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Ferreira-Alfaya FJ. Inequalities in health literacy between European population and newly arrived male sub-Saharan migrants in Europe. Health Promot Int 2024; 39:daae129. [PMID: 39382388 DOI: 10.1093/heapro/daae129] [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: 10/10/2024] Open
Abstract
Increases in migration pressure from sub-Saharan Africa to Europe have increased in recent years. Despite this trend, the health literacy needs of migrants in host communities have not been sufficiently studied. This research aims to explore the health literacy of migrants newly arriving in Europe and compare it with the health literacy levels of the European population, utilizing data obtained from the European health literacy survey. A convenience sampling cross-sectional study was conducted at the Temporary Immigrant Stay Center in Melilla (Spain) in June 2022 using a validated French and Arabic version of the 16-item European health literacy survey questionnaire. A total of 106 sub-Saharan migrants ≥ 18 years of age were surveyed. The general health literacy index of the migrants was 30.02 points (on a scale of 50), placing it in the 'problematic' level. Of the participants, 57.54% had a limited ability to obtain, understand and apply health information and make appropriate health-related decisions. The largest gap compared to European citizens was observed in skills to understand information related to disease prevention. These results reinforce that migrant status is a social determinant of low health literacy and suggest that health professionals should extend their educational role to this vulnerable group.
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Campbell JK, Erickson JM. Interactive Health Literacy and Symptom Self-management in Patients With Lung Cancer: A Critical Realist Analysis. Cancer Nurs 2024; 47:397-407. [PMID: 37158678 DOI: 10.1097/ncc.0000000000001245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Patients with lung cancer experience multiple symptoms requiring self-management. Little is known about how self-management is influenced by interactive health literacy, defined as communicating with healthcare providers to obtain and process information. OBJECTIVE This study explored how interactive health literacy relates to symptom self-management among patients with lung cancer. A second aim explored how interactive health literacy might be integrated into the Individual and Family Self-management Theory. METHODS This study used a cross-sectional mixed-methods design. Quantitative data included demographics, the All Aspects of Health Literacy Scale, and the Memorial Symptom Assessment-Short Form. Qualitative data were collected using semistructured interviews. Data analysis followed a critical realist model. RESULTS Twelve adults who recently received treatment for lung cancer reported an average of 14 symptoms that caused moderate distress. Average interactive health literacy of the sample was in the moderate range. Participants' experiences of self-management differed based on their interactive health literacy. A generative mechanism proposes that those with higher interactive health literacy who accessed online information used this information as a basis for engaging with providers regarding potential symptom self-management strategies. CONCLUSIONS Interactive health literacy skills may play a role in patients' ability and confidence in symptom self-management through interactions with oncology providers. Further research should clarify the relationship between interactive health literacy, self-efficacy, and collaboration with oncology providers. IMPLICATIONS FOR PRACTICE The patient-provider relationship is a key factor influencing how patients obtain and process symptom self-management information. Oncology providers should implement patient-centered strategies to engage patients in symptom self-management.
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Affiliation(s)
- Julie K Campbell
- Authors Affiliations: School of Nursing, Lee University, Cleveland, Tennessee (Dr Campbell); and College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI (Dr Erickson)
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Elhakim T, Brea AR, Fidelis W, Paravastu SS, Malavia M, Omer M, Mort A, Ramasamy SK, Tripathi S, Dezube M, Smolinski-Zhao S, Daye D. PRO-READ IR: Enhanced PROcedural Information READability for Patient-Centered Care in Interventional Radiology With Large Language Models. J Am Coll Radiol 2024:S1546-1440(24)00702-6. [PMID: 39216782 DOI: 10.1016/j.jacr.2024.08.010] [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: 07/01/2024] [Revised: 08/15/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To evaluate the extent to which Generative Pre-trained Transformer 4 (GPT-4) can educate patients by generating easily understandable information about the most common interventional radiology (IR) procedures. MATERIALS AND METHODS We reviewed 10 IR procedures and prepared prompts for GPT-4 to provide patient educational instructions about each procedure in layman's terms. The instructions were then evaluated by four clinical physicians and nine nonclinical assessors to determine their clinical appropriateness, understandability, and clarity using a survey. A grade-level readability assessment was performed using validated metrics to evaluate accessibility to a wide patient population. The same procedures were also evaluated from the patient instructions available at radiologyinfo.org and compared with GPT-generated instructions utilizing a paired t test. RESULTS Evaluation by four clinical physicians shows that nine GPT-generated instructions were fully appropriate, whereas arterial embolization instructions was somewhat appropriate. Evaluation by nine nonclinical assessors shows that paracentesis, dialysis catheter placement, thrombectomy, ultrasound-guided biopsy, and nephrostomy-tube instructions were rated excellent by 57% and good by 43%. The arterial embolization and biliary-drain instructions were rated excellent by 28.6% and good by 71.4%. In contrast, thoracentesis, port placement, and CT-guided biopsy instructions received 43% excellent, 43% good, and 14% fair. The readability assessment across all procedural instructions showed a better Flesch-Kincaid mean grade of GPT-4 instructions compared with radiologyinfo.org (7.8 ± 0.87 versus 9.6 ± 0.83; P = .007) indicating excellent readability at 7th- to 8th-grade level compared with 9th to 10th grade. Additionally there was a lower Gunning Fog mean index (10.4 ± 1.2 versus 12.7 ± 0.93; P = .006), and higher Flesch Reading Ease mean score (69.4 ± 4.8 versus 51.3±3.9; P = .0001) indicating better readability. CONCLUSION IR procedural instructions generated by GPT-4 can aid in improving health literacy and patient-centered care in IR by generating easily understandable explanations.
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Affiliation(s)
- Tarig Elhakim
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Massachusetts General Hospital, Boston, Massachusetts.
| | - Allison R Brea
- Tufts university school of medicine, Boston, Massachusetts
| | - Wilton Fidelis
- Georgetown university school of medicine, Washington, DC
| | - Sriram S Paravastu
- University of Missouri- Kansas City School of Medicine, Kansas City, Missouri
| | - Mira Malavia
- University of Missouri- Kansas City School of Medicine, Kansas City, Missouri
| | - Mustafa Omer
- The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Ana Mort
- Saint Louis University School of Medicine, St Louis, Missouri
| | | | - Satvik Tripathi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Sara Smolinski-Zhao
- Associate Program Director of the Interventional Radiology Residency, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Dania Daye
- Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Boston, Massachusetts; IR Division Quality Director and Co-Director of IR Research and also Director of Precision Interventional and Medical Imaging Lab at the Division of Vascular and Interventional Radiology, Massachusetts General Hospital
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Pominville R, Tay K, Callegari M, Pei E, Sarica E, Jesse E, Prunty M, Loeb A, Thirumavalavan N, Ghayda RA. Evaluating the readability of online testosterone search results. Int J Impot Res 2024; 36:399-402. [PMID: 36864203 PMCID: PMC9979109 DOI: 10.1038/s41443-023-00682-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
With the budding interest in testosterone therapy (TTh), online health information plays a significant role in patients' health care decisions. Therefore, we evaluated the source and readability of web-based information available to patients regarding TTh on Google. From Google search terms "Testosterone Therapy" and "Testosterone Replacement", 77 unique sources were identified. Sources were categorized as Academic, Commercial, Institutional, or Patient Support, then evaluated using validated readability and English language text assessment tools: the Flesch Reading Ease score, Flesch Kincade, Gunning Fog, Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index and Automated Readability index. The average grade level for understanding academic sources was 16 (college senior); commercial, institutional, and patient support sources were 13 (college freshman); 8 and 5 grade levels, respectively, above the average U.S. adult. Patient support sources were most prevalent, while commercial sources were the least at 35 and 14%, respectively. The average reading ease score was 36.8, indicative of difficult-to-read material overall. These results indicate that the most immediate online sources for TTh information exceed the average reading level of most adults within the U.S., hence more effort should be taken to publish accessible and readable material to improve patient health literacy.
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Affiliation(s)
- Raymond Pominville
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
| | - Kimberly Tay
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA.
| | - Michael Callegari
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
| | - Evonne Pei
- Case Western Reserve University College of Medicine, Cleveland, OH, USA
| | - Erhan Sarica
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Erin Jesse
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
| | - Megan Prunty
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
| | - Aram Loeb
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
| | - Nannan Thirumavalavan
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
| | - Ramy Abou Ghayda
- University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA
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Agner J, Bau KE, Bruland D. An Introduction to Health Literacy and Social Contexts with Recommendations for Health Professionals and Researchers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:240. [PMID: 38397728 PMCID: PMC10888032 DOI: 10.3390/ijerph21020240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
Rarely do individuals seek, obtain, and understand health information in a solitary void [...].
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Affiliation(s)
- Joy Agner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA;
| | - Katharine Elizabeth Bau
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA;
| | - Dirk Bruland
- Institute for Educational and Health-Care Research in the Health Sector, Bielefeld University of Applied Sciences and Arts, Interaktion 1, 33619 Bielefeld, Germany;
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Bokova E, Prasade N, Rosen JM, Lim IIP, Levitt MA, Rentea RM. State of the Art Bowel Management for Pediatric Colorectal Problems: Spinal Anomalies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1558. [PMID: 37761519 PMCID: PMC10529947 DOI: 10.3390/children10091558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Patients with spinal abnormalities often struggle with fecal and/or urinary incontinence (up to 87 and 92%, respectively) and require a collaborative approach to bowel management in conjunction. METHODS To define existing approaches and propose state-of-the-art bowel management, a literature search was performed using Medline/PubMed, Google Scholar, Cochrane, and EMBASE databases and focusing on the manuscripts published July 2013 and July 2023. RESULTS Patients with spinal anomalies have impaired innervation of the rectum and anal canal, decreasing the success rate from laxatives and rectal enemas. Thus, transanal irrigations and antegrade flushes are widely utilized in this group of patients. Based on spinal MRI, the potential for bowel control in these children depends on age, type, and lesion level. On referral for bowel management, a contrast study is performed to assess colonic motility and evacuation of stool, followed by a series of abdominal X-rays to define colonic emptying and adjust the regimen. The options for management include laxatives, rectal enemas, transanal irrigations, antegrade flushes, and the creation of a stoma. Approximately 22-71% of patients achieve social continence dependent on the type and level of the lesion. CONCLUSION Patients with spinal anomalies require a thorough assessment for continence potential and stool burden prior to initiation of bowel management. The optimal treatment option is defined according to the patient's age, anatomy, and mobility. The likelihood of independent bowel regimen administration should be discussed with the patients and their caregivers.
