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Deek H, Türkoğlu N, Massouh AR, Kavuran E. Psychometric evaluation of the Arabic version of the heart failure-specific health literacy scale in a socio-politically challenged setting. J Adv Nurs 2024. [PMID: 39180745 DOI: 10.1111/jan.16386] [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: 02/22/2024] [Revised: 07/01/2024] [Accepted: 07/31/2024] [Indexed: 08/26/2024]
Abstract
INTRODUCTION Low levels of formal education among Lebanese people with HF were reported. Additionally, limited discharge education is provided to this population. Therefore, it was necessary to evaluate the health literacy levels among this population following the translation of the heart failure-specific health literacy scale into Arabic and to evaluate its psychometric properties in the Lebanese setting. METHODS A cross-sectional design conducted on participants from the community with confirmed cases of heart failure. A research team was trained for data collection. Following securing participants' consents, baseline sociodemographic characteristics and the Arabic version of the heart failure-specific health literacy scale were administered. Data collection took place between June and December 2022. A pilot sample analysis was done to confirm homogeneity between the English and the Arabic versions. Exploratory and confirmatory factor analysis were performed to evaluate content and construct validity of the scale. Cronbach alpha was done to evaluate reliability. RESULTS The pilot analysis confirmed homogeneity of the items of the Arabic and English versions of the scale. The final sample of 343 participants was randomly divided to two parts for each of the exploratory factor analysis and confirmatory factor analysis. The mean age was 64 years with the majority being male participants. In terms of exploratory factor analysis, the three subscales of the literacy scale explained 60% of the variance. The best acceptable fit was found on 11 items of the scale after dropping the 10th item from the analysis. The Cronbach alpha of the scale was 0.68. CONCLUSION The Arabic version of the heart failure-specific health literacy scale was evaluated to be a valid and reliable tool. Further analysis should be done on the dropped item, and correlations should be done with significant variables such as self-care. REPORTING METHOD STROBE checklist. PATIENT/PUBLIC CONTRIBUTION No patient/public contribution. CONTRIBUTION TO THE WIDER GLOBAL COMMUNITY Participants with heart failure were shown to have low levels of literacy in Lebanon. Additionally, low literacy levels are also common among Lebanese older adults living in high income, Western Countries. Therefore, this valid and reliable scale can be used to evaluate health literacy among people with heart failure in Lebanon and among Lebanese and other Arabic-speaking older adults globally.
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Affiliation(s)
- Hiba Deek
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Nihan Türkoğlu
- Department of Public Health Nursing, Nursing Faculty, Ataturk University, Erzurum, Turkey
| | - Angela R Massouh
- Adult and Critical Care Nursing, Undergraduate Division, Research, Education, and Innovation, Cardiology and Heart Failure, Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Esin Kavuran
- Department of Nursing Fundamentals, Nursing Faculty, Ataturk University, Erzurum, Turkey
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Evripidou M, Efthymiou A, Velonaki V, Kalokairinou A, Papastavrou E. Ethics in Patients' Health Literacy: a scoping review and a critical discussion. Health Promot Int 2024; 39:daae100. [PMID: 39180350 DOI: 10.1093/heapro/daae100] [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: 08/26/2024] Open
Abstract
A growing body of literature has acknowledged that a high number of populations with low Health Literacy (HL) is related to poor health outcomes, inequities in healthcare and high economic costs. Those findings have formulated the research questions of this review: (i) what ethical issues arise within the context of patients' HL and (ii) What is the relationship between HL and quality of life? This review followed the guidelines of Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) and it was conducted in five databases: PubMed, CINAHL, MEDLINE, Scopus and Science Direct between June 2022 and December 2023. Out of the 3164 titles retrieved, 285 abstracts were eligible to proceed. Following a thorough examination of the full text of 61 papers, 45 sources were identified that met the inclusion criteria. The data analysis process was guided by the research questions, employing a thematic approach. Four themes were identified: the use of language and patient understanding, human rights, the principlism approach (justice, beneficence, non-maleficence and autonomy) and quality of life. The first theme mainly focused on the relation of HL with the notion of consent forms and national action plans. Human rights in relation to HL were discussed as a minor issue. The bioethical framework by Beauchamp and Childress (Principles of Biomedical Ethics, 6th edn. Oxford University Press, New York, NY, 2009), was addressed by several studies, with a particular focus on justice and the loss of autonomy. Quality of life indicated a positive correlation with HL by most of the authors, while few studies revealed a moderate correlation.
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Affiliation(s)
- Melina Evripidou
- Medical Department, Limassol General Hospital, Limassol, 38 Themistokli street, 3050, Cyprus
| | - Areti Efthymiou
- Hellenic Mediterranean University, Nursing Department, Athens, 157 72, Greece
| | - Venetia Velonaki
- National and Kapodistrian University of Athens, Nursing, Athens, 157 72, Greece
| | - Athina Kalokairinou
- National and Kapodistrian University of Athens, Nursing, Athens, 157 72, Greece
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Inanaga R, Toida T, Aita T, Kanakubo Y, Ukai M, Toishi T, Kawaji A, Matsunami M, Okada T, Munakata Y, Suzuki T, Kurita N. Trust, Multidimensional Health Literacy, and Medication Adherence among Patients Undergoing Long-Term Hemodialysis. Clin J Am Soc Nephrol 2024; 19:463-471. [PMID: 38127331 PMCID: PMC11020446 DOI: 10.2215/cjn.0000000000000392] [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: 09/09/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Basic health literacy and trust in physicians can influence medication adherence in patients receiving dialysis. However, how high-order health literacy is associated with medication adherence and how trust in physicians mediates this association remain unclear. We assessed the inter-relationships between health literacy, trust in physicians, and medication adherence. We investigated the mediating role of trust in physicians in the relationship between health literacy and medication adherence. METHODS This multicenter cross-sectional study included Japanese adults receiving outpatient hemodialysis at six dialysis centers. Multidimensional health literacy was measured using the 14-item Functional, Communicative, and Critical Health Literacy scale. Trust in physicians was measured using the five-item Wake Forest Physician Trust scale. Medication adherence was measured using the 12-item Adherence Starts with Knowledge scale. A series of general linear models were created to analyze the associations between health literacy and Adherence Starts Knowledge scores with and without trust in physicians. Mediation analysis was performed to determine whether trust in physicians mediated this association. RESULTS In total, 455 patients were analyzed. Higher functional and communicative health literacies were associated with less adherence difficulties (per 1-point higher: -1.79 [95% confidence interval (CI): -2.59 to -0.99] and -2.21 [95% CI: -3.45 to -0.96], respectively), whereas higher critical health literacy was associated with greater adherence difficulties (per 1-point higher: 1.69 [95% CI: 0.44 to 2.94]). After controlling for trust in physicians, the magnitude of the association between health literacies and medication adherence decreased. Trust in physicians partially mediated the association between functional or communicative health literacy and medication adherence (especially beliefs) and completely mediated the association between critical health literacy and medication adherence (especially behaviors). CONCLUSIONS Functional and communicative health literacies were positively associated with medication adherence, whereas critical health literacy was negatively associated with it. Each association was mediated by trust in physicians.
