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Ye X, Liu R, Che S, Zhang Y, Wu J, Jiang Y, Luo X, Xie C. Role perceptions and experiences of adult children in remote glucose management for older parents with type 2 diabetes mellitus: a qualitative study. BMC Geriatr 2024; 24:653. [PMID: 39097684 PMCID: PMC11297597 DOI: 10.1186/s12877-024-05224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 07/15/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND With the advent of the smart phone era, managing blood glucose at home through apps will become more common for older individuals with diabetes. Adult children play important roles in glucose management of older parents. Few studies have explored how adult children really feel about engaging in the glucose management of their older parents with type 2 diabetes mellitus (T2DM) through mobile apps. This study provides insights into the role perceptions and experiences of adult children of older parents with T2DM participating in glucose management through mobile apps. METHODS In this qualitative study, 16 adult children of older parents with T2DM, who had used mobile apps to manage blood glucose for 6 months, were recruited through purposive sampling. Semi-structured, in-depth, face-to-face interviews to explore their role perceptions and experiences in remotely managing their older parents' blood glucose were conducted. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed to ensure rigor in the study. The data collected were analyzed by applying Colaizzi's seven-step qualitative analysis method. RESULTS Six themes and eight sub-themes were identified in this study. Adult children's perceived roles in glucose management of older parents with T2DM through mobile apps could be categorized into four themes: health decision-maker, remote supervisor, health educator and emotional supporter. The experiences of participation could be categorized into two themes: facilitators to participation and barriers to participation. CONCLUSION Some barriers existed for adult children of older parents with T2DM participating in glucose management through mobile apps; however, the findings of this study were generally positive. It was beneficial and feasible for adult children to co-manage the blood glucose of older parents. Co-managing blood glucose levels in older parents with T2DM can enhance both adherence rates and confidence in managing blood glucose effectively.
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Affiliation(s)
- Xiang Ye
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Rongzhen Liu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Shangjie Che
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yanqun Zhang
- Department of Emergency, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Jiaqi Wu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Ya Jiang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Xiangrong Luo
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Cuihua Xie
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China.
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Wang SL, Shien TWH, Chen TH, Hsiao PN, Hsiao SM, Kung LF, Hwang SJ, Chiu YW, Tsai YC, Chang JM. The factors of perceived disease knowledge and self-care behavior in type 2 diabetic patients with chronic kidney disease: A cross-sectional study. Medicine (Baltimore) 2023; 102:e34791. [PMID: 37933073 PMCID: PMC10627621 DOI: 10.1097/md.0000000000034791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/26/2023] [Indexed: 11/08/2023] Open
Abstract
Chronic kidney diseases (CKD) is an important public health issue worldwide, and diabetes mellitus is the main cause of CKD. Having sufficient disease knowledge and good self-care behavior both help to prevent the progression of diabetes mellitus and CKD. This cross-sectional study enrolled 181 type 2 diabetic patients with CKD from July 2017 to October 2017. Perceived Kidney Knowledge survey and structured questionnaires of self-care behavior were used to measure perceived disease knowledge and CKD Self-Care (CKDSC) scales respectively with the determinants analyzed by linear regression. Meanwhile, socio-demographic information, kidney function and laboratory data were collected. Of 181 enrolled patients, the mean age was 66.8 ± 9.7 years, 59.1% were male and the mean estimated glomerular filtration rate was 33.1 ± 23.1 mL/min/1.73 m2. The mean scores of CKDSC and perceived disease knowledge were 63.2 and 22.4, respectively. High scores of disease knowledge were significantly correlated with low glycated hemoglobin (P = .03) and high scores of overall self-care behavior (P = .03) and aspects of self-care behavior, including diet (P = .003), exercise (P = .02), and home blood pressure monitoring (P = .04). The relationship between young age and high scores of disease knowledge was found (P = .001); however, old age was significantly associated with high scores of overall self-care behavior (P < .001) while additionally, married patients had high scores of regular medication behavior (P = .03). Our findings identified the significant factors correlated with disease knowledge and self-care behavior in type 2 diabetic patients with CKD. Healthcare givers should establish personalized health education plans to improve perceived disease knowledge and self-care behavior.