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Affiliation(s)
- Elizaveta Bokova
- Comprehensive Colorectal Center, Department of Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Ninad Prasade
- Comprehensive Colorectal Center, Department of Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - John M. Rosen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Irene Isabel P. Lim
- Comprehensive Colorectal Center, Department of Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
- Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Marc A. Levitt
- Division of Colorectal and Pelvic Reconstruction, Children’s National Medical Center, Washington, DC 20010, USA
| | - Rebecca M. Rentea
- Comprehensive Colorectal Center, Department of Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
- Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA
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Shao Y, Hu H, Liang Y, Hong Y, Yu Y, Liu C, Xu Y. Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. PATIENT EDUCATION AND COUNSELING 2023; 114:107829. [PMID: 37270933 DOI: 10.1016/j.pec.2023.107829] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This study was conducted to determine the effectiveness and impact of health literacy interventions for patients with chronic diseases. METHODS We searched PubMed, Web of Science, Embase, Scopus, and EBSCO CINAHL from inception through March 2022. Eligible chronic diseases include diabetes, heart disease, cancer, and chronic obstructive pulmonary disease. RCTs were included in eligible studies to assess health literacy and other relevant health outcomes. Two investigators selected studies, extracted data, and assessed the methodological quality of included studies independently. RESULTS A total of 18 studies involving 5384 participants were included in the final analysis. The implementation of health literacy interventions exhibited a significant improvement in the health literacy level of individuals diagnosed with chronic diseases (SMD = 0.75, 95% CI = 0.40-1.10). Analysis of heterogeneity sources indicated statistically significant variations in the effects of interventions across different diseases and age groups (P < 0.05). However, no significant impact was observed on patients with chronic obstructive pulmonary disease (COPD), interventions with a follow-up duration exceeding three months, or application-based interventions on the health literacy level of individuals with chronic diseases. Remarkably, our findings revealed that health literacy interventions exerted a positive influence on health status (SMD = 0.74, 95% CI = 0.13-1.34), depression and anxiety (SMD = 0.90, 95% CI = 0.17-1.63), as well as self-efficacy (SMD = 0.28, 95% CI = 0.15-0.41) among patients diagnosed with chronic diseases. Furthermore, a specific analysis was conducted to evaluate the effects of these interventions on hypertension and diabetes control. The results demonstrated that health literacy interventions were more effective in enhancing hypertension control compared to diabetes control. CONCLUSION Health literacy interventions have demonstrated effectiveness in improving the health of patients with chronic diseases. The importance of emphasizing the quality of these interventions cannot be overstated, as factors such as appropriate intervention tools, extended intervention duration, and reliable primary care services play crucial roles in their efficacy.
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Affiliation(s)
- Yingshan Shao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Huaqin Hu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yaxin Liang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yangyang Hong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yiqing Yu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, China.
| | - Yihua Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China.
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Al-Tamimi A, Parić M, Groot W, Pavlova M. Yemeni refugees' health literacy and experience with the Dutch healthcare system: a qualitative study. BMC Public Health 2023; 23:902. [PMID: 37202761 DOI: 10.1186/s12889-023-15732-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/22/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The Netherlands is receiving increasing numbers of Yemeni refugees due to the ongoing war in Yemen. Since there is a lack of knowledge about access to healthcare by refugees, this study investigates the experiences of Yemeni refugees with the Dutch healthcare system from a health literacy perspective. METHODS Qualitative semi-structured in-depth interviews were conducted among 13 Yemeni refugees in the Netherlands, to gauge their level of health literacy and investigate their experiences with the Dutch healthcare system. Participants were invited using convenience and snowball sampling. Interviews were done in Arabic and then transcribed and translated ad verbatim to English. Deductive thematic analysis was conducted on the transcribed interviews based on the Health Literacy framework. RESULTS The participants knew how to use primary and emergency care, and were aware of health problems related to smoking, physical inactivity, and an unhealthy diet. However, some participants lacked an understanding of health insurance schemes, vaccination, and food labels. They also experienced language barriers during the first months after arrival. Furthermore, participants preferred to postpone seeking mental healthcare. They also showed mistrust towards general practitioners and perceived them as uncaring and hard to convince of their health complaints. CONCLUSION Yemeni refugees in our study are well-acquainted with many aspects of Dutch healthcare, disease prevention, and health promotion. However, trust in healthcare providers, vaccination literacy and mental health awareness must improve, as also confirmed by other studies. Therefore, it is suggested to ensure appropriate cultural mediation services available for refugees as well as training for healthcare providers focused on understanding cultural diversity, developing cultural competence and intercultural communication. This is crucial to prevent health inequalities, improve trust in the healthcare system and tackle unmet health needs regarding mental healthcare, access to primary care, and vaccination.
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Affiliation(s)
- Abdulhakeem Al-Tamimi
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6229 GT, The Netherlands.
| | - Martina Parić
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6229 GT, The Netherlands
| | - Wim Groot
- Department of Health Services Research, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6229 GT, Netherlands
- School of Business and Economics, Maastricht University, Maastricht, 6211 LM, Netherlands
- Maastricht Graduate School of Governance. Maastricht University, Maastricht, 6211 AX, Netherlands
| | - Milena Pavlova
- Department of Health Services Research, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6229 GT, Netherlands
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Ramón-Arbués E, Granada-López JM, Antón-Solanas I, Cobos-Rincón A, Rodríguez-Calvo A, Gea-Caballero V, Tejada-Garrido CI, Juárez-Vela R, Echániz-Serrano E. Factors related with nursing students' health literacy: a cross sectional study. Front Public Health 2023; 11:1053016. [PMID: 37275493 PMCID: PMC10234423 DOI: 10.3389/fpubh.2023.1053016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 04/07/2023] [Indexed: 06/07/2023] Open
Abstract
Background Nursing professionals have a crucial role in promoting health literacy in health services, so it is necessary to ensure health literacy skills in future health professionals. Objective The objective of the study was to examine the health literacy of nursing students and its associated factors. Methods A cross-sectional descriptive study was carried out on 460 nursing students. For data collection, a semi-structured questionnaire was obtained on sociodemographic characteristics, perception and health care, use of the health system and lifestyles. In addition, health literacy was assessed using the European Health Literacy Questionnaire. Results 6.1% of the participants had an inadequate level of health literacy and 36.5% problematic. The probability of having sufficient health literacy is directly associated with age; and inversely with smoking, prolonged screen time and living alone (p < 0.05). Conclusion A large percentage of nursing students need to improve their health literacy skills. It is necessary to integrate a greater number of contents in health literacy in the curriculum of nursing students.
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Affiliation(s)
- Enrique Ramón-Arbués
- Faculty of Health Sciences, San Jorge University, Villanueva de Gállego, Spain
- SAPIENF Investigation Group, Zaragoza, Spain
| | - José Manuel Granada-López
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- GIISA021 Seguridad y Cuidados Investigation Group, Zaragoza, Spain
| | - Isabel Antón-Solanas
- SAPIENF Investigation Group, Zaragoza, Spain
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Antonio Rodríguez-Calvo
- Department of Anesthesia, Complex University of Salamanca, Salamanca, Spain
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Community Health and Care Research Group, SALCOM, Valencia, Spain
| | - Clara Isabel Tejada-Garrido
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Emmanuel Echániz-Serrano
- SAPIENF Investigation Group, Zaragoza, Spain
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
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The association between health literacy and medical out-of-pocket expenses among residents in China. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01792-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Jovelijic J, Shinners LR, Coutts RA. An evaluation of the use of an iPad for hospital orientation in a regional hospital. Collegian 2023. [DOI: 10.1016/j.colegn.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Bahrambeygi F, Rakhshanderou S, Ramezankhani A, Ghaffari M. Hospital health literacy conceptual explanation: A qualitative content analysis based on experts and population perspectives. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:31. [PMID: 37034858 PMCID: PMC10079191 DOI: 10.4103/jehp.jehp_494_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/01/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND AIM Given the complexities of the health care system and the importance of the subject and effects of health literacy in all aspects of care, defining specific health literacy in this context seems necessary. The purpose of this research was to explain the concept of hospital health literacy (HHL), its definition, and the related dimensions using the qualitative research method. MATERIALS AND METHODS An exploratory qualitative design was used. Exploratory, open-ended, and face-to-face interviews based on the interview guide were used to elicit participants' perspectives between July 2021 and January 2022. By using the content analysis method, researchers coded transcripts and collated these codes into sub-categories and then merged them into the main category and explored the dimensions of the concept. RESULTS A total of 23 service providers and 25 service recipients were included in the study. Analysis of qualitative data led to the identification of 6 categories and 25 sub-categories including cognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, media literacy, and emotional literacy. CONCLUSION The findings of the present study provide a deep understanding of the concept of HHL that could be applied to develop valid and reliable measurement tools for assessing HHL among a variety of populations. Also, it is hoped that the present attempt can be useful to guide future research and interventions as well as to provide a clear base for planning, implementing, and evaluating interventions aimed at promoting individuals' health literacy in health settings.
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Affiliation(s)
- Fatemeh Bahrambeygi
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghaffari
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lu J, Sun S, Gu Y, Li H, Fang L, Zhu X, Xu H. Health literacy and health outcomes among older patients suffering from chronic diseases: A moderated mediation model. Front Public Health 2023; 10:1069174. [PMID: 36703841 PMCID: PMC9873261 DOI: 10.3389/fpubh.2022.1069174] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Aging brings with an increased risk of chronic diseases among older adults, which could affect health outcomes. Evidence has showed that health literacy is associated with health outcomes. However, limited studies explore the underlying mechanism between health literacy and health outcomes. Hence, this study aimed to determine whether self-efficacy for managing chronic disease mediates the relationship between health literacy and health outcomes among older patients with chronic diseases, and to explore whether disease duration moderates the relationship between health literacy, self-efficacy for managing chronic disease, and health outcomes. Methods Participants were recruited from tertiary hospitals in Zhejiang Province, China from May 2019 to June 2020 using a convenience sampling method. A total of 471 older patients with chronic diseases completed questionnaires measuring demographics, disease-related information, health literacy, self-efficacy for managing chronic disease, and health outcomes. The mediation effect was examined using the structural equation model method, based on the bias-corrected bootstrapping method. The moderation effect was tested by the multiple-group analysis. Results A good fit model suggested that self-efficacy for managing chronic disease partially mediated the relationships between health literacy and health outcomes. In addition, disease duration moderated the relationships between health literacy, self-efficacy for managing chronic disease, and health outcomes. Discussion The findings highlight that adequate health literacy improved health outcomes among older patients with chronic diseases, which was further promoted by self-efficacy for managing chronic diseases. Moreover, a long disease duration could enhance the effect.
