ball K, Steenhuis IHM. Food and health promotion literacy among employees with a low and medium level of education in the Netherlands. BMC Public Health 2021; 21:1273. [PMID: 34193103 PMCID: PMC8243473 DOI: 10.1186/s12889-021-11322-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/18/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Prior research indicates a positive association between socioeconomic position and health literacy levels. We hypothesize comparable socioeconomic gradients for food literacy. This study aims to determine the level of self-perceived food literacy and health promotion literacy among adults with a low and medium level of education and from various subgroups, as well as the association between these food and health literacy levels. Furthermore, this study aims to explore the associations of self-perceived food literacy (SPFL) and health promotion literacy (HPL) in BMI. METHODS A cross-sectional study was conducted among employees with a low and medium level of education. Descriptive analyses were performed to compute SPFL and HPL levels. Analyses of variance were performed to test differences between subgroups. The correlation between SPFL and HPL was computed by Pearson's r. Multivariate linear regression analyses were used to explore 1) the association between SPFL and HPL adjusted for demographic characteristics 2) the associations between SPFL and HPL in BMI. RESULTS The majority (63.1%) of all participants (n = 222) scored low on SPFL and 34.5% scored inadequate or problematic on HPL. No significant educational or weight-status differences were found in SPFL or HPL levels. On most levels, women compared to men and older compared to younger employees scored significantly higher. A small positive correlation between the two mean levels was found, r = .25, P < .001 (n = 203). Multivariate linear regression analyses showed a significant association between SPFL and HPL (B = .31, 95% CI = .15-.48). No significant associations between SPFL and HPL in BMI were found. CONCLUSIONS This study suggests there is room for improvement in SPFL and HPL among adults with a low and medium level of education. Future research should consider comparing low and middle socioeconomic with high socioeconomic groups when exploring food and health literacy. Regarding health promotion activities for adults with a low and medium level of education, it is recommended to focus on improving both food and health literacy. Furthermore, more research is needed to explore direct proxies of weight-status to better understand the role of food and health literacy in overweight patterns.
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Affiliation(s)
- Hanne C S Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands.
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS, Ede, The Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University and Research, 6700 EW, Wageningen, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands
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Saunders GH, Grush L, Vachhani J, Echt KV, Griest S, Lewis MS. Heterogeneity in Vison, Hand Function, Cognition, and Health Literacy Among Older Veterans: Impacts, Outcomes, and Clinical Recommendations for First-Time Hearing Aid Users. J Am Acad Audiol 2021; 32:355-365. [PMID: 34062607 DOI: 10.1055/s-0041-1728800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Age-related changes (both normal and pathological), and health literacy are relevant to audiological practice. Changes associated with the musculoskeletal, vascular, and nervous systems drive manual, visual, and cognitive function. These in turn affect the capabilities required for effective hearing aid (HA) skill acquisition, use, and management. Meanwhile, health literacy influences the ability to gain access to, understand, and use information, which is important for promoting and maintaining HA use and management. Understanding the interindividual variability of these variables can help audiologists characterize those individuals who might have suboptimal HA outcomes. This knowledge can then inform better clinical practices and guide implementation of processes to improve care quality and outcomes. PURPOSE The aim of the study is to assess the variation in manual, visual, and cognitive function, and health literacy, among community-dwelling older individuals, and to determine whether and which of these variables are associated with reported HA outcome and/or the knowledge and skill to manage HAs. RESEARCH DESIGN Data presented here were collected as part of an efficacy trial of four variants of HA orientation. The data were collected at baseline (prior to HA fitting) and after 4 to 8 weeks of HA use. STUDY SAMPLE The study sample consists of 265 U.S. Veterans aged 51 to 87 years with no previous HA experience who were scheduled to receive their first pair of HAs from the Veterans Administration. DATA COLLECTION AND ANALYSIS We assessed baseline measures of hand function, vision, cognition, and health literacy just prior to participants receiving their first pair of HAs. HA management skills and knowledge, and HA outcome were measured after 4 to 8 weeks of HA use using the Hearing Aid Skills and Knowledge (HASK) and International Outcomes Inventory for Hearing Aids (IOI-HA), respectively. Data collected here was compared with published norms to assess variation in baseline measures. Associations between baseline performance and outcomes data were examined using t-tests comparing participants who performed at or above age-based norms with those who performed below age-based norms. RESULTS Participants' performance on the baseline measures was highly variable, with the proportions of individuals performing below norms varying by test measure. When combining data across the nine baseline measures, approximately 10% of participants performed below published norms on five or more measures, and 85% performed below norms on at least one measure. Poor manual dexterity, ability to learn a new task, and ability to draw inferences from spoken information negatively impacted HA management and outcome. CONCLUSION There was a considerable heterogeneity among a community-dwelling sample of first time HA users in terms of sensory, cognitive, and motor function. Clinicians should consider modifying their clinical practice to account for such heterogeneity and best support their patients in adapting to new HAs.