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Affiliation(s)
- Shu-Li Wang
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Tzu-Hui Chen
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Ni Hsiao
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Ming Hsiao
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lan-Fang Kung
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- Doctoral Degree Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Wen Chiu
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chun Tsai
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of General Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Liquid Biopsy and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung M University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Selvakumar D, Sivanandy P, Ingle PV, Theivasigamani K. Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1401. [PMID: 37629691 PMCID: PMC10456640 DOI: 10.3390/medicina59081401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 08/27/2023]
Abstract
A prospective study was conducted to investigate the impact of treatment burden and health literacy on medication adherence among older adults with multiple chronic conditions (MCC) and to explore the potential moderating effects of demographic and clinical factors. Face-to-face structured interviews were conducted among older adults aged 60 and above using the Burden of Treatment Questionnaire (TBQ-15), Short Form Health Literacy Questionnaire (HLS-SF12), and Malaysia Medication Adherence Assessment Tool (MyMAAT). This study included 346 older adults aged 60 years and above with two or more chronic conditions (n = 346). Hypertension (30.2%), hyperlipidemia (24.0%), and diabetes (18.0%) were the most reported chronic conditions among participants. The mean score of treatment burden was 53.4 (SD = 28.2), indicating an acceptable burden of treatment. The mean score of health literacy was 16.4 (SD = 12.6), indicating a limited health literacy level among participants; meanwhile, the mean score of medication adherence was 32.6 (SD = 12.3), indicating medication non-adherence among participants. Medication adherence was significantly correlated with treatment burden (r = -0.22, p < 0.0001), health literacy (r = 0.36, p < 0.0001), number of chronic conditions (r = -0.23, p < 0.0001), and age (r = -0.11, p < 0.05). The study findings emphasize that multimorbid older adults with high treatment burdens and low health literacy are more likely to have poor medication adherence. This underscores the importance for clinicians to address these factors in order to improve medication adherence among older adults with multiple chronic conditions (MCC).
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Affiliation(s)
- Dharrshinee Selvakumar
- School of Postgraduate Studies, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Palanisamy Sivanandy
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Pravinkumar Vishwanath Ingle
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
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Castro E, Kelly NR, Budd EL. Healthcare provider-delivered healthy eating recommendations among U.S. Hispanic/Latino adults. Prev Med Rep 2023; 33:102216. [PMID: 37223558 PMCID: PMC10201819 DOI: 10.1016/j.pmedr.2023.102216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/25/2023] Open
Abstract
U.S. Hispanic/Latino adults are at heightened risk for developing diet-related chronic diseases. Healthcare provider recommendations have shown to be effective for promoting health behavior change, but little is known about healthcare provider healthy eating recommendations among Hispanics/Latinos. To investigate the prevalence of and adherence to healthcare provider-delivered healthy eating recommendations among a U.S. sample of Hispanic/Latino adults, participants (N = 798; M = 39.6±15.1 years; 52% Mexican/Mexican American) were recruited via Qualtrics Panels to complete an online survey in January 2018. Most (61%) participants reported having ever received a healthcare provider-delivered dietary recommendation. Higher body mass index (AME = 0.015 [0.009, 0.021]) and having a chronic health condition (AME = 0.484 [0.398, 0.571]) were positively associated with receiving a dietary recommendation while age (AME = -0.004 [-0.007, -0.001]) and English proficiency (AME = -0.086 [-0.154, -0.018]) were negatively associated. Participants reported adhering regularly (49.7%) and sometimes (44.4%) to recommendations. There were no significant associations with patient characteristics and adherence to a healthcare provider-delivered dietary recommendation. Findings inform next steps toward increasing implementation of brief dietary counseling from healthcare providers to support prevention and management of chronic diseases among this under-studied population.
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Affiliation(s)
- Esmeralda Castro
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Elizabeth L. Budd
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
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Poureslami I, Hohn RE, Kopec JA, Sawatzky R, Aaron SD, Gupta S, Goldstein R, Boulet LP, Tregobov N, Shum J. Evaluation of a New Performance-Based Health Literacy Measurement Tool for Individuals With Chronic Airways Disease. Respir Care 2023; 68:638-648. [PMID: 36411057 PMCID: PMC10171345 DOI: 10.4187/respcare.10441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low health literacy is a global challenge. Health literacy is positively correlated with chronic airways disease desirable outcomes. Despite the importance of health literacy in disease management, current health literacy measurement tools are suboptimal. As part of a multi-stage project to develop a performance-based, disease-specific Vancouver Airways Health Literacy Tool (VAHLT) for individuals with chronic airways disease, this study assessed the relationships between the VAHLT scores and characteristics of patients with chronic airways disease. The primary aim of the study was to provide preliminary evidence of construct validity of the VAHLT. METHODS A cross-sectional study design was applied. Study subjects were recruited from 6 specialty care clinics to complete the VAHLT measurement tool. Demographic and clinical data, including quality of life and disease control, were collected via validated questionnaires. The study subjects also completed a spirometry test. Inferential analysis was conducted by using mean difference testing and correlational methods. RESULTS A total of 320 subjects were recruited, and, after imputing missing data, 315 were ultimately analyzed. The subjects were predominantly women (61%), white (83%), had a post-high-school education (74%), and a mean ± SD age of 65.2 ± 13.2 y. Age was significantly negatively correlated with the VAHLT scores (P = .004); the subjects with a post-high school education had significantly higher VAHLT scores than those with a high school education or less (P < .001). No significant sex or ethnicity related differences in VAHLT scores were observed. For clinical outcomes, no significant differences were found between the VAHLT scores and disease severity or measures of quality of life and asthma control. CONCLUSIONS We report a chronic airways disease-specific health literacy measurement tool developed with the involvement of patients and professionals. Age and education were highly correlated with health literacy, which emphasizes the importance of addressing these factors in health literacy interventions among patients with chronic airways disease.