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Affiliation(s)
- Jinjin Lu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shuting Sun
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yechun Gu
- General Surgery Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang, China
| | - Huihui Li
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liangyu Fang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoling Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China,*Correspondence: Xiaoling Zhu ✉
| | - Hongbo Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China,Hongbo Xu ✉
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Sertkaya Z, Koyuncu E, Nakipoğlu Yüzer GF, Özgirgin N. Investigation of health literacy level and its effect on quality of life in patients with spinal cord injury. J Spinal Cord Med 2023; 46:62-67. [PMID: 34726584 PMCID: PMC9897774 DOI: 10.1080/10790268.2021.1991162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine the health literacy (HL) level in patients with traumatic spinal cord injury (SCI) and evaluate the relationship between HL and the quality of life (QoL). STUDY DESIGN Cross-sectional study. SETTING Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Turkey. PARTICIPANTS A total of 77 patients with traumatic SCI aged 15-65 years where the trauma had occurred at least a month ago before data collection and who were attending the rehabilitation program at the hospital as inpatients we included in the study. OUTCOME MEASURES The European Health Literacy Questionnaire Turkish Adaptation (HLS-TR) was used for the evaluation of the HL level, and the Short Form-36 was used for the evaluation of the QoL. RESULTS The HL level was inadequate in 32.5%, problematic-limited in 40.3%, sufficient in 19.5%, and excellent in 7.8% of the patients. The vitality and mental health subdimensions of the QoL were found to be statistically significantly better in participants with excellent, sufficient or problematic-limited HL compared to those with an inadequate level. CONCLUSIONS According to our results, the HL level of the majority of patients with SCI who are hospitalized in our hospital is low, and there is a relationship between HL and QoL. In conclusion, steps need to be taken to increase the HL levels of patients to improve their QoL, taking into account the important effect of HL on the QoL.
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Affiliation(s)
- Zilan Sertkaya
- Department of Physical Medicine and Rehabilitation, Soma State Hospital, Soma/Manisa, Turkey
| | - Engin Koyuncu
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Turkey,Department of Physical Medicine and Rehabilitation, University of Medical Sciences, Ankara, Turkey,Correspondence to: Engin Koyuncu, Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, University of Medical Sciences, Ankara, Turkey; Ph: 05052553671.
| | - Güldal Funda Nakipoğlu Yüzer
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Turkey,Department of Physical Medicine and Rehabilitation, University of Medical Sciences, Ankara, Turkey
| | - Neşe Özgirgin
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Turkey,Department of Physical Medicine and Rehabilitation, University of Medical Sciences, Ankara, Turkey
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Muacevic A, Adler JR, Mamilly A, Saad Aldine A, De Alba L, Arevalo O, Ahuja C, Cuellar HH. The Complexity of Online Patient Education Materials About Interventional Neuroradiology Procedures Published by Major Academic Institutions. Cureus 2023; 15:e34233. [PMID: 36852354 PMCID: PMC9962712 DOI: 10.7759/cureus.34233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction Health literacy is an independent predictor of population health status and is directly related to the readability of available patient education material. The National Institutes of Health (NIH) and the American Medical Association have recommended that patient education materials (PEMs) be written between a fourth- and a sixth-grade education level. The authors assessed the readability of online PEMs about neurointerventional procedures that have been published by several academic institutions across the US. Methods Online PEMs regarding five common neurointerventional procedures, including mechanical thrombectomy for large vessel occlusion, cerebral diagnostic angiography, carotid artery stenting, endovascular aneurysm embolization, and epidural steroid injection collected from the websites of 20 top institutions in Neurology and Neurosurgery. The materials were assessed via five readability scales and then were statistically analyzed and compared to non-institutional education websites (Wikipedia.com and WebMD.com). Results None of the PEMs were written at or below the NIH's recommended 6th-grade reading level. The average educational level required to comprehend the texts across all institutions, as assessed by the readability scales, was 10-11th grade level. Some materials required a college-level education or higher. Material from non-institutional websites had significantly lower readability scores compared to the 20 institutions. Conclusions Current PEMs related to neurointerventional procedures are not written at or below the NIH's recommended fourth- to sixth-grade education level. Given the complexity of those procedures, significant attention should be pointed toward an improvement in the available online materials.
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Dias MDRJ, Alves Faria ADC, Ferreira MSM, Faleiros F, Novo A, Gonçalves MN, da Rocha CG, Teles PJFC, Ribeiro MP, Ventura da Silva JMA, Ribeiro OMPL. From Health Literacy to Self-Care: Contributions of the Specialist Nurse in Rehabilitation Nursing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137767. [PMID: 35805436 PMCID: PMC9265364 DOI: 10.3390/ijerph19137767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 02/05/2023]
Abstract
(1) Background: Initiatives aimed at assessing and intervening in health literacy have the potential to promote adherence to self-care behaviours, which is the main focus of intervention by rehabilitation nurses. Thus, the objectives were to analyse the level of health literacy of working-age citizens and identify priority areas for intervention by rehabilitation nurses. (2) Methods: Quantitative, correlational and cross-sectional study, conducted in a multinational company, with the participation of 161 workers. The data were collected between 14 April and 7 May 2021, using a self-completion questionnaire composed of sociodemographic and clinical characterization and the European Health Literacy Survey, following a favourable opinion from the Ethics Committee and the company’s management. (3) Results: Overall, low to moderate literacy scores were predominant. Age and education were significantly associated with literacy scores. Workers with higher levels of health literacy had no diagnosed illnesses, took less medication, reported less sadness, fewer memory changes and less muscle and joint pain. (4) Conclusions: The fact that higher levels of health literacy trigger self-care behaviours and, consequently, fewer health problems reinforces the need for rehabilitation nurses to invest in this area.
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Affiliation(s)
| | - Ana da Conceição Alves Faria
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal; (A.d.C.A.F.); (J.M.A.V.d.S.)
- North Region Health Administration, 4000-447 Porto, Portugal
| | | | - Fabiana Faleiros
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil;
| | - André Novo
- CINTESIS@RISE, 4200-450 Porto, Portugal;
- Escola Superior de Saúde do Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
| | | | - Carla Gomes da Rocha
- Institute of Health, School of Health Sciences, HES-SO Valais-Wallis, 1950 Sion, Switzerland;
| | | | | | - João Miguel Almeida Ventura da Silva
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal; (A.d.C.A.F.); (J.M.A.V.d.S.)
- Medicine Department, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Olga Maria Pimenta Lopes Ribeiro
- CINTESIS@RISE, 4200-450 Porto, Portugal;
- Nursing Department, Nursing School of Porto, 4200-072 Porto, Portugal;
- Correspondence: ; Tel.: +351-910050871
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Correa-Rodríguez M, Rueda-Medina B, Callejas-Rubio JL, Ríos-Fernández R, de la Hera-Fernández J, Ortego-Centeno N. The Relationship Between Health Literacy and Quality of Life, Attitudes and Perceptions of Covid-19 and Vaccination Among Patients with Systemic Autoimmune Diseases. Clin Nurs Res 2022; 31:981-990. [PMID: 35484917 DOI: 10.1177/10547738221090558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to evaluate health literacy in a population of patients with systemic autoimmune diseases (SAD), and to analyze their potential relationships with health-related quality of life (HRQoL), attitudes and beliefs of Covid-19 and vaccination, and perceptions of changes in medical care during the pandemic. A cross-sectional study was conducted among 395 patients (81.1% were living in Spain). An anonymous online survey was distributed to an online SAD association. Health literacy was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the SF-36 tool was used to assess HRQoL. More than half of patients (57.7%) have inadequate health literacy and the mean health literacy level was 9.63(5.66). Patients with inadequate health literacy levels presented the lowest HRQoL scores in all SF-36 domains (p < .001). Health literacy scores were positively correlated with all SF-36 domains (p < .001). The reservations to get vaccinated against Covid-19 were linked to health literacy level (p = 0.024). There are high levels of inadequate health literacy among patients with SAD and it is associated with worse HRQoL and risk attitudes about Covid-19 vaccination and medical care during the pandemic.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José-Luis Callejas-Rubio
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Raquel Ríos-Fernández
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Javier de la Hera-Fernández
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Norberto Ortego-Centeno
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Department of Medicine, University of Granada, Granada, Spain
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Cesar FCR, Moraes KL, Brasil VV, Alves AG, Barbosa MA, Oliveira LMDAC. Professional Responsiveness to Health Literacy: A Scoping Review. Health Lit Res Pract 2022; 6:e96-e103. [PMID: 35522856 PMCID: PMC9126054 DOI: 10.3928/24748307-20220418-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Flaviane Cristina Rocha Cesar
- Address correspondence to Flaviane Cristina Rocha Cesar, MSc, PhD, Avenida Elizabeth Marques, 45 - St. Maysa, Trindade, Goiás, Brazil, 75380-307;
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Rosano A, Lorini C, Unim B, Griebler R, Cadeddu C, Regazzi L, Galeone D, Palmieri L. Coronavirus-Related Health Literacy: A Cross-Sectional Study during the COVID-19 Pandemic in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073807. [PMID: 35409490 PMCID: PMC8998061 DOI: 10.3390/ijerph19073807] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 12/10/2022]
Abstract
The COVID-19 pandemic has caused an overabundance of valid and invalid information to spread rapidly via traditional media as well as by internet and digital communication. Health literacy (HL) is the ability to access, understand, appraise, and apply health information, making it fundamental for finding, interpreting, and correctly using COVID-19 information. A cross-sectional study of a sample of 3500 participants representative of the Italian adult population aged 18+ years was conducted in Italy in 2021. A validated HL questionnaire was employed, including sections on coronavirus-related HL, general HL, sociodemographic characteristics, risk factors, and respondents’ lifestyle. Of our sample, 49.3% had “excellent” levels of coronavirus-related HL and 50.7% had “sufficient” (20.7%) or “limited” (30.0%) levels. Although the overall HL-COVID level was high, many participants reported difficulties dealing with COVID-19 information; in particular, participants older than 65 years, with a low education level, living in southern regions of Italy, and with high financial deprivation. Targeted public information campaigns and the promotion of HL are required for better navigation of health information environments. The COVID-19 pandemic has highlighted the need to improve HL and to prepare the general population for future emergency and non-emergency situations, confirming that HL can be considered a social vaccine.