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Affiliation(s)
- Gabrielle H Saunders
- VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon.,Manchester Center for Audiology and Deafness (ManCAD), School of Social Sciences, University of Manchester, Manchester, United Kingdom
| | - Leslie Grush
- VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon
| | - Jay Vachhani
- VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon
| | - Katharina V Echt
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education and Clinical Center (GRECC), Birmingham, Alabama and Atlanta, Georgia.,Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Susan Griest
- VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon.,Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - M Samantha Lewis
- VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon.,Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.,School of Audiology, Pacific University, Hillsboro, Oregon
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Lavin CV, Fahy EJ, Abbas DB, Griffin M, Deleon NMD, Lee DK, Khosla RK, Bruckman K, Lorenz HP, Wan DC. Readability of Online Patient Information Relating to Cleft Palate Surgery. Cleft Palate Craniofac J 2021; 59:330-335. [PMID: 33960204 DOI: 10.1177/10556656211013177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE It is important for health care education materials to be easily understood by caretakers of children requiring craniofacial surgery. This study aimed to analyze the readability of Google search results as they pertain to "Cleft Palate Surgery" and "Palatoplasty." Additionally, the study included a search from several locations globally to identify possible geographic differences. DESIGN Google searches of the terms "Cleft Palate Surgery" and "Palatoplasty" were performed. Additionally, searches of only "Cleft Palate Surgery" were run from several internet protocol addresses globally. MAIN OUTCOME MEASURES Flesch-Kincaid Grade Level and Readability Ease, Gunning Fog Index, Simple Measure of Gobbledygook (SMOG) index, and Coleman-Liau Index. RESULTS Search results for "Cleft Palate Surgery" were easier to read and comprehend compared to search results for "Palatoplasty." Mean Flesch-Kincaid Grade Level scores were 7.0 and 10.11, respectively (P = .0018). Mean Flesch-Kincaid Reading Ease scores were 61.29 and 40.71, respectively (P = .0003). Mean Gunning Fog Index scores were 8.370 and 10.34, respectively (P = .0458). Mean SMOG Index scores were 6.84 and 8.47, respectively (P = .0260). Mean Coleman-Liau Index scores were 12.95 and 15.33, respectively (P = .0281). No significant differences were found in any of the readability measures based on global location. CONCLUSIONS Although some improvement can be made, craniofacial surgeons can be confident in the online information pertaining to cleft palate repair, regardless of where the search is performed from. The average readability of the top search results for "Cleft Palate Surgery" is around the seventh-grade reading level (US educational system) and compares favorably to other health care readability analyses.