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Affiliation(s)
- Ryohei Inanaga
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Nephrology, Shin-Yurigaoka General Hospital, Kanagawa, Japan
| | - Tatsunori Toida
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- School of Pharmaceutical Sciences, Kyushu University of Health and Welfare, Miyazaki, Japan
| | - Tetsuro Aita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of General Internal Medicine, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yusuke Kanakubo
- Tessyoukai Kameda Family Clinic Tateyama, Chiba, Japan
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
| | - Mamiko Ukai
- Tessyoukai Kameda Family Clinic Tateyama, Chiba, Japan
| | - Takumi Toishi
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Atsuro Kawaji
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Masatoshi Matsunami
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Tadao Okada
- Tessyoukai Kameda Family Clinic Tateyama, Chiba, Japan
| | - Yu Munakata
- Chikuseikai Munakata Clinic, Tokyo, Japan
- Munakata Clinic, Chiba, Japan
| | - Tomo Suzuki
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan
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Koole D, Lans A, Lang JH, de Groot TM, Borkhetaria P, Verlaan JJ, Schwab JH, Tobert DG. Limited health literacy results in lower health-related quality of life in spine patients. Spine J 2024; 24:263-272. [PMID: 37774984 DOI: 10.1016/j.spinee.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND CONTEXT Spinal conditions impact health-related quality of life (HRQoL). Patient education and counseling improve HRQoL, yet the effects may be limited for patients with inadequate health literacy (HL). Despite the established relationship between HRQoL and HL in other fields, research in the orthopedic spine population is lacking. PURPOSE To investigate if limited HL results in lower HRQoL and to evaluate factors are associated with HRQoL in patients seen at an outpatient orthopedic spine center. STUDY DESIGN/SETTING Prospective single-center cross-sectional study. PATIENT SAMPLE Patients 18 years of age or older seen at a tertiary urban academic hospital- based multi-surgeon outpatient spine center. OUTCOME MEASURES EQ-5D-5L health-related quality of life (HRQoL) questionnaire, and the Newest Vital Sign (NVS) HL assessment tool. METHODS Between October 2022 and February 2023, consecutive English-speaking patients over the age of 18 and new to the outpatient spine clinic were approached for participation in this cross-sectional survey study. Patients completed a sociodemographic survey, EQ-5D-5L HRQoL questionnaire, and Newest Vital Sign (NVS) HL assessment tool. The EQ-5D-5L yields two continuous outcomes: an index score ranging from below 0 to 1 and a visual analog scale (EQ-VAS) score ranging from 0 to 100. The NVS scores were divided into limited (0-3) and adequate (4-6) HL. Multivariate linear regression with purposeful selection of variables was performed to identify independent factors associated with HRQoL. RESULTS Out of 397 eligible patients, 348 (88%) agreed to participate and were included in statistical analysis. Limited HL was independently associated with lower EQ-5D-5L index scores (B=1.07 [95% CI 1.00-1.15], p=.049. Other factors associated with lower EQ-5D-5L index scores were being obese (BMI≥30), having housing concerns, and being an active smoker. Factors associated with lower EQ-VAS scores were being underweight (BMI<18.5), obese, having housing concerns, and higher updated Charlson comorbidity index (uCCI) scores. Being married was associated with higher EQ-VAS scores. CONCLUSIONS Limited HL is associated with lower EQ-5D-5L index scores in spine patients, indicating lower HRQoL. To effectively apply HL-related interventions in this population, a better understanding of the complex interactions between patient characteristics, social determinants of health, and HRQoL outcomes is required. Further research should focus on interventions to improve HRQoL in patients with limited HL and how to accurately identify these patients. LEVEL OF EVIDENCE Level II prognostic.
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Affiliation(s)
- Dylan Koole
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA; Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden University, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Amanda Lans
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA; Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands.
| | - Julian H Lang
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
| | - Tom M de Groot
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
| | - Pranati Borkhetaria
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
| | - Jorrit-Jan Verlaan
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
| | - Daniel G Tobert
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
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Holmen H, Flølo T, Tørris C, Løyland B, Almendingen K, Bjørnnes AK, Albertini Früh E, Grov EK, Helseth S, Kvarme LG, Malambo R, Misvær N, Rasalingam A, Riiser K, Sandbekken IH, Schippert AC, Sparboe-Nilsen B, Sundar TKB, Sæterstrand T, Utne I, Valla L, Winger A, Torbjørnsen A. Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:36. [PMID: 38248501 PMCID: PMC10815593 DOI: 10.3390/ijerph21010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Social inequalities in health, health literacy, and quality of life serve as distinct public health indicators, but it remains unclear how and to what extent they are applied and combined in the literature. Thus, the characteristics of the research have yet to be established, and we aim to identify and describe the characteristics of research that intersects social inequality in health, health literacy, and quality of life. We conducted a scoping review with systematic searches in ten databases. Studies applying any design in any population were eligible if social inequality in health, health literacy, and quality of life were combined. Citations were independently screened using Covidence. The search yielded 4111 citations, with 73 eligible reports. The reviewed research was mostly quantitative and aimed at patient populations in a community setting, with a scarcity of reports specifically defining and assessing social inequality in health, health literacy, and quality of life, and with only 2/73 citations providing a definition for all three. The published research combining social inequality in health, health literacy, and quality of life is heterogeneous regarding research designs, populations, contexts, and geography, where social inequality appears as a contextualizing variable.