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Affiliation(s)
- Aldo Rosano
- National Institute for the Analysis of Public Policy, Corso d’Italia 33, 00198 Rome, Italy;
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy;
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Via Giano della Bella 34, 00162 Rome, Italy;
| | - Robert Griebler
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, Stubenring 6, A-1010 Vienna, Austria;
| | - Chiara Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (L.R.)
| | - Luca Regazzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (C.C.); (L.R.)
| | - Daniela Galeone
- Ministry of Health, Viale Giorgio Ribotta, 5, 00144 Rome, Italy;
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Via Giano della Bella 34, 00162 Rome, Italy;
- Correspondence:
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Kanu C, Brown CM, Rascati K, Moczygemba LR, Mackert M, Wilfong L. General versus disease-specific health literacy in patients with breast cancer: a cross-sectional study. Support Care Cancer 2022; 30:5533-5538. [PMID: 35316403 DOI: 10.1007/s00520-022-06988-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/13/2022] [Indexed: 11/25/2022]
Abstract
Health literacy is recognized as a critical factor affecting communication across the continuum of cancer care and plays a key role in patients' ability to meaningfully discuss their condition with healthcare providers. However, there is no consensus on the best approach to measure health literacy in clinical practice. The aims of this study were to compare general and disease-specific measurements of health literacy in patients with breast cancer as well as examine their relationships with patient-provider communication. During office visits, patients with HER-2 + breast cancer who received care at oncology clinics with value-based models of care completed a survey including the 6-item cancer health literacy tool (CHLT-6), 6-item newest vital sign (NVS), 2 items measuring difficulty of patient-provider communication, and 11 demographic/clinical items. The mean age of 146 participants was 57.1 ± 10.8 years. Most participants had adequate general health literacy as measured by the NVS (79%) and a high probability of adequate cancer health literacy (≥ 0.7) as measured by the CHLT-6 (92%). Most patients easily communicated with healthcare providers (90.2%) and understood information they provided (83.5%). However, there was no significant relationship between patient-provider communication and health literacy. Both the CHLT-6 and NVS may be useful tools to assess the health literacy of patients with cancer in clinical practice. Study findings of adequate health literacy and ease of communication might have been influenced by the value-based care models adopted by participating clinics. Further research in more diverse samples of patients with cancer and different types of oncology practice settings is warranted.
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Affiliation(s)
- Chisom Kanu
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA.
| | - Carolyn M Brown
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Karen Rascati
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | | | - Michael Mackert
- Moody College of Communication, University of Texas at Austin, Austin, TX, USA
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21
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Han KT, Kim W, Kim S. Disparities in healthcare expenditures according to economic status in cancer patients undergoing end-of-life care. BMC Cancer 2022; 22:303. [PMID: 35317774 PMCID: PMC8939210 DOI: 10.1186/s12885-022-09373-y] [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: 07/07/2021] [Accepted: 03/02/2022] [Indexed: 11/25/2022] Open
Abstract
Backgrounds A desire for better outcome influences cancer patients’ willingness to pay. Whilst cancer-related costs are known to have a u-shaped distribution, the actual level of healthcare utilized by patients may vary depending on income and ability to pay. This study examined patterns of healthcare expenditures in the last year of life in patients with gastric, colorectal, lung, and liver cancer and analyzed whether differences exist in the level of end-of-life costs for cancer care according to economic status. Methods This study is a retrospective cohort study which used data from the Korean National Elderly Sampled Cohort, 2002 to 2015. End-of-life was defined as 1 year before death. Economic status was classified into three categorical variables according to the level of insurance premium (quantiles). The relationship between the dependent and independent variables were analyzed using multiple gamma regression based on the generalized estimated equation (GEE) model. Results This study included 3083 cancer patients, in which total healthcare expenditure was highest in the high-income group. End-of-life costs increased the most in the last 3 months of life. Compared to individuals in the ‘middle’ economic status group, those in the ‘high’ economic status group (RR 1.095, 95% CI 1.044–1.149) were likely to spend higher amounts. The percentage of individuals visiting a general hospital was highest in the ‘high’ economic status group, followed by the ‘middle’ and ‘low’ economic status groups. Conclusion Healthcare costs for cancer care increased at end-of-life in Korea. Patients of higher economic status tended to spender higher amounts of end-of-life costs for cancer care. Further in-depth studies are needed considering that end-of-life medical costs constitute a large proportion of overall expenditures. This study offers insight by showing that expenditures for cancer care tend to increase noticeably in the last 3 months of life and that differences exist in the amount spent according economic status. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09373-y.
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Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Woorim Kim
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Seongnam, Republic of Korea.
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Valentini J, Fröhlich D, Stolz R, Mahler C, Martus P, Klafke N, Horneber M, Frasch J, Kramer K, Bertz H, Grün B, Tomaschko-Ubeländer K, Joos S. Interprofessional evidence-based counselling programme for complementary and integrative healthcare in patients with cancer: study protocol for the controlled implementation study CCC-Integrativ. BMJ Open 2022; 12:e055076. [PMID: 35149568 PMCID: PMC8845169 DOI: 10.1136/bmjopen-2021-055076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION According to international literature, patients with cancer wish to have information on complementary and integrative healthcare (CIH). Medical guidelines recommend actively approaching patients with cancer discussing potential benefits and risks of individual CIH methods. While some CIH methods, for example, acupuncture and yoga, have been proven effective in high-quality studies, other CIH methods lack studies or bear the risk of interactions with chemotherapeutics, for example, herbal drugs. Therefore, an evidence-based interprofessional counselling programme on CIH will be implemented at four Comprehensive Cancer Centres in the federal state of Baden-Wuerttemberg, Germany. METHODS AND ANALYSIS A complex intervention consisting of elements on patient, provider and system levels will be developed and evaluated within a multilayer evaluation design with confirmatory evaluation on patient level. Patients with a cancer diagnosis within the last 6 months will receive three individual counselling sessions on CIH within 3 months (=intervention on patient level). The counselling will be provided by an interprofessional team of medical and nursing staff. For this purpose, an intensive online training programme, a CIH knowledge database and an interprofessional team-building process were developed and implemented (=intervention on provider level). Moreover, training events on the basics of CIH are offered in the outpatient setting (=intervention on system level). Primary outcome of the evaluation at the patient level is patient activation measured (PAM) with the PAM-13 after 3 months. Secondary outcomes, for example, quality of life, self-efficacy and clinical parameters, will be assessed at baseline, after 3 months and at 6 months follow-up. The intervention group (n=1000) will be compared with a control group (n=500, treatment as usual, no CIH counselling. The outcomes and follow-up times in the control group are the same as in the intervention group. Moreover, the use of health services will be analysed in both groups using routine data. A qualitative-quantitative process evaluation as well as a health economic evaluation will identify relevant barriers and enabling factors for later roll-out. ETHICS AND DISSEMINATION The study has been approved by the appropriate Institutional Ethical Committee of the University of Tuebingen, No. 658/2019BO1. The results of these studies will be disseminated to academic audiences and in the community. TRIAL REGISTRATION NUMBER DRKS00021779; Pre-results.
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Affiliation(s)
- Jan Valentini
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Daniela Fröhlich
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Regina Stolz
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Cornelia Mahler
- Institute for Health Sciences, Department of Nursing Science, University Hospital Tübingen, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital Tübingen, Tübingen, Germany
| | - Nadja Klafke
- Department of General Practice and Health Services Reseach, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Horneber
- Department of Internal Medicine, Division of Pneumology, Paracelsus Medical University, Klinikum Nurnberg, Nurnberg, Germany
| | - Jona Frasch
- aQua Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany
| | - Klaus Kramer
- Department of Integrative Medicine, Faculty of Medicine, University Hospital Ulm, Ulm, Germany
| | - Hartmut Bertz
- Department of Medicine I, Faculty of Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Barbara Grün
- Department of Medical Oncology, National Centre for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
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Martins S, Augusto C, Martins MRO, Silva MJ, Okan O, Dadaczynsky K, Duarte A, Fronteira I, Ramos N, Rosário R. Adaptation and validation and of the Digital Health Literacy Instrument for Portuguese university students. Health Promot J Austr 2022; 33 Suppl 1:390-398. [DOI: 10.1002/hpja.580] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/09/2022] [Accepted: 02/03/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Silvana Martins
- Health Sciences Research Unit: Nursing (UICISA: E) Nursing School of Coimbra (ESEnfC) 3000‐232 Coimbra
| | - Cláudia Augusto
- Health Sciences Research Unit: Nursing (UICISA: E) Nursing School of Coimbra (ESEnfC) 3000‐232 Coimbra
- School of Nursing University of Minho Braga Portugal
| | - Maria R. O. Martins
- Global Health and Tropical Medicine Institute of Hygiene and Tropical Medicine NOVA University of Lisbon 1349‐008 Lisbon Portugal
| | | | - Orkan Okan
- Faculty of Educational Science Interdisciplinary Centre for Health Literacy Research Bielefeld University 33615 Bielefeld Germany
| | - Kevin Dadaczynsky
- Department of Nursing and Health Science Fulda University of Applied Sciences 36037 Fulda Germany
- Center for Applied Health Science Leuphana University of Lüneburg 21335 Lüneburg Germany
| | - Ana Duarte
- School of Nursing University of Minho Braga Portugal
- CIEC‐UM ‐ Research Centre on Child Studies
| | - Inês Fronteira
- Global Health and Tropical Medicine Institute of Hygiene and Tropical Medicine NOVA University of Lisbon 1349‐008 Lisbon Portugal
| | - Neide Ramos
- Global Health and Tropical Medicine Institute of Hygiene and Tropical Medicine NOVA University of Lisbon 1349‐008 Lisbon Portugal
| | - Rafaela Rosário
- Health Sciences Research Unit: Nursing (UICISA: E) Nursing School of Coimbra (ESEnfC) 3000‐232 Coimbra
- School of Nursing University of Minho Braga Portugal
- CIEC‐UM ‐ Research Centre on Child Studies
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Liu L, Jia HH, Zhou YQ, Liu YR, Yin F, Liu XF. The illness perception and health promotion behaviour of young and middle-aged patients with hyperuricaemia: A qualitative study. Nurs Open 2022; 9:1343-1352. [PMID: 35092168 PMCID: PMC8859027 DOI: 10.1002/nop2.1179] [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: 08/23/2021] [Revised: 12/01/2021] [Accepted: 01/09/2022] [Indexed: 11/07/2022] Open
Abstract
AIM The purpose of this qualitative study was to describe the health-promoting behaviours of patients with hyperuricaemia and influencing factors. DESIGN A descriptive qualitative design was used to gain insight into the personal experience of health promotion behaviour in patients with hyperuricaemia. METHODS Sixteen patients were sampled in face-to-face interviews with maximum variation, and the data were transcribed verbatim. The data analysis was based on the phrases of thematic analysis outlined by Braun and Clarke (2006). RESULTS Four main themes were identified in the data: (a) Perception of disease; (b) Motivation to change health-promoting behaviour; (c) Strategies for health-promoting behaviour; and (d) Encounter obstacles to change health-promoting behaviour.