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Affiliation(s)
- Christopher V Lavin
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Evan J Fahy
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Darren B Abbas
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Michelle Griffin
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nestor M Diaz Deleon
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniel K Lee
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Rohit K Khosla
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Karl Bruckman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Hermann Peter Lorenz
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Curtis LM, Kwasny MJ, Opsasnick L, O'Conor RM, Yoshino-Benavente J, Eifler M, Federman AD, Altschul D, Wolf MS. Change in Health Literacy over a Decade in a Prospective Cohort of Community-Dwelling Older Adults. J Gen Intern Med 2021; 36:916-922. [PMID: 33559068 PMCID: PMC8042084 DOI: 10.1007/s11606-020-06423-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 12/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Health literacy is often viewed as a static trait in longitudinal studies, which may over or underestimate an individual's ability to manage one's health. OBJECTIVES We sought to examine health literacy over time among older adults using three widely used measures. DESIGN A prospective cohort study. PARTICIPANTS Community-dwelling adults ages 55 to 74 at baseline with at least one follow-up visit (N = 656) recruited from one academic internal medicine clinic and six community health centers in Chicago, IL. MEASURES Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA), Newest Vital Sign (NVS), and Rapid Estimate of Adult Literacy in Medicine (REALM) at baseline and up to three follow-up time points. RESULTS In unadjusted analyses, significant changes since baseline were found beginning at the second follow-up (mean (M) = 6.0 years, SD = 0.6) for the TOFHLA (M = - 0.9, SD = 0.95, p = 0.049) and the REALM (M = 0.3, SD = 2.5, p = 0.004) and at the last follow-up (M = 8.6 years, SD = 0.5) for the NVS (M = - 0.2, SD = 1.4, p = 0.02). There were non-linear effects of baseline age on TOFHLA and NVS scores over time (piecewise cubic spline p = 0.01 and p < 0.001, respectively) and no effect on REALM scores (B = 0.02, 95% CI - 0.01 to 0.04, p = 0.17) using multivariable mixed-effects linear regression models, controlling for race, education, income, and comorbidity. CONCLUSION We found a negative relationship between age and health literacy over time as measured by the TOFHLA and NVS. Health literacy barriers appear to be more prevalent among individuals in later life, when self-care demands are similarly increasing. Clinicians might consider strategies to assess and respond to limited health literacy, particularly among patients 70 and older. REALM performance remained stable over 10 years of follow-up. This questions whether health literacy tools measure the same attribute. Prospective health literacy studies should carefully consider what measures to use, depending on their objective.
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Affiliation(s)
- Laura M Curtis
- Center for Applied Health Research on Aging (CAHRA), Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA.
| | - Mary J Kwasny
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Lauren Opsasnick
- Center for Applied Health Research on Aging (CAHRA), Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA
| | - Rachel M O'Conor
- Center for Applied Health Research on Aging (CAHRA), Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA
| | - Julia Yoshino-Benavente
- Center for Applied Health Research on Aging (CAHRA), Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA
| | - Morgan Eifler
- Center for Applied Health Research on Aging (CAHRA), Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA
| | - Alex D Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mt. Sinai, 17 East 102nd Street, 7th Floor, New York, NY, 10029, USA
| | - Drew Altschul
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Room F2, Psychology Building, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Michael S Wolf
- Center for Applied Health Research on Aging (CAHRA), Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA
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Kwan Y, Choi S, Eom TR, Kim TH. Development of a Structured Interview to Explore Interpersonal Schema of Older Adults Living Alone Based on Autobiographical Memory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052316. [PMID: 33652880 PMCID: PMC7956442 DOI: 10.3390/ijerph18052316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 11/21/2022]
Abstract
With a growing public interest in the social health of older adults, studies focusing on social networks and interpersonal relationships of older adults are needed. The present study was conducted to develop a structured interview to evaluate the interpersonal schema based on Self-Defining Memory of older adults. First, the word cues that the older adults often report on interpersonal events were confirmed. Next, the indices and scoring rules were prepared, including Relationship frequency (RF), Conflict frequency (CF), Dominance mean (Dm), and Warmth mean (Wm). Healthy older adults living alone (mean age = 71.81, SD = 3.95) were interviewed. Finally, the correlation between each index and Short form of Korean Inventory of Interpersonal Problems Circumplex Scales (KIIP-SC) was analyzed for criterion validity. The inter-rater reliability was substantial (Kappa = 0.61~0.66). Based on the analysis of criterion validity, the indices of CF, Dm, and Wm indices showed an appropriate level of criterion validity. This study developed a structural interview based on a novel system of reporting autobiographical memory and established indices with appropriate validity to evaluate interpersonal relationships. The interview is expected to identify the characteristics of interpersonal relationships of the older adults and contribute to the establishment of the older adults’ community accordingly.
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Affiliation(s)
- Yunna Kwan
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju 26426, Korea;
- Department of Psychology, Duksung Women’s University, Seoul 01369, Korea;
| | - Sungwon Choi
- Department of Psychology, Duksung Women’s University, Seoul 01369, Korea;
| | - Tae Rim Eom
- Health Insurance Research Institute, National Health Insurance Service, Wonju 26464, Korea;
| | - Tae Hui Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju 26426, Korea;
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
- Correspondence: ; Tel.: +82-33-741-0534
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