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Intervention Centre, Oslo University Hospital, 4950 Oslo, Norway
| | - Tone Flølo
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Department of Surgery, Voss Hospital, Haukeland University Hospital, 5704 Voss, Norway
| | - Christine Tørris
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Kari Almendingen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Rosah Malambo
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Anurajee Rasalingam
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Kirsti Riiser
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Ida Hellum Sandbekken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Ana Carla Schippert
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Bente Sparboe-Nilsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden
| | - Turid Kristin Bigum Sundar
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Torill Sæterstrand
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Lisbeth Valla
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), 0484 Oslo, Norway
| | - Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
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6
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Dijkman EM, ter Brake WWM, Drossaert CHC, Doggen CJM. Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review. Healthcare (Basel) 2023; 12:11. [PMID: 38200917 PMCID: PMC10778720 DOI: 10.3390/healthcare12010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Assessment of (digital) health literacy in the hospital can raise staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools should ideally address multiple domains of health literacy, fit to the complex hospital context and have a short administration time, to enable routine assessment. This review aims to create an overview of tools for measuring (digital) health literacy in hospitals. A search in Scopus, PubMed, WoS and CINAHL, following PRISMA guidelines, generated 7252 hits; 251 studies were included in which 44 assessment tools were used. Most tools (57%) were self-reported and 27% reported an administration time of <5 min. Almost all tools addressed the domain 'understanding' (98%), followed by 'access' (52%), 'apply' (50%), 'appraise' (32%), 'numeracy' (18%), and 'digital' (18%). Only four tools were frequently used: the Newest Vital Sign (NVS), the Short Test of Functional Health Literacy for Adults ((S)TOFHLA), the Brief Health Literacy Screener (BHLS), and the Health Literacy Questionnaire (HLQ). While the NVS and BHLS have a low administration time, they cover only two domains. HLQ covers the most domains: access, understanding, appraise, and apply. None of these four most frequently used tools measured digital skills. This review can guide health professionals in choosing an instrument that is feasible in their daily practice, and measures the required domains.
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Affiliation(s)
- Eline M. Dijkman
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Department of Surgery, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Wouter W. M. ter Brake
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
| | | | - Carine J. M. Doggen
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
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Liu Y, Guo Y, Yan X, Ding R, Tan H, Wang Y, Wang X, Wang L. Assessment of health literacy in patients with polycystic ovary syndrome and its relationship with health behaviours: a cross-sectional study. BMJ Open 2023; 13:e071051. [PMID: 38000817 PMCID: PMC10680007 DOI: 10.1136/bmjopen-2022-071051] [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: 12/14/2022] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE Healthy behaviours are important for people with polycystic ovary syndrome (PCOS). However, adopting and maintaining lifestyle changes involves a complex set of behavioural changes, which most patients fail to adhere to. The current research on health literacy, which includes individual and social skills needed in health self-management, in patients with PCOS is limited. Therefore, this study aimed to explore health literacy, health behaviours and the relationship between the two to expand research on PCOS management. DESIGN Cross-sectional study. SETTING A gynaecological outpatient clinic. PARTICIPANTS A total of 286 patients with PCOS (≥18 years, diagnosed via Rotterdam criteria, able to self-report and give informed consent) were recruited from March to June 2022. OUTCOME MEASURES Health literacy and health behaviours in patients with PCOS were assessed using the Health Literacy Management Scale and the Health Promoting Lifestyle Profile (Chinese version). Multiple logistic regression was used to analyse the factors influencing health literacy, and linear regression to assess the relationship between health literacy and health behaviours, with an F-significance test; p<0.05 was considered statistically significant. RESULTS Overall, most patients with PCOS had insufficient health literacy (55.9%). The influencing factors of health literacy in patients with PCOS were age (β=0.154, p<0.05), Body Mass Index (β=-0.140, p<0.05), income (β=1.228, p<0.05), duration of illness (β=0.110, p<0.05) and educational level (β=1.552, p<0.05). Moreover, 40.6% of patients with poor health behaviours, and 31.8% with moderate health behaviours, needed to improve their health behaviours. Health literacy was positively correlated with health behaviours in patients with PCOS (r=0.473, p<0.05). CONCLUSION The positive correlation between health literacy and health behaviour in patients with PCOS indicates that promoting health literacy in future treatment and management of PCOS may be beneficial.
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Affiliation(s)
- Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
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Toapanta N, Salas-Gama K, Pantoja PE, Soler MJ. The role of low health literacy in shared treatment decision-making in patients with kidney failure. Clin Kidney J 2023; 16:i4-i11. [PMID: 37711638 PMCID: PMC10497376 DOI: 10.1093/ckj/sfad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Indexed: 09/16/2023] Open
Abstract
The classic paternalist medicine in nephrology has been modified to a shared decision-making model that clearly offers a benefit in patients with kidney disease. One of the cornerstones of shared treatment decision in patients with kidney failure is the understanding of kidney disease. As kidney disease is silent until advanced stages and is also an entity with a complex pathophysiology with little knowledge in the general population, its presence and understanding are difficult for most people. Health literacy (HL) plays a crucial role in the care of patients with kidney disease and the shared treatment decision. Limited HL has been associated with inefficient use of health services, non-compliance of medications, worse quality of life and increased mortality. In this review, we will address the importance of low HL in nephrology in terms of diagnosis, measurement, its effect on shared decision-making and how to increase it in people with kidney disease.
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Affiliation(s)
- Néstor Toapanta
- Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Karla Salas-Gama
- Quality, Process and Innovation Direction, Vall d'Hebron University Hospital, Barcelona, Spain
- Health Services Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital University, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- PhD candidate at the Methodology of Biomedical Research and Public Health program, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Percy Efrain Pantoja
- Quality, Process and Innovation Direction, Vall d'Hebron University Hospital, Barcelona, Spain
- Health Services Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital University, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - María José Soler
- Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain
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Dinh TTH, Bonner A. Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases. BMC Health Serv Res 2023; 23:923. [PMID: 37649013 PMCID: PMC10466814 DOI: 10.1186/s12913-023-09907-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Self-management in chronic diseases is essential to slowing disease progression and preventing complications. However, empirical research on the associations of critical factors, such as health literacy, social support, and self-efficacy with self-management in the context of multiple chronic diseases is scarce. This study aimed to investigate these associations and provides insights for healthcare providers to develop effective educational strategies for people with multiple chronic diseases. METHODS Using a cross-sectional survey design, adults (n = 600) diagnosed with at least two chronic diseases were conveniently recruited. To measure health literacy, social support, self-efficacy, and chronic disease self-management behaviours, the Health Literacy Questionnaire (HLQ), Medical Outcome Study - Social Support Survey, Self-efficacy in Managing Chronic Disease, and Self-management in Chronic Diseases instruments were utilized respectively. Comorbidity status was assessed using Age-adjusted Charlson Comorbidity Index (ACCI). A generalised linear regression model was used with a backward technique to identify variables associated with self-management. RESULTS Participants' mean age was 61 years (SD = 15.3), 46% were female, and most had up to 12 years of education (82.3%). Mean scores for HLQ domains 1-5 varied from 2.61 to 3.24 (possible score 1-4); domains 6-9 from 3.29 to 3.65 (possible score 1-5). The mean scores were 52.7 (SD = 10.4, possible score 0-95), 5.46 (SD = 1.9, possible score 0-10) and 82.1 (SD = 12.4, possible score 30-120) for social support, self-efficacy, and self-management, respectively. Mean ACCI was 6.7 (SD = 2.1). Eight factors (age > 65 years, being female, 4 health literacy domains, greater social support, and higher self-efficacy levels) were significantly associated with greater self-management behaviours while comorbidity status was not. The factors that showed the strongest associations with self-management were critical health literacy domains: appraisal of health information, social support for health, and healthcare provider support. CONCLUSIONS Developing critical health literacy abilities is a more effective way to enhance self-management behaviours than relying solely on self-confidence or social support, especially for people with multiple chronic diseases. By facilitating communication and patient education, healthcare providers can help patients improve their critical health literacy, which in turn can enhance their self-management behaviours.