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Affiliation(s)
- Li Liu
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Hong-Hong Jia
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Yan-Rui Liu
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Fei Yin
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
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OUP accepted manuscript. Health Promot Int 2022:6573373. [DOI: 10.1093/heapro/daac043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sørensen K, Levin-Zamir D, Duong TV, Okan O, Brasil VV, Nutbeam D. Building health literacy system capacity: a framework for health literate systems. Health Promot Int 2021; 36:i13-i23. [PMID: 34897445 PMCID: PMC8672927 DOI: 10.1093/heapro/daab153] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The human and social implications of poor health literacy are substantial and wide-ranging. Health literacy represents the personal competencies and organizational structures, resources and commitment that enable people to access, understand, appraise and use information and services in ways that promote and maintain good health. A large-scale societal improvement of health literacy will require political buy-in and a systematic approach to the development of health literacy capacity at all levels. This article builds the case for enhancing health literacy system capacity and presents a framework with eight action areas to accommodate the structural transformation needed at micro, meso and macro levels, including a health literate workforce, health literate organization, health literacy data governance, people-centred services and environments based on user engagement, health literacy leadership, health literacy investments and financial resources, health literacy-informed technology and innovation, and partnerships and inter-sectoral collaboration. Investment in the health literacy system capacity ensures an imperative and systemic effort and transformation which can be multiplied and sustained over time and is resilient towards external trends and events, rather than relying on organizational and individual behavioural change alone. Nevertheless, challenges still remain, e.g. to specify the economic benefits more in detail, develop and integrate data governance systems and go beyond healthcare to engage in health literacy system capacity within a wider societal context.
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Affiliation(s)
| | - Diane Levin-Zamir
- Department of Health Education and Promotion,
Clalit, Tel Aviv and School of Public Health, University of Haifa,
Haifa, Israel
| | - Tuyen V Duong
- School of Nutrition and Health Sciences, Taipei
Medical University, Taipei, Taiwan
| | - Orkan Okan
- Interdisciplinary Centre for Health Literacy
Research, Bielefeld University, Germany
| | | | - Don Nutbeam
- Sydney School of Public Health, University of
Sydney, Sydney, Australia
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Sanmarchi F, Esposito F, Bucci A, Toscano F, Golinelli D. Association between Economic Growth, Mortality, and Healthcare Spending in 31 High-Income Countries. Forum Health Econ Policy 2021; 24:101-118. [PMID: 36259392 DOI: 10.1515/fhep-2021-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/03/2022] [Indexed: 11/07/2022]
Abstract
This study aims to investigate the association between gross domestic product (GDP), mortality rate (MR) and current healthcare expenditure (CHE) in 31 high-income countries. We used panel data from 2000 to 2017 collected from WHO and OECD databases. The association between CHE, GDP and MR was investigated through a random-effects model. To control for reverse causality, we adopted a test of Granger causality. The model shows that the MR has a statistically significant and negative effect on CHE and that an increase in GDP is associated with an increase of CHE (p < 0.001). The Granger causality analysis shows that all the variables exhibit a bidirectional causality. We found a two-way relationship between GDP and CHE. Our analysis highlights the economic multiplier effect of CHE. In the debate on the optimal allocation of resources, this evidence should be taken into due consideration.
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Affiliation(s)
- Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy
| | - Francesco Esposito
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy
| | - Andrea Bucci
- Department of Economics, University of Chieti-Pescara, Pescara, Italy
| | - Fabrizio Toscano
- Department of Internal Medicine, Montefiore Medical Center, Bronx, New York City, USA
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy
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Lubasch JS, Voigt-Barbarowicz M, Ernstmann N, Kowalski C, Brütt AL, Ansmann L. Organizational Health Literacy in a Hospital-Insights on the Patients' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312646. [PMID: 34886374 PMCID: PMC8656520 DOI: 10.3390/ijerph182312646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/11/2023]
Abstract
Health literacy-sensitive communication has been found to be an important dimension of organizational health literacy measured from the patients' perspective. Little is known about the role of health literacy-sensitive communication in complex care structures. Therefore, our aim was to assess which hospital characteristics (in terms of process organization) and patient characteristics (e.g., age, chronic illness, etc.) contribute to better perceptions of health literacy-sensitive communication, as well as whether better health literacy-sensitive communication is associated with better patient reported experiences. Data were derived from a patient survey conducted in 2020 in four clinical departments of a university hospital in Germany. Health literacy-sensitive communication was measured with the HL-COM scale. Data from 209 patients (response rate 24.2%) were analyzed with a structural equation model (SEM). Results revealed that no patient characteristics were associated with HL-COM scores. Better process organization as perceived by patients was associated with significantly better HL-COM scores, and, in turn, better HL-COM scores were associated with more patient-reported social support provided by physicians and nurses as well as fewer unmet information needs. Investing into good process organization might improve health literacy-sensitive communication, which in turn has the potential to foster the patient-provider relationship as well as to reduce unmet information needs of patients.
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Affiliation(s)
- Johanna Sophie Lubasch
- Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (M.V.-B.); (A.L.B.); (L.A.)
- Correspondence: ; Tel.: +49-441-798-4606
| | - Mona Voigt-Barbarowicz
- Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (M.V.-B.); (A.L.B.); (L.A.)
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany;
| | | | - Anna Levke Brütt
- Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (M.V.-B.); (A.L.B.); (L.A.)
| | - Lena Ansmann
- Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (M.V.-B.); (A.L.B.); (L.A.)
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Hou WH, Kuo KN, Chen MJ, Chang YM, Tsai HW, Chan DC, Su CT, Han DS, Shen HN, Li CY. Simple scoring algorithm to identify community-dwelling older adults with limited health literacy: a cross-sectional study in Taiwan. BMJ Open 2021; 11:e045411. [PMID: 34824102 PMCID: PMC8627398 DOI: 10.1136/bmjopen-2020-045411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Health literacy (HL) is the degree of individuals' capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL. DESIGN A cross-sectional study. SETTING Four communities in northern, central and southern Taiwan. PARTICIPANTS A total of 648 older adults were included. Moreover, 85% of the core data set was used to generate the prediction model for the scoring algorithm, and 15% was used to test the fitness of the model. PRIMARY AND SECONDARY OUTCOME MEASURES Pearson's χ2 test and multiple logistic regression were used to identify the significant factors associated with the HL level. An optimal cut-off point for the scoring algorithm was identified on the basis of the maximum sensitivity and specificity. RESULTS A total of 350 (54.6%) patients were classified as having limited HL. We identified 24 variables that could significantly differentiate between sufficient and limited HL. Eight factors that could significantly predict limited HL were identified as follows: a socioenvironmental determinant (ie, dominant spoken dialect), a health service use factor (ie, having family doctors), a health cost factor (ie, self-paid vaccination), a heath behaviour factor (ie, searching online health information), two health outcomes (ie, difficulty in performing activities of daily living and requiring assistance while visiting doctors), a participation factor (ie, attending health classes) and an empowerment factor (ie, self-management during illness). The scoring algorithm yielded an area under the curve of 0.71, and an optimal cut-off value of 5 represented moderate sensitivity (62.0%) and satisfactory specificity (76.2%). CONCLUSION This simple scoring algorithm can efficiently and effectively identify community-dwelling older adults with a high risk of limited HL.
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Affiliation(s)
- Wen-Hsuan Hou
- Master's Program in Long-Term Care & School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Geriatric Medicine & Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ken N Kuo
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Mu-Jean Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yao-Mao Chang
- Health Policy and Care Research Center, College of Public Health, Taipei Medical University, Taipei, Taiwan
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Han-Wei Tsai
- Master's Program in Long-Term Care & School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ding-Cheng Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- Superintendent Office, National Taiwan University Hospital Chutung Branch, Hsinchu, Taiwan
| | - Chien-Tien Su
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- School of Public Health,College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
- Health Science and Wellness Center, National Taiwan University, Taipei, Taiwan
| | - Hsiu-Nien Shen
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Faculty of Public Health, Department of Epidemiology, Universitas Airlangga, Surabaya, Indonesia
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
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Barbaro A, Amicarella SE, Ferrari P, Sorcini I, Zedda M. Embedded librarians: An innovative experience in health and wellness communication. Health Info Libr J 2021; 39:194-197. [PMID: 34792265 DOI: 10.1111/hir.12410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/13/2021] [Indexed: 11/27/2022]
Abstract
The article discusses the experiences of Italian librarians taking part in an institutional project to produce a new general-public-oriented health web portal. The web portal was set up to provide verified and easily understandable health information, and to debunk health-related fake news circulating on the internet. The different roles, knowledge and skills acquired in during the project this are discussed and show how the librarian's knowledge and skills were of fundamental importance for the success of the Web Portal. By collaborating with other professions new skills such as social media management, video creation and Search Engine Optimization were gained, which enhanced the information literacy role of the service.