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Affiliation(s)
- Thi Thuy Ha Dinh
- School of Nursing, University of Tasmania, Launceston, TAS, Australia.
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia.
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia
- Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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10
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Jung MJ, Roh YS. Healthcare providers' support and outcomes in hemodialysis patients: The mediating effect of health literacy. PATIENT EDUCATION AND COUNSELING 2023; 111:107714. [PMID: 36948072 DOI: 10.1016/j.pec.2023.107714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/27/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study aimed to identify the mediating effect of health literacy (HL) on the relationship between healthcare providers' support and outcomes in patients on hemodialysis. METHODS A convenience sample of 149 hemodialysis patients participated in a cross-sectional survey. Mediation analysis with the percentile bootstrap method was used to identify the mediating effect of HL on the relationship between healthcare providers' support and patient outcomes. RESULTS Healthcare providers' support and HL were significant predictors of patient outcomes. HL mediated the relationship between healthcare providers' support and patient outcomes. CONCLUSION The HL of hemodialysis patients is essential in the relationship between healthcare providers' support and patient outcomes. Patient educators should implement a multifaceted HL-tailored intervention strategy to improve the HL of hemodialysis patients. PRACTICE IMPLICATIONS Hemodialysis patients' HL is a crucial mediating factor in the relationship between healthcare providers' support and patient outcomes. A multifaceted HL-tailored intervention strategy is needed to improve HL and, thus, health outcomes among hemodialysis patients.
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Affiliation(s)
- Myung Jin Jung
- Red Cross College of Nursing, Chung-Ang University, Seoul, the Republic of Korea
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, Seoul, the Republic of Korea.
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11
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Billany RE, Thopte A, Adenwalla SF, March DS, Burton JO, Graham-Brown MPM. Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: a systematic review. J Nephrol 2023; 36:1267-1281. [PMID: 36645651 PMCID: PMC10333418 DOI: 10.1007/s40620-022-01537-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/21/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Low health literacy is widely reported in people with chronic kidney disease (CKD) and has been associated with reduced disease self-management, poor health outcomes, increased mortality and poorer quality of life. However, these associations are still not well understood. METHODS Electronic-based systematic searches were performed to identify studies examining associations between health literacy and self-management behaviours and/or health outcomes in patients with CKD. A tabular and narrative synthesis of the data was performed. Meta-analysis was not appropriate due to the heterogeneity of study designs and methods. RESULTS Searches identified 48 studies that met the inclusion criteria. A total of 41 published articles, six conference abstracts, and one thesis were included. Of the 48 studies, 11 were cohort and 37 were cross-sectional. In total there were 25,671 patients; 16,952 from cohort studies. Median study sample size was 159 (IQR 92-275). Study quality was high (5), moderate (24) and poor (19). Thirteen measures of health literacy were used. Despite the limitations of the available evidence, there appear to be consistent relationships between higher health literacy and favourable self-management behaviours for patients with CKD. Definitive relationships between health literacy and patient outcomes are far less clear and remain incompletely understood. DISCUSSION Conclusive evidence describing a causal link between health literacy and patient outcomes remains limited, but for many outcomes, a consistent association is described. In addition to associations with mortality, hospitalisation and clinical events, there were consistent associations between health literacy and favourable self-management behaviours which could support the development of patient education aimed at improving health literacy.
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Affiliation(s)
- Roseanne E Billany
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - Ashnee Thopte
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Sherna F Adenwalla
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel S March
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - James O Burton
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Matthew P M Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
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12
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Kelepouris E, St Peter W, Neumiller JJ, Wright EE. Optimizing Multidisciplinary Care of Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus. Diabetes Ther 2023:10.1007/s13300-023-01416-2. [PMID: 37209236 DOI: 10.1007/s13300-023-01416-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023] Open
Abstract
Diabetes is the leading cause of chronic kidney disease (CKD), a condition associated with significant morbidity and mortality. As these patients have a high risk of developing cardiovascular disease and end-stage kidney disease, there is a need for early detection and early initiation of appropriate therapeutic interventions that slow disease progression and prevent adverse outcomes. Due to the complex nature of diabetes and CKD management, a holistic, patient-centered, collaborative care approach delivered by a coordinated multidisciplinary team (ideally including a clinical pharmacist as part of a comprehensive medication management program) is needed. In this review, we discuss the barriers to effective care, the current multidisciplinary approach used for CKD prevention and treatment, and the potential ways that the multidisciplinary management of CKD associated with type 2 diabetes mellitus can be refined to improve patient outcomes.
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Affiliation(s)
- Ellie Kelepouris
- Division of Renal Electrolyte and Hypertension, University of Pennsylvania, Philadelphia, PA, USA.
| | - Wendy St Peter
- University of Minnesota, Minneapolis, MN, USA
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
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13
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Association between health literacy and medication adherence in chronic diseases: a recent systematic review. Int J Clin Pharm 2023; 45:38-51. [PMID: 36369411 DOI: 10.1007/s11096-022-01470-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Poor medication adherence is a serious barrier to successful chronic disease management. Previous reviews reported that low health literacy could be associated with medication non-adherence but conclusions were uncertain. AIM The aim of this systematic review was to clarify the relationship between health literacy and medication adherence in adults with chronic diseases. A secondary objective was to identify the factors that influence medication adherence. METHOD Publications analyzing the relationship between health literacy and adherence in adults with chronic diseases were identified through 6 databases between 2015 and 2020. A quality assessment was conducted in order to improve the interpretation of the relationship between health literacy and medication adherence. A narrative synthesis was then performed to describe the relationship between health literacy and medication adherence. The factors influencing medication adherence were then analyzed as a secondary outcome. RESULTS Among the 27 studies, 17 and 10 were considered to be of good and medium methodological quality, respectively. Concerning the relationship between health literacy and adherence, 14 reported a positive relationship, 1 study suggested a negative relationship, 3 found mixed results, and 9 reported not finding a relationship. Patient-related factors such as medication beliefs, self-efficacy, or medication knowledge, as well as demographic factors such as ethnic minority and incomes influence medication adherence. CONCLUSION The present review confirms an unclear relationship between health literacy and medication adherence. Although health literacy plays a substantial role in medication adherence, other factors must be taken into account when addressing non-adherence.