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Affiliation(s)
- Annarita Barbaro
- Knowledge Service - Library, National Institute of Health (ISS), Rome, Italy
| | | | - Paola Ferrari
- Knowledge Service - Library, National Institute of Health (ISS), Rome, Italy
| | - Ilaria Sorcini
- Knowledge Service - Library, National Institute of Health (ISS), Rome, Italy
| | - Monica Zedda
- Knowledge Service - Library, National Institute of Health (ISS), Rome, Italy
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Rague JT, Kim S, Hirsch JA, Meyer T, Rosoklija I, Larson JE, Swaroop VT, Bowman RM, Bowen DK, Cheng EY, Gordon EJ, Chu DI, Isakova T, Yerkes EB, Chu DI. Assessment of Health Literacy and Self-reported Readiness for Transition to Adult Care Among Adolescents and Young Adults With Spina Bifida. JAMA Netw Open 2021; 4:e2127034. [PMID: 34581795 PMCID: PMC8479582 DOI: 10.1001/jamanetworkopen.2021.27034] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Health literacy has been shown to play an important role in transitions of care in adult populations, with low health literacy associated with adverse health outcomes. The role of health literacy in the transition from pediatric to adult care has been less well studied. Among adolescents and young adults with spina bifida, high rates of unsuccessful transition have been shown, but how patient health literacy affects transition readiness remains unknown. OBJECTIVE To determine whether health literacy is associated with transition readiness in adolescents and young adults with spina bifida. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study involved collection of patient-reported questionnaires between June 2019 and March 2020 at a multidisciplinary spina bifida center at a single, free-standing children's hospital. Patient demographic and clinical characteristics were obtained from medical record review. Patients were aged 12 years or older with a diagnosis of spina bifida (myelomeningocele and nonmyelomeningocele) whose primary language was English or Spanish. Data analysis was performed from October 2020 to March 2021. EXPOSURES Health literacy as assessed by the Brief Health Literacy Screening Tool. MAIN OUTCOMES AND MEASURES The primary outcome was total Transition Readiness Assessment Questionnaire (TRAQ) score, normalized into units of SD. Nested, multivariable linear regression models assessed the association between health literacy and TRAQ scores. RESULTS The TRAQ and Brief Health Literacy Screening Tool were completed by 200 individuals (median [range] age, 17.0 [12.0-31.0] years; 104 female participants [52.0%]). Most of the patients were younger than 18 years (110 participants [55.0%]) and White (136 participants [68.0%]) and had myelomeningocele (125 participants [62.5%]). The mean (SD) TRAQ score was 3.3 (1.1). Sixty-six participants (33.0%) reported inadequate health literacy, 60 participants (30.0%) reported marginal health literacy, and 74 participants (37.0%) reported adequate health literacy. In univariable analysis, health literacy, age, type of spina bifida, level of education, self-administration vs completion of the questionnaires with assistance, ambulatory status, and urinary incontinence were associated with total TRAQ score. In all nested, sequentially adjusted, multivariable models, higher health literacy remained a significant, stepwise, independent variable associated with higher TRAQ score. In the fully adjusted model, having adequate compared with inadequate health literacy was associated with an increase in normalized TRAQ score of 0.49 SD (95% CI, 0.19-0.79). CONCLUSIONS AND RELEVANCE Patient-reported transition readiness is associated with health literacy, even after adjustment for education level and other demographic and clinical factors. Developing and implementing health literacy-sensitive care programs during the transition process may improve patient transition readiness.
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Affiliation(s)
- James T. Rague
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Soojin Kim
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Josephine A. Hirsch
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Theresa Meyer
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Ilina Rosoklija
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Jill E. Larson
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Vineeta T. Swaroop
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Robin M. Bowman
- Division of Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Diana K. Bowen
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Earl Y. Cheng
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Elisa J. Gordon
- Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel I. Chu
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham
| | - Tamara Isakova
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elizabeth B. Yerkes
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - David I. Chu
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Kang HJ, Flores-Sandoval C, Law B, Sibbald S. Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence. Eval Health Prof 2021; 45:223-234. [PMID: 34409879 PMCID: PMC9446429 DOI: 10.1177/01632787211040859] [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] [Indexed: 11/16/2022]
Abstract
Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient way to capture various constructs of teamwork. This allows evaluators to better understand team functioning, areas of strength, and to identify potential areas for improvement. However, the majority of published surveys are yet to be validated. We conducted a review of psychometric evidence to identify instruments frequently used in practice and identified in the literature. The databases searched included MEDLINE, EMBASE, CINAHL, and PsycINFO. After excluding duplicates and irrelevant articles, 15 articles met the inclusion criteria for full assessment. Seven surveys were validated and most frequently identified in the literature. This review aims to facilitate the selection of instruments that are most appropriate for research and clinical practice. More research is required to develop surveys that better reflect the current reality of teamwork in our evolving health system, including a greater consideration for patient as team members. Additionally, more research is needed to encompass an increasing development of team assessment tools.
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Affiliation(s)
- Hosung Joel Kang
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Cecilia Flores-Sandoval
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada
| | - Benson Law
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Shannon Sibbald
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Department of Family Medicine, Schulich School of Dentistry and Medicine, University of Western Ontario, London, Ontario, Canada
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Sánchez-Arenas R, Doubova SV, González-Pérez MA, Pérez-Cuevas R. Factors associated with COVID-19 preventive health behaviors among the general public in Mexico City and the State of Mexico. PLoS One 2021; 16:e0254435. [PMID: 34297730 PMCID: PMC8301657 DOI: 10.1371/journal.pone.0254435] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/27/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate factors associated with COVID-19 preventive health behaviors among adults in Mexico City and the State of Mexico. Methods and findings We conducted a cross-sectional survey from June to October 2020 through a structured, internet-based questionnaire in a non-probabilistic sample of adults >18 years living in Mexico City and the State of Mexico. The independent variables included sociodemographic and clinical factors; health literacy; access to COVID-19 information; and perception of COVID-19 risk and of preventive measures’ effectiveness. The dependent variable was COVID-19 preventive health behaviors, defined as the number of preventive actions adopted by participants. The data were analyzed through multivariate negative binomial regression analysis. The survey was completed by 1,030 participants. Most participants were women (70.7%), had a high school or above level of education (98.8%), and had adequate health literacy and access to COVID-19 information. Only 18% perceived having a high susceptibility to COVID-19, though 83.8% recognized the disease’s severity and 87.1% the effectiveness of preventive measures. The median number of COVID-19 preventive actions was 13.5 (range 0–19). The factors associated with preventive health behavior were being female, of older age, a professional worker, a homemaker, or a retiree; engaging in regular physical exercise; having high health literacy and access to COVID-19 information sources; and perceiving COVID-19 as severe and preventive measures as effective. Conclusion People with high education and internet access in Mexico City and the State of Mexico reported significant engagement in COVID-19 preventive actions during the first wave of the COVID-19 pandemic.
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Affiliation(s)
- Rosalinda Sánchez-Arenas
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Svetlana V. Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
- * E-mail:
| | | | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Kingston, Jamaica
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Bremer D, Klockmann I, Jaß L, Härter M, von dem Knesebeck O, Lüdecke D. Which criteria characterize a health literate health care organization? - a scoping review on organizational health literacy. BMC Health Serv Res 2021; 21:664. [PMID: 34229685 PMCID: PMC8259028 DOI: 10.1186/s12913-021-06604-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/02/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Organizational health literacy (OHL) aims to respond to the health literacy needs of patients by improving health information and services and making them easier to understand, access, and apply. This scoping review primarily maps criteria characterizing health literate health care organizations. Secondary outcomes are the concepts and terminologies underlying these criteria as well as instruments to measure them. METHODS The review was carried out following the JBI Manual on scoping reviews. The databases CINAHL, Cochrane Library, JSTOR, PsycINFO, PubMed, Web of Science Core Collection, and Wiley Online Library were searched in July 2020. Three researchers screened the records and extracted the data. The results were synthesized systematically and descriptively. RESULTS The literature search resulted in 639 records. After removing duplicates, screening by title and abstract, and assessing full-texts for eligibility, the scoping review included 60 publications. Criteria for OHL were extracted and assigned to six main categories (with 25 subcategories). The most prevalent topic of organizational health literacy refers to communication with service users. Exemplary criteria regarding this main category are the education and information of service users, work on easy-to-understand written materials as well as oral exchange, and verifying understanding. The six main categories were defined as 1) communication with service users; 2) easy access & navigation; 3) integration & prioritization of OHL; 4) assessments & organizational development; 5) engagement & support of service users, and 6) information & qualification of staff. The criteria were based on various concepts and terminologies. Terminologies were categorized into four conceptual clusters: 1) health literacy in various social contexts; 2) health literate health care organization; 3) organizational behavior, and 4) communication in health care. 17 different assessment tools and instruments were identified. Only some of the toolkits and instruments were validated or tested in feasibility studies. CONCLUSIONS Organizational health literacy includes a significant number of distinct organizational criteria. The terminologies used in the OHL literature are heterogeneous based on a variety of concepts. A comprehensive, consensus-based conceptual framework on OHL is missing.
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Affiliation(s)
- Daniel Bremer
- Department of Medical Psychology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Izumi Klockmann
- Department of Medical Sociology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Leonie Jaß
- Department of Medical Sociology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Daniel Lüdecke
- Department of Medical Sociology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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Mialhe FL, Moraes KL, Bado FMR, Brasil VV, Sampaio HADC, Rebustini F. Psychometric properties of the adapted instrument European Health Literacy Survey Questionnaire short-short form. Rev Lat Am Enfermagem 2021; 29:e3436. [PMID: 34231791 PMCID: PMC8253353 DOI: 10.1590/1518-8345.4362.3436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. METHOD the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. RESULTS the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. CONCLUSION the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.
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Affiliation(s)
- Fábio Luiz Mialhe
- Universidade Estadual de Campinas, Faculdade de Odontologia de
Piracicaba, Piracicaba, SP, Brazil
| | | | - Fernanda Maria Rovai Bado
- Universidade Estadual de Campinas, Faculdade de Odontologia de
Piracicaba, Piracicaba, SP, Brazil
- Secretaria Municipal de Saúde, Piracicaba, SP, Brazil
| | | | | | - Flávio Rebustini
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades,
São Paulo, SP, Brazil
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["I better stay at home…"-health system decisions to support the use of routine healthcare during the COVID-19 pandemic]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:277-284. [PMID: 33580268 PMCID: PMC7880208 DOI: 10.1007/s00103-021-03282-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/14/2021] [Indexed: 12/20/2022]
Abstract
Hintergrund In der COVID-19-Pandemie ging die Versorgung nichtübertragbarer Erkrankungen zeitweise deutlich zurück, auch weil Menschen Angst vor einer Ansteckung hatten. Wir führen eine Bestandsaufnahme zur organisationalen Gesundheitskompetenz in der Regelversorgung nichtübertragbarer Erkrankungen in der ersten Welle der COVID-19-Pandemie durch und fragen: Inwiefern wurden Menschen mit gesundheitlichen Beschwerden dabei unterstützt, gesundheitskompetente Entscheidungen für oder gegen die Inanspruchnahme von Versorgungsleistungen zu treffen? Methodik Strukturierende Inhaltsanalyse der Internetpräsenzen der Mitglieder der Arbeitsgemeinschaft der Wissenschaftlich Medizinischen Fachgesellschaften (AWMF; n = 179), der kassen(zahn)ärztlichen Vereinigungen (K(Z)Ven; n = 38), ausgewählter Krankenkassen (n = 21), ausgewählter Behandlungseinrichtungen (n = 25) und überregionaler Anbieter von Gesundheitsinformationen (n = 5) zu Informationen und Angeboten zum Thema. Ergebnisse Die geprüften Internetpräsenzen informieren weitgehend rund um COVID-19, aber nur selten darüber, wie man sich bei einer (vermuteten) anderen Erkrankung in Bezug auf die Inanspruchnahme von Versorgungsleistungen verhält. 2 Portale von Anbietern von Gesundheitsinformationen, eine Krankenkasse, aber keine der KVen bieten explizite Entscheidungshilfen an. KVen weisen öfter, aber nicht durchgängig auf die generelle Möglichkeit von Videosprechstunden hin. Diskussion Für die meisten Patient*innen gab es damit keine gezielten Informationen zu dem Thema. Angesichts der Fortdauer der COVID-19-Pandemie gilt es, vorhandene vertrauenswürdige, qualitativ hochwertige Informations- und Beratungskapazitäten auszubauen und ihre Bekanntheit zu erhöhen, um gesundheitskompetente Entscheidungen auch in der Pandemie zu ermöglichen.
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Anderson S. Examining the relationship between patient experience and readmission rates: A profile deviation analysis. Health Serv Manage Res 2021; 34:234-240. [PMID: 33410722 DOI: 10.1177/0951484820987499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study is to examine the relationship between patient experience and readmissions by exploring whether the deviation from an ideal patient-experience profile is linked to higher readmissions. Using patient experience scores, hospitals were assigned to one of four groups based on their deviation from an ideal profile. The readmission rates for the four groups were analyzed using Profile Deviation, ANOVA, and Least Significant Difference. Patient experience is a central component of hospital performance, specifically, readmission rates. Findings indicate as patient experience scores decrease, profile deviation increases, with a corresponding increase in readmission rate. This study provides empirical support for administrators focusing on patient experience as part of an overall strategy for reducing hospital readmissions. The key feature of this research is the use of a profile deviation methodology to examine the relationship between patient experience and readmission rates.
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Affiliation(s)
- Sidney Anderson
- 7174Texas State University, McCoy College of Business, San Marcos, TX, USA
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Abstract
Abstract
Inefficient health service utilisation puts pressure on health systems and may cause such negative individual consequences as over-medicalisation or exacerbation of health problems. While previous research has considered the key relevance of health literacy (HL) for efficient use of health services, the results of that research have been somewhat inconclusive. Possible reasons for diverging results of prior research may be grounded in different measurement concepts of HL and the disregarding of age-specific effects. This paper analyses the association between individuals’ HL typology based on a two-dimensional concept and indicators of health service utilisation measured by registered data covering the number of doctor visits and medication costs. Our results confirm a significant interaction effect between age and HL typology. The age-related increase in health service utilisation is strongest for individuals with the combination of high subjective HL but low health-related knowledge, while the smallest increase is for individuals with the constellation of high subjective HL combined with high health-related knowledge. Individuals with specific constellations of HL (that is, individuals with high subjective HL but low health-related knowledge) are associated with reduced service utilisation in younger ages but higher service utilisation in later stages of life, compared to other groups. These results are likely to be attributed to a higher external health-related locus of control and more traditional paternalistic role expectations in such groups.
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Vianello FA, Zaccagnini F, Pinato C, Maculan P, Buja A. Health status of female Moldovan migrants to Italy by health literacy level and age group: a descriptive study. BMC Public Health 2020; 20:1502. [PMID: 33008354 PMCID: PMC7532569 DOI: 10.1186/s12889-020-09582-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/21/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Migration flows from Eastern Europe to Italy have been large and continue to grow. The purpose of this study was to examine the health status of a population of Moldovan migrant women, and their access to health care services in northern Italy, by age group and health literacy level. METHODS We administered an ad-hoc questionnaire to adult Moldovan women. A bivariate analysis was conducted to test the association between health literacy and age groups with other variables (lifestyles, symptoms and diseases, access to health services). A stepwise logistic regression analysis was run to test the association between access to primary care and health literacy. Moreover, the study compare Moldovan women data with a sample of Italian women of the same age range living in North-Eastern region. RESULTS Our sample included 170 Moldovan women (aged 46.5 ± 12.3) in five occupational categories: home care workers (28.2%); cleaners (27.1%); health care workers (5.9%); other occupations (28.8%); and unemployed (10%). Active smokers were twice as prevalent among the women with a low health literacy. Health literacy level also determined access to primary healthcare services. For all age groups, the Moldovan sample reported a higher prevalence of allergies, lumbar disorders and depression than the Italian controls. CONCLUSIONS The reported prevalence of some diseases was higher among Moldovan migrant women than among Italian resident women. Health literacy was associated with the migrant women's lifestyle and the use of primary health care services, as previously seen for the autochthonous population.
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Affiliation(s)
- Francesca Alice Vianello
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Piazza Capitaniato 3, 35129, Padova, Italy
| | - Federica Zaccagnini
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Piazza Capitaniato 3, 35129, Padova, Italy
| | - Carlo Pinato
- Melanoma and Sarcoma Unit, Veneto Institute of Oncology, IOV-IRCCS, via Gattamelata 64, 35128, Padova, Italy
| | - Pietro Maculan
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Via Loredan 18, 35128, Padova, Italy
| | - Alessandra Buja
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Via Loredan 18, 35128, Padova, Italy.
- Laboratory for Assessing Health Care Services and Health Promotion, Hygiene and Public Health Unit, Dept. of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padova, Via Loredan, 18, 35131, Padova, Italy.
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Estrella ML, Allen-Meares P. Tools to Measure Health Literacy among US African Americans and Hispanics/Latinos with Type 2 Diabetes: A Scoping Review of the Literature. PATIENT EDUCATION AND COUNSELING 2020; 103:2155-2165. [PMID: 32451221 PMCID: PMC7508870 DOI: 10.1016/j.pec.2020.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/27/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To provide an overview of the health literacy tools that have been validated in samples of African Americans and Hispanics/Latinos with type 2 diabetes, growing segments of the US population. METHODS Following PRISMA guidelines, three electronic databases were searched. The following inclusion criteria were used: peer-reviewed research; examined validity of a health literacy tool; and included US African American and/or Hispanic/Latino adults with type 2 diabetes. RESULTS Sixteen studies were selected; none exclusively included African Americans while 3 exclusively included Hispanics/Latinos in the sample. Seventeen health literacy tools were identified. Among African Americans, 2 health literacy screeners, 2 diabetes knowledge, and 3 numeracy tools have been validated. Among Hispanics/Latinos, 1 health literacy screener, 1 diabetes knowledge, and 1 numeracy tool have been validated. However, cross-cultural adaptation principles were rarely considered in the development and validation of these tools. CONCLUSION In those with type 2 diabetes, future studies should investigate the validity of health literacy screeners among English-speaking Hispanics/Latinos and general health literacy tools among African Americans and Hispanics/Latinos. Evidence on the validity of diabetes knowledge and numeracy tools was mixed across studies. PRACTICE IMPLICATIONS Findings can inform the selection of culturally-appropriate health literacy tools in clinical and research settings.
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Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk St., Chicago, IL 60612, USA.
| | - Paula Allen-Meares
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk St., Chicago, IL 60612, USA; Office of Health Literacy, University of Illinois at Chicago, 808 S. Wood Street, Chicago, IL 60612, USA.
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Okan O, Bollweg TM, Berens EM, Hurrelmann K, Bauer U, Schaeffer D. Coronavirus-Related Health Literacy: A Cross-Sectional Study in Adults during the COVID-19 Infodemic in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5503. [PMID: 32751484 PMCID: PMC7432052 DOI: 10.3390/ijerph17155503] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 12/15/2022]
Abstract
There is an "infodemic" associated with the COVID-19 pandemic-an overabundance of valid and invalid information. Health literacy is the ability to access, understand, appraise, and apply health information, making it crucial for navigating coronavirus and COVID-19 information environments. A cross-sectional representative study of participants ≥ 16 years in Germany was conducted using an online survey. A coronavirus-related health literacy measure was developed (HLS-COVID-Q22). Internal consistency was very high (α = 0.940; ρ = 0.891) and construct validity suggests a sufficient model fit, making HLS-COVID-Q22 a feasible tool for assessing coronavirus-related health literacy in population surveys. While 49.9% of our sample had sufficient levels of coronavirus-related health literacy, 50.1% had "problematic" (15.2%) or "inadequate" (34.9%) levels. Although the overall level of health literacy is high, a vast number of participants report difficulties dealing with coronavirus and COVID-19 information. The participants felt well informed about coronavirus, but 47.8% reported having difficulties judging whether they could trust media information on COVID-19. Confusion about coronavirus information was significantly higher among those who had lower health literacy. This calls for targeted public information campaigns and promotion of population-based health literacy for better navigation of information environments during the infodemic, identification of disinformation, and decision-making based on reliable and trustworthy information.