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Passi R, Kaur M, Lakshmi PVM, Cheng C, Hawkins M, Osborne RH. Health literacy strengths and challenges among residents of a resource-poor village in rural India: Epidemiological and cluster analyses. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001595. [PMID: 36963029 PMCID: PMC10022012 DOI: 10.1371/journal.pgph.0001595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/28/2022] [Indexed: 02/19/2023]
Abstract
Cluster analysis can complement and extend the information learned through epidemiological analysis. The aim of this study was to determine the relative merits of these two data analysis methods for describing the multidimensional health literacy strengths and challenges in a resource poor rural community in northern India. A cross-sectional survey (N = 510) using the Health Literacy Questionnaire (HLQ) was undertaken. Descriptive epidemiology included mean scores and effect sizes among sociodemographic characteristics. Cluster analysis was based on the nine HLQ scales to determine different health literacy profiles within the population. Participants reported highest mean scores for Scale 4. Social support for health (2.88) and Scale 6. Ability to actively engage with healthcare professionals (3.66). Lower scores were reported for Scale 3. Actively managing my health (1.81) and Scale 8. Ability to find good health information (2.65). Younger people (<35 years) had much higher scores than older people (ES >1.0) for social support. Eight clusters were identified. In Cluster A, educated younger men (mean age 27 years) reported higher scores on all scales except one (Scale 1. Feeling understood and supported by a healthcare professional) and were the cluster with the highest number (43%) of new hypertension diagnoses. In contrast, Cluster H also had young participants (mean age 30 years) but with low education (72% illiterate) who scored lowest across all nine scales. While epidemiological analysis provided overall health literacy scores and associations between health literacy and other characteristics, cluster analysis provided nuanced health literacy profiles with the potential to inform development of solutions tailored to the needs of specific population subgroups.
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Affiliation(s)
- Reetu Passi
- Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P V M Lakshmi
- Department of Community Medicine and School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Christina Cheng
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Melanie Hawkins
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Richard H Osborne
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
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15
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Improving health literacy in disease prevention in glomerulonephritis. Int Urol Nephrol 2023; 55:221-223. [PMID: 35739372 DOI: 10.1007/s11255-022-03263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/02/2022] [Indexed: 01/05/2023]
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Gao Y, Yan K, Yan X, Xi N, Gao J, Ren H. Correlation between health literacy and health‐related quality of life in patients with diabetic peripheral neuropathy: The mediating role of self‐management. Nurs Open 2022; 10:3164-3177. [PMID: 36572957 PMCID: PMC10077377 DOI: 10.1002/nop2.1566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022] Open
Abstract
AIM The aims of the study were to analyse the current situation of health literacy (HL), self-management and health-related quality of life (HRQOL) in patients with diabetic peripheral neuropathy (DPN), to explore the correlation between the three and to verify the mediating role of self-management in HL and HRQOL. DESIGN A cross-sectional survey. METHODS The convenience sampling method was used to select 401 DPN patients attending the First Hospital of Jinzhou Medical University in Liaoning Province, China, from December 2020 to December 2021 as the study population. The research instrument included socio-demographic characteristics questionnaire, Health Literacy Management Scale (HeLMS), Summary of Diabetes Self-Care Activities (SDSCA) and Short-Form 12-item Health Survey (SF-12). SPSS 25.0 was applied to the data for descriptive analysis, Pearson correlation analysis and stratified multiple regression analysis. Mediating effects were tested using SPSS PROCESS macro 4.0 software. RESULTS HL and self-management of DPN patients correlated positively with HRQOL. The mediation role of self-management was significant in the relationship between HL and physical and mental HRQOL (physical component summary: β = 0.26, P < 0.01; mental component summary: β = 0.18, P < 0.01), with mediating effects accounting for 35.62% and 34.62% of the total effect. CONCLUSIONS There was a positive correlation between HL, self-management and HRQOL in patients with DPN. Self-management plays a partially mediating role in the relationship between HL and HRQOL in DPN patients. It means that HRQOL in this population can be improved by increasing HL and thus self-management in DPN patients. PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Yuqi Gao
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Keshu Yan
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Xiangru Yan
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Na Xi
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Jia Gao
- Tie Coal General Hospital of Liaoning Health Industry Group Tieling City Liaoning Province China
| | - Hengjie Ren
- First Affiliated Hospital of Jinzhou Medical University Jinzhou City Liaoning Province China
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Rague JT, Kim S, Hirsch J, Meyer T, Rosoklija I, Larson JE, Swaroop VT, Bowman R, Bowen DK, Cheng EY, Gordon EJ, Holmbeck G, Chu DI, Isakova T, Yerkes EB, Chu DI. The Association of Health Literacy with Health-Related Quality of Life in Youth and Young Adults with Spina Bifida: A Cross-Sectional Study. J Pediatr 2022; 251:156-163.e2. [PMID: 35970239 PMCID: PMC9843738 DOI: 10.1016/j.jpeds.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The objective of the study was to determine if health literacy is associated with health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with spina bifida. STUDY DESIGN Between June 2019 and March 2020, the Patient-Reported Outcome Measurement Information System Pediatric Global Health-7 (PGH-7), a measure of HRQOL, and the Brief Health Literacy Screening Tool (BRIEF) were administered to patients ≥12 years old with a diagnosis of spina bifida seen in our multidisciplinary spina bifida center. Questionnaires were completed at scheduled clinic visits. The primary outcome was the PGH-7 normalized T-score. The primary exposure was the BRIEF score. Demographic and clinical characteristics were obtained from the medical record. Nested, multivariable linear regression models assessed the association between health literacy and the PGH-7 score. RESULTS Of 232 eligible patients who presented to clinic, 226 (97.4%) met inclusion criteria for this study. The median age was 17.0 years (range: 12-31). Most individuals were female (54.0%) and had myelomeningocele (61.5%). Inadequate, marginal, and adequate health literacy levels were reported by 35.0%, 28.3%, and 36.7% of individuals. In univariable analysis, higher health literacy levels were associated with higher PGH-7 scores. In nested, sequentially adjusted multivariable linear regression models, a higher health literacy level was associated with a stepwise increase in the PGH-7 score. In the fully adjusted model, adequate health literacy and marginal health literacy, compared with inadequate health literacy, were associated with increases in a PGH-7 score of 3.3 (95% CI: 0.2-6.3) and 1.1 (95% CI: -2.0 to 4.2), respectively. CONCLUSIONS Health literacy was associated with HRQOL after adjusting for demographic and clinical factors. Strategies incorporating health literacy are needed to improve HRQOL in AYAs with spina bifida.
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Affiliation(s)
- James T Rague
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Soojin Kim
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Josephine Hirsch
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Theresa Meyer
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Ilina Rosoklija
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Jill E Larson
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Vineeta T Swaroop
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Robin Bowman
- Division of Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Diana K Bowen
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Earl Y Cheng
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Elisa J Gordon
- Department of Surgery-Division of Transplantation, Center of Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Grayson Holmbeck
- Department of Psychology, Loyola University of Chicago, Chicago, IL
| | - Daniel I Chu
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Tamara Isakova
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, and Division of Nephrology and Hypertension, Feinberg School of Medicine at Northwestern University, Chicago, IL
| | - Elizabeth B Yerkes
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - David I Chu
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Low Health Literacy Is Associated with Poorer Physical and Mental Health-Related Quality of Life in Dialysed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13265. [PMID: 36293839 PMCID: PMC9602746 DOI: 10.3390/ijerph192013265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Health-related quality of life (HRQoL) is an important health indicator in chronic diseases like kidney diseases. Health literacy (HL) may strongly affect HRQoL, but evidence is scarce. Therefore, we assessed the associations of HL with HRQoL in dialysed patients. We performed a cross-sectional study in 20 dialysis clinics across Slovakia (n = 542 patients, mean age = 63.6 years, males = 60.7%). We assessed the association of categorised HL (low, moderate, high) with the SF36 physical component score (PCS) and mental component score (MCS) using generalised linear models adjusted for age, gender, education, and comorbidity (Charlson Comorbidity Index, CCI). We found significant associations of HL with PCS and MCS in dialysed patients, adjusted for age, gender, education, and CCI. Low-HL patients had a lower PCS (B = -3.27, 95%-confidence interval, CI: -5.76/-0.79) and MCS (B = -6.05, 95%-CI: -8.82/-3.29) than high-HL patients. Moderate-HL patients had a lower MCS (B = -4.26, 95%-CI: -6.83/-1.69) than high-HL patients. HL is associated with physical and mental HRQoL; this indicates that dialysed patients with lower HL deserve specific attention and tailored care to have their HRQoL increased.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University Bratislava, Mlynské luhy 4, 821 05 Bratislava, Slovakia
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
- II. Internal Clinic Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia
| | - Andrea F. de Winter
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Uzdil N, Kılıç Z. Health literacy and attitudes to holistic, complementary and alternative medicine in peritoneal dialysis patients: A descriptive study. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Demir N, Koz S, Ugurlu CT. Health literacy in chronic kidney disease patients: association with self-reported presence of acquaintance with kidney disease, disease burden and frequent contact with health care provider. Int Urol Nephrol 2022; 54:2295-2304. [PMID: 35122168 DOI: 10.1007/s11255-022-03124-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Limited data suggest that health literacy (HL) is associated with kidney functions and clinical outcomes in patients with non-dialysis chronic kidney disease (CKD). We aimed to identify factors associated with the level of HL in a CKD population that has not been studied previously. METHODS Patients with stage I-V (non-dialysis) CKD according to the Kidney Disease Outcomes Quality Initiative classification were enrolled in the study from two tertiary healthcare centers. Data were collected cross-sectionally using the European Health Literacy Survey (HLS-EU). RESULTS Data of 208 participants were analyzed. HLS-EU scores had the highest correlations with age (r = - 0.494, p = 0.0001) and education (r = 0.476, p = 0.0001). Estimated glomerular filtration rate (e-GFR) was significantly correlated with HLS-EU score (r = 0.186, p = 0.01). Presence of a self-reported acquaintance with any kind of kidney disease was associated with higher HL. On the other hand, participants with multiple comorbidities, and therefore with more frequent contact with the health system, had lower HL than those without such frequent contact. Similarly, those with a high disease burden had lower HL than those without. HLS-EU scores were also significantly associated with gender, marital status, occupational status, self-perception of health, restriction of daily activities, participation in social activities, place of residence, blood pressure, body mass index, and serum parathyroid hormone and albumin levels. CONCLUSION Low HL is prevalent among CKD patients and is associated with e-GFR. Presence of an acquaintance with any kind of kidney disease is positively associated with HL. Presence of multiple comorbidities might be a limiting factor for the improvement of HL, which might also be expected to improve as a result of frequent contact with healthcare providers.
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Affiliation(s)
- Nevgul Demir
- Department of Family Medicine, Ministry of the Health Kecioren Research and Education Hospital, Kecioren, Ankara, Turkey.
| | - Suleyman Koz
- Department of Nephrology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Evaluating the impact of the Understanding Multiple Sclerosis online course on participant MS knowledge, health literacy, resilience, self-efficacy, quality of life, and MS symptom severity. Mult Scler Relat Disord 2022; 60:103717. [DOI: 10.1016/j.msard.2022.103717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 11/19/2022]
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23
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Health Literacy and Change in Health-Related Quality of Life in Dialysed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020620. [PMID: 35055440 PMCID: PMC8776225 DOI: 10.3390/ijerph19020620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 12/10/2022]
Abstract
Health-related quality of life (HRQoL) is likely to deteriorate with the progression of chronic kidney disease (CKD). This change may be worsened by low health literacy (HL). We performed a longitudinal study at over 20 dialysis clinics in Slovakia (n = 413; mean age = 64.8 years; males = 58.4%). We assessed the association of three HL groups with a change in HRQoL over two years using binary logistic regression adjusted for type of vascular access, dialysis effectiveness, comorbidity, age and gender. We found that patients with low HL had poorer HRQoL at baseline in comparison to high-HL patients. We did not find significant associations of lower HL with the deterioration of mental or physical HRQoL after two years. In the adjusted model, patients with lower HL were not more likely to have deteriorated physical (low-HL patients: odds ratio/95% confidence interval: 0.99/0.53–1.84; moderate-HL patients: 0.97/0.55–1.73) or mental HRQoL (low-HL patients: 1.00/0.53–1.87; moderate-HL patients: 0.95/0.53–1.70) in comparison to high-HL patients. The HRQoL of lower-HL patients is worse at baseline but develops similarly to that of high-HL patients during dialysis treatment. Their relative HRQoL, thus, does not worsen further, but it does not improve either. Tailoring care to their needs may help to decrease the burden of low HL in dialysed patients.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Correspondence: ; Tel.: +421-055-234-3390
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 11 Kosice, Slovakia;
- II. Internal Clinic, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 11 Kosice, Slovakia;
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenná 5, 040 01 Kosice, Slovakia;
| | - Andrea F. de Winter
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