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Affiliation(s)
- Orkan Okan
- Interdisciplinary Centre for Health Literacy Research, Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany
| | - Torsten Michael Bollweg
- Centre for Prevention and Intervention in Childhood and Adolescence, Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany;
| | - Eva-Maria Berens
- School of Public Health, Interdisciplinary Centre for Health Literacy Research, Bielefeld University, 33615 Bielefeld, Germany;
| | - Klaus Hurrelmann
- Department of Public Health and Education, Hertie School of Governance, 10117 Berlin, Germany;
| | - Ullrich Bauer
- Interdisciplinary Centre for Health Literacy Research, Centre for Prevention and Intervention in Childhood and Adolescence, Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany;
| | - Doris Schaeffer
- Interdisciplinary Centre for Health Literacy Research, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany;
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Landi S, Ivaldi E, Testi A. The role of regional health systems on the waiting time inequalities in health care services: Evidences from Italy. Health Serv Manage Res 2020; 34:136-147. [PMID: 32475173 DOI: 10.1177/0951484820928302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Inequalities in effective access to healthcare are present among countries and within the same country. Despite in Italy exist the principle of equity in access to health system, there are evidence of different access rates in the form of unequal waiting time within the country. Waiting times are an instruments to ration healthcare services dealing with resource scarsity. Theoretically, it is a fair tool because waiting times should depend only on health needs and not on the ability to pay. However, a growing literature has pointed out that belonging to a particular socioeconomic status leads to waiting times inequalities for healthcare services. Many countries have socioeconomic disparities among regions, and healthcare organizations need to take into account these differences. The increasing power of Regional Health Authorities in decentralized health systems, as in the case of Italy, has generated different organizational ways to provide health care, possibly leading to different access rates in the form of unequal waiting time within the country. This paper aims to understand if the administrative area (Regional Health Authorities) in charge of health services affects waiting times lowering or strengthening health care access inequalities. Using a series of logistic regression models, this work suggests the presence of two vectors: socioeconomic inequalities and regional inequalities. Health organizations need to implement different kinds of answers for each vectors of inequalities.
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Affiliation(s)
- Stefano Landi
- Department of Management, Università Ca' Foscari, Venezia, Italy
| | - Enrico Ivaldi
- Department of Statistics, University of Genoa Faculty of Political Science, Genova, Italy
| | - Angela Testi
- Department of Economics, University of Genoa Faculty of Economics, Genova, Italy
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Anwar MA, Barrera-Machuca AA, Calderon N, Wang W, Tausan D, Vayali T, Wishart D, Cullis P, Fraser R. Value-based healthcare delivery through metabolomics-based personalized health platform. Healthc Manage Forum 2020; 33:126-134. [PMID: 32077764 DOI: 10.1177/0840470420904733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Type 2 diabetes is routinely identified in clinical practice by tests that rely on a hyperglycemic index. However, people at risk for developing type 2 diabetes may not present with hyperglycemia. We identified several underlying risks for type 2 diabetes, insulin resistance, and associated co-morbidities, using a liquid chromatography mass spectrometry-based analysis of blood metabolites, in participants with normoglycemia and no clinical symptoms. Personalized lifestyle recommendations, including diet, exercise, and nutritional supplement recommendations, were conveyed to these participants by a web-based platform, and after 100 days of following their recommendations, these participants reported reductions in the health risks associated with type 2 diabetes and associated diseases. Our comprehensive metabolite-based assay can be used for type 2 diabetes risk stratification, and our personalized lifestyle recommendation system could be deployed as a preventative treatment option to improve health outcomes, reduce the incidence of chronic disease, and live healthier lives in an evidence-based way.
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Affiliation(s)
| | - Aldo A Barrera-Machuca
- Molecular You Corporation, Vancouver, British Columbia, Canada
- School of Interactive Arts and Technology (SIAT), Simon Fraser University, Burnaby, British Columbia, Canada
| | - Nadya Calderon
- Molecular You Corporation, Vancouver, British Columbia, Canada
- School of Interactive Arts and Technology (SIAT), Simon Fraser University, Burnaby, British Columbia, Canada
| | - Windy Wang
- Molecular You Corporation, Vancouver, British Columbia, Canada
| | - Daniel Tausan
- Molecular You Corporation, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thara Vayali
- Molecular You Corporation, Vancouver, British Columbia, Canada
| | - David Wishart
- Molecular You Corporation, Vancouver, British Columbia, Canada
- Department of Biological Sciences and Computing Science, University of Alberta, Edmonton, Alberta, Canada
| | - Pieter Cullis
- Molecular You Corporation, Vancouver, British Columbia, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Fraser
- Molecular You Corporation, Vancouver, British Columbia, Canada
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Cavallone M, Palumbo R. Debunking the myth of industry 4.0 in health care: insights from a systematic literature review. TQM JOURNAL 2020. [DOI: 10.1108/tqm-10-2019-0245] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIndustry 4.0, artificial intelligence and digitalization have got a momentum in health care. However, scholars and practitioners do not agree on their implications on health services' quality and effectiveness. The article aims at shedding light on the applications, aftermaths and drawbacks of industry 4.0 in health care, summarizing the state of the art.Design/methodology/approachA systematic literature review was undertaken. We arranged an ad hoc research design, which was tailored to the study purposes. Three citation databases were queried. We collected 1,194 scientific papers which were carefully considered for inclusion in this systematic literature review. After three rounds of analysis, 40 papers were taken into consideration.FindingsIndustry 4.0, artificial intelligence and digitalization are revolutionizing the design and the delivery of care. They are expected to enhance health services' quality and effectiveness, paving the way for more direct patient–provider relationships. In addition, they have been argued to allow a more appropriate use of available resources. There is a dark side of health care 4.0 involving both management and ethical issues.Research limitations/implicationsIndustry 4.0 in health care should not be conceived as a self-nourishing innovation; rather, it needs to be carefully steered at both the policy and management levels. On the one hand, comprehensive governance models are required to realize the full potential of health 4.0. On the other hand, the drawbacks of industry 4.0 should be timely recognized and thoroughly addressed.Originality/valueThe article contextualizes the state of the art of industry 4.0 in the health care context, providing some insights for further conceptual and empirical developments.
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Allen-Meares P, Lowry B, Estrella ML, Mansuri S. Health Literacy Barriers in the Health Care System: Barriers and Opportunities for the Profession. HEALTH & SOCIAL WORK 2020; 45:62-64. [PMID: 31993624 PMCID: PMC8453407 DOI: 10.1093/hsw/hlz034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/24/2019] [Accepted: 05/14/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Paula Allen-Meares
- Health Literacy and Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago
| | - Brienne Lowry
- Health Literacy and Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago
| | - Mayra L Estrella
- Health Literacy and Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago
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Palumbo R, Annarumma C, Manna R, Musella M, Adinolfi P. Improving quality by involving patient. The role of health literacy in influencing patients’ behaviors. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1620458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rocco Palumbo
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| | - Carmela Annarumma
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| | - Rosalba Manna
- Department of Business and Quantitative Studies, University of Naples ‘Parthenope’, Naples, Italy
| | - Marco Musella
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| | - Paola Adinolfi
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
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Farmanova E, Bonneville L, Bouchard L. Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 55:46958018757848. [PMID: 29569968 PMCID: PMC5871044 DOI: 10.1177/0046958018757848] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey.
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Doubova SV, Infante C, Villagrana-Gutiérrez GL, Martínez-Vega IP, Pérez-Cuevas R. Adequate health literacy is associated with better health outcomes in people with type 2 diabetes in Mexico. PSYCHOL HEALTH MED 2019; 24:853-865. [PMID: 30706719 DOI: 10.1080/13548506.2019.1574356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study evaluates the health literacy of people with type 2 diabetes and its association with health outcomes. We conducted a cross-sectional survey in two family medicine clinics of the Mexican Institute of Social Security that included 778 diabetic patients >19 years of age. The Spanish version of the European Health Literacy questionnaire served to measure health literacy. Multiple logistic regressions were performed to determine the association between the independent variable (health literacy) and dependent variables (good self-rated health, glycemic control, and diabetes-related hospitalizations) after controlling for conceptually relevant patient's characteristics. Only 17.6% of patients had adequate health literacy; while, the remaining percentage showed inadequate (23%), or problematic (59.4%) health literacy. After adjusting for the patients' characteristics, those with adequate health literacy had 4.66 (95%CI: 2.26-9.61) times the odds of good self-rated health compared to those with inadequate literacy. Patients with adequate health literacy had 0.65 (95%CI: 0.49-0.86) times the odds of hospitalization due to diabetes compared to those with inadequate literacy. Compared to inadequate health literacy, problematic literacy was associated with increased odds of glycemic control. In conclusion, healthcare providers should actively address the health literacy needs of patients to increase good self-rated health, glucose control and reduce hospitalizations.
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Affiliation(s)
- Svetlana V Doubova
- a Epidemiology and Health Services Research Unit , CMN Siglo XXI, Mexican Institute of Social Security , Mexico City , Mexico
| | - Claudia Infante
- b Instituto de Investigaciones Sociales , Universidad Nacional Autónoma de México. Circuito Mario de la Cueva s/n. Ciudad de la Investigación en Humanidades, Ciudad Universitaria , Mexico City , Mexico
| | | | - Ingrid Patricia Martínez-Vega
- a Epidemiology and Health Services Research Unit , CMN Siglo XXI, Mexican Institute of Social Security , Mexico City , Mexico
| | - Ricardo Pérez-Cuevas
- d National Institute of Public Health , Health Systems Research Center , Cuernavaca City , Mexico
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Cameron FJ, Moore B, Gillam L. Two's company, is three a crowd? Ethical cognition in decision making and the role of industry third parties in pediatric diabetes care. Pediatr Diabetes 2019; 20:15-22. [PMID: 30311720 DOI: 10.1111/pedi.12786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/18/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022] Open
Abstract
Families of children with diabetes increasingly obtain health information from a variety of sources. Doctor-patient relationships have accordingly become more fluid and dynamic with input from other parties. These outside parties include representatives from the diabetes health care industry-industry third parties (ITPs). This review is an exploration of the ethical principles and cognitive processes involved when doctors and patients negotiate around health care practices and the role of ITPs in that dialogue. Ethical principles of conflicts of interest, beneficence (act in the best interests of the patient), non-maleficence (act so as to do no harm) and justice (act so as to allocate resources fairly or justly) are relevant considerations. Reflexive and analytic thinking and various cognitive biases also play a significant part in clinical decision making. A complex case example is analyzed to highlight a process of ethical cognition in decision making to ensure high-value care and optimal patient outcomes.
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Affiliation(s)
- Fergus J Cameron
- Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Bryanna Moore
- Children's Mercy Bioethics Center, Kansas City, Missouri.,Children's Bioethics Centre, Royal Children's Hospital, Melbourne, Australia
| | - Lynn Gillam
- Children's Bioethics Centre, Royal Children's Hospital, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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50
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Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries. SUSTAINABILITY 2018. [DOI: 10.3390/su10124439] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.
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