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Murali KM, Mullan J, Roodenrys S, Cheikh Hassan HI, Lonergan MA. Exploring the Agreement Between Self-Reported Medication Adherence and Pharmacy Refill-Based Measures in Patients with Kidney Disease. Patient Prefer Adherence 2022; 16:3465-3477. [PMID: 36605331 PMCID: PMC9809402 DOI: 10.2147/ppa.s388060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
AIM To assess the quantitative and categorical agreement between two methods of measuring medication adherence: pharmacy refill-based medication possession rates and self-reported medication adherence scale. BACKGROUND Categorisation of adherence metrics using empirical cut-off scores can lead to misclassification, which can be overcome by expressing adherence as a continuous variable. Pharmacy refill-based adherence can be reported as actual rates, but the validity of expressing self-reported medication adherence scores as a continuous variable to reflect adherence is unknown and its quantitative agreement with refill-based adherence rates untested. METHODS Patients with kidney disease, including dialysis patients, from Illawarra Shoalhaven region of New South Wales, Australia were recruited between January 2015 and June 2016 to this cross-sectional study. Medication adherence was assessed using the self-reported Morisky Medication Adherence Scale (MMAS) and two pharmacy refill-based measures, Medication Possession Ratio (MPR) and Proportion of Days Covered (PDC) for antihypertensives and cardiometabolic drugs. Categorical and quantitative agreement between self-reported adherence and pharmacy refill-based adherence were assessed using tests of trend, analysis of covariance (ANCOVA), Cohen's kappa and Bland-Altman analysis. RESULTS We recruited 113 patients. There was a significant declining trend of MPR (p < 0.001) and PDC (<0.001 for antihypertensives, p = 0.004 for cardiometabolic) scores among categories with worsening MMAS adherence. Adjusted ANCOVA showed significant association between self-report and pharmacy refill-based adherence (p < 0.001). Weighted Cohen's kappa statistics showed fair agreement between the self-report and pharmacy refill-based categories. Bland-Altman's analysis showed less than 5% of cases were outside the limits of agreement (-0.36 to 0.27) and the bias for MMAS was negative (-0.05 to -0.09), indicating MMAS did not overestimate adherence. CONCLUSION There is modest agreement between pharmacy refill-based measures and self-report MMAS measures when assessed categorically or quantitatively. Assessing adherence as a continuous variable should be considered to overcome the challenges associated with categorization of adherence based on arbitrary thresholds.
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Affiliation(s)
- Karumathil M Murali
- Department of Nephrology, Wollongong Hospital, Wollongong, NSW, Australia
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- Correspondence: Karumathil M Murali, Department of Nephrology, Wollongong Hospital, Wollongong, NSW, 2500, Australia, Tel +61 2 42952800, Fax +61 2 4295 2916, Email
| | - Judy Mullan
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Steven Roodenrys
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Hicham I Cheikh Hassan
- Department of Nephrology, Wollongong Hospital, Wollongong, NSW, Australia
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Maureen A Lonergan
- Department of Nephrology, Wollongong Hospital, Wollongong, NSW, Australia
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population. Int J Public Health 2021; 66:585801. [PMID: 34744558 PMCID: PMC8565259 DOI: 10.3389/ijph.2021.585801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/05/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL. Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test. Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001. Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.
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Affiliation(s)
- Ivana Skoumalova
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Andrea Madarasova Geckova
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic.,FMC-Dialysis Services Slovakia, Kosice, Slovakia
| | | | - Peter Kolarcik
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Andrea F de Winter
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Jitse P van Dijk
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Sijmen A Reijneveld
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
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Dinh HTT, Nguyen NT, Bonner A. Healthcare systems and professionals are key to improving health literacy in chronic kidney disease. J Ren Care 2021; 48:4-13. [PMID: 34291578 DOI: 10.1111/jorc.12395] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Comorbidity is prevalent in people with chronic kidney disease (CKD) and this status burdens one's health literacy skills to understand about their health, make decisions, and to adhere with treatment. OBJECTIVES To examine health literacy in people with CKD and comorbidities. DESIGN A cross-sectional study was conducted between November 2018 and April 2019. PARTICIPANTS Convenience sampling recruited 367 adults with CKD and at least one comorbid disease. MEASUREMENTS Data were collected using the 9-domain Health Literacy Questionnaire. Demographic and clinical characteristics were also collected. Charlson Comorbidity Index calculated comorbidity status. Parametric tests were used to distinguish health literacy between various groups. RESULTS Participants' average age was 58.8 years, 54.7% had CKD Grade 5, 72.5% had a severe comorbidity index (≥6), and nearly 40% were on haemodialysis. Lower health literacy proportions were found in domains related to Healthcare providers' support (58.3%) and Appraisal of health information (38.4%). Lower levels of education, income, or living in rural areas were each significantly more likely to contribute to lower health literacy levels (range 4-7 domains). Greater comorbidity severity was also significantly associated with lower health literacy in two domains. CONCLUSION People with CKD had difficulties in various health literacy domains primarily related to communication and critical appraisal. These domains can be improved by healthcare professionals and changes in hospital policies. Due to frequent contact with patients in kidney services, renal clinicians have a crucial role in ensuring greater communication occurs as this will better assist patients to understand their healthcare needs.
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Affiliation(s)
- Ha T T Dinh
- School of Nursing, University of Tasmania, Launceston, Tasmania, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Nguyet T Nguyen
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
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27
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Adherence to Therapy, Physical and Mental Quality of Life in Patients with Multiple Sclerosis. J Pers Med 2021; 11:jpm11070672. [PMID: 34357139 PMCID: PMC8303119 DOI: 10.3390/jpm11070672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
Ensuring multiple sclerosis (MS) patients' adherence to therapy is often challenging, but it is crucial to their survival and health-related quality of life (HRQoL). The aim of the present study was to outline connections between adherence, physical and mental HRQoL, levels of psychological readiness to engage in a treatment, levels of social support, anthropometric, socio-demographic and clinical factors in patients suffering from MS. This cross-sectional study involved a sample of 237 Italian MS patients. A survey was conducted with a structured self-administered online questionnaire using validated measures of quality of life, adherence to therapy and anthropometric, socio-demographic, psychological and clinical variables. A path analysis was used to test the overall structure of the associations between the variables. The pathway indicates a positive association between mental health index and a stronger degree of engagement and being or having been in a long-term relationship. Physical health index was positively associated with age, having an occupation, and having a specific form of MS. Having had relapses in the previous year raised the odds of better adherence to therapy, while an increase in Body Mass Index (BMI) reduced them. Our findings could help in the management of MS patients, promoting behavioral interventions that take the psychological and socio-demographic peculiarities of each patient into account with a view to improving their adherence to therapy.
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28
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Li A. Individual and organizational health literacies: moderating psychological distress for individuals with chronic conditions. J Public Health (Oxf) 2021; 44:651-662. [PMID: 33955477 DOI: 10.1093/pubmed/fdab133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/13/2021] [Accepted: 04/10/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND People with chronic conditions experience high psychological distress. METHODS Using the National Health Survey in Australia during 2017-18, the study assessed whether and which health literacies moderated the relationship between chronic conditions and psychological distress for diabetes, chronic kidney disease (CKD), cardiovascular disease (CVD), arthritis, other musculoskeletal conditions, asthma, other chronic lower respiratory diseases and cancer. Psychological distress was regressed on chronic diseases, health literacy domains and their interactions, controlling for demographic, socioeconomic and health factors. RESULTS Of 5790 adults, 4212 (72.75%) aged 18-64; 846 (14.6%) had high or very high psychological distress, 1819 (31.4%) had diabetes, CKD or CVD, 2645 (45.7%) musculoskeletal conditions, and 910 (15.7%) lower respiratory conditions. Having sufficient information from healthcare providers was associated with the lowest level of psychological distress for CKD and cancer. Social support was associated with significantly lower levels of psychological distress for cardiovascular, musculoskeletal and lower respiratory conditions. Understanding health information was associated with the largest improvement in psychological distress for diabetes. CONCLUSIONS Higher health literacies were associated with reduced risks of psychological distress among individuals managing chronic conditions. Interventions for improving self-management and health inequalities should incorporate disease-specific health literacy enhancement strategies at individual and organizational levels.
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Affiliation(s)
- Ang Li
- Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
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29
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Shah JM, Ramsbotham J, Seib C, Muir R, Bonner A. A scoping review of the role of health literacy in chronic kidney disease self-management. J Ren Care 2021; 47:221-233. [PMID: 33533199 DOI: 10.1111/jorc.12364] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/02/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic kidney disease is a serious health condition and is increasing globally. Effective self-management could slow disease progression and improve health outcomes, although the contribution of health literacy and knowledge for self-management is not well known. AIM To investigate the recent evidence of health literacy and the relationship between health literacy, knowledge and self-management of chronic kidney disease. METHODS Arksey and O'Malley's framework informed this scoping review. Eligible studies involving adults with any grade of chronic kidney disease, measuring all dimensions of health literacy (i.e., functional, communicative, and critical), disease-specific knowledge and self-management, published in English between January 2005 and March 2020, were included. RESULTS The scoping review found 12 eligible studies, with 11 assessing all dimensions of health literacy. No study examined health literacy, knowledge and self-management. When individuals had greater health literacy, this was associated with greater knowledge about the disease. Communicative health literacy was a significant predictor of medication, diet and fluid adherence, and overall self-management behaviours. CONCLUSION This scoping review shows that disease-specific knowledge is important for health literacy and that health literacy is essential for effective self-management of chronic kidney disease. The implications of these relationships can inform strategies for the development of evidence-based patient education to support increased self-management. There is also a need for further research to explore these associations.
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Affiliation(s)
- Jennifer M Shah
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Joanne Ramsbotham
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Rachel Muir
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia.,Kidney Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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30
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Do BN, Tran TV, Phan DT, Nguyen HC, Nguyen TTP, Nguyen HC, Ha TH, Dao HK, Trinh MV, Do TV, Nguyen HQ, Vo TT, Nguyen NPT, Tran CQ, Tran KV, Duong TT, Pham HX, Nguyen LV, Nguyen KT, Chang PWS, Duong TV. Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey. J Med Internet Res 2020; 22:e22894. [PMID: 33122164 PMCID: PMC7674138 DOI: 10.2196/22894] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/25/2020] [Accepted: 10/28/2020] [Indexed: 01/16/2023] Open
Abstract
Background The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. Objective The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. Methods We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. Results The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively. Conclusions The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.
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Affiliation(s)
- Binh N Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.,Division of Military Science, Military Hospital 103, Hanoi, Vietnam.,Director Office, Military Hospital 103, Hanoi, Vietnam
| | - Tien V Tran
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.,Division of Military Science, Military Hospital 103, Hanoi, Vietnam.,Director Office, Military Hospital 103, Hanoi, Vietnam
| | - Dung T Phan
- Faculty of Nursing, Hanoi University of Business and Technology, Hanoi, Vietnam.,Nursing Office, Viet Duc University Hospital, Hanoi, Vietnam
| | - Hoang C Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam.,President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Thao T P Nguyen
- Health Management Training Institute, Hue University of Medicine and Pharmacy, Thua Thien Hue, Vietnam.,Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Huu C Nguyen
- Department of Thoracic and Cardiovascular Surgery, E Hospital, Hanoi, Vietnam.,Director Office, E Hospital, Hanoi, Vietnam
| | - Tung H Ha
- Director Office, General Hospital of Agricultural, Hanoi, Vietnam
| | - Hung K Dao
- Director Office, Bac Ninh Obstetrics and Pediatrics Hospital, Bac Ninh, Vietnam
| | - Manh V Trinh
- Director Office, Quang Ninh General Hospital, Quang Ninh, Vietnam
| | - Thinh V Do
- Director Office, Bai Chay Hospital, Quang Ninh, Vietnam
| | - Hung Q Nguyen
- Director Office, Quang Ninh Obstetrics and Pediatrics Hospital, Quang Ninh, Vietnam
| | - Tam T Vo
- Director Office, Trieu Phong District Health Center, Quang Tri, Vietnam
| | - Nhan P T Nguyen
- General Planning Department, Da Nang Oncology Hospital, Da Nang, Vietnam
| | - Cuong Q Tran
- Director Office, Thu Duc District Health Center, Ho Chi Minh, Vietnam.,Faculty of Health, Mekong University, Vinh Long, Vietnam
| | - Khanh V Tran
- Director Office, Hospital District 2, Ho Chi Minh, Vietnam
| | - Trang T Duong
- Nursing Office, Tan Phu District Hospital, Ho Chi Minh, Vietnam
| | - Hai X Pham
- Director Office, District 9 Health Center, Ho Chi Minh, Vietnam
| | - Lam V Nguyen
- President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.,Aesthetic Plastic Surgery & Skin Care Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Kien T Nguyen
- Department of Health Education, Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Peter W S Chang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Public Health and Community Medicine, Tufts University School Of Medicine, Boston, MA, United States
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
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31
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Skoumalova I, Geckova AM, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7913. [PMID: 33126638 PMCID: PMC7663113 DOI: 10.3390/ijerph17217913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023]
Abstract
Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21-3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26-2.98) or anxiety (OR/95% CI: 1.81/1.22-2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients' psychological distress to ensure adequate adherence with recommended diet.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia;
- 2nd Department of Internal Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia;
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia;
| | - Andrea F. de Winter
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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