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Affiliation(s)
- Iraj Poureslami
- Division of Respiratory Medicine, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
- Canadian Multicultural Health Promotion Society, Burnaby, British Columbia, Canada
| | - Ric E Hohn
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jacek A Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rick Sawatzky
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Shawn D Aaron
- Division of Respiratory Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Samir Gupta
- Division of Respiratory Medicine, Department of Medicine, University of Toronto, Unity Health, Toronto, Ontario Canada
| | - Roger Goldstein
- Division of Respiratory Medicine, Department of Medicine, West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
| | - Louis-Philippe Boulet
- Division of Respiratory Medicine, Department of Medicine, Laval University, Quebec, Quebec, Canada
| | - Noah Tregobov
- Division of Respiratory Medicine, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
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Melariri HI, Kalinda C, Chimbari MJ. Patients' views on health promotion and disease prevention services provided by healthcare workers in a South African tertiary hospital. BMC Health Serv Res 2023; 23:368. [PMID: 37061700 PMCID: PMC10105350 DOI: 10.1186/s12913-023-09351-5] [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: 01/11/2022] [Accepted: 05/13/2022] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Patients' views and experiences in healthcare institutions provide a means of assessing the quality of services patients receive from healthcare workers (HCWs). However, the views of patients on the health promotion (HP) and disease prevention (DP) services offered by HCWs and the delivery mode have not been adequately studied. AIM This study assessed the views of patients on HP and DP services provided by various categories of HCWs. SETTING The study was conducted at a tertiary hospital in the Nelson Mandela Bay Municipality, South Africa. METHOD An exploratory cross-sectional study was conducted among 500 patients. The questionnaire elicited responses from patients regarding the HP and DP services received from the different cadres of HCWs at three different admission phases: pre-admission phase (PAP), admission phase (ADP), and post-admission phase (POP). Descriptive, bivariate, and multivariate analysis was conducted. RESULTS In the PAP, most patients (83.33%, n = 5; 87.85%, n = 217; and 76.14%, n = 150) seen by the rehabilitation health workers, medical doctors, and nurses respectively were empowered to manage their health. Patients attended to by nurses were 0.45 (95% CI 0.27-0.74) times less likely than those attended to by medical doctors to receive information that that will help them address the physical and environmental needs. In the ADP, patients attended to by nurses were less likely, compared to those attended to by medical doctors to be empowered to have good control over their health. In the POP, patients attended to by nurses are more likely to have their health behaviours change for better compared to those not seen by any HCW. CONCLUSION Patients attending tertiary hospital received greater HP and DP services during the PAP and ADP of patient care. Greatest influence for behavioural change of patients on HP and DP were achieved from the medical doctors, nurses and rehabilitation service staff. Improving structural factors may prove beneficial in enhancing patients' experience from all HCW groups and phases of patient care.
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Affiliation(s)
- Herbert I Melariri
- College of Health Sciences, Disipline of Public Health Medicine, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa.
- Eastern Cape Department of Health, Port Elizabeth Provincial Hospital, Buckingham Rd, Mount Croix, Gqeberha, 6001, South Africa.
| | - Chester Kalinda
- College of Health Sciences, Disipline of Public Health Medicine, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa
- University of Global Health Equity (UGHE), Bill and Joyce Cummings Institute of Global Health, PO Box 6955, Kigali, 20093, Rwanda
| | - Moses J Chimbari
- College of Health Sciences, Disipline of Public Health Medicine, University of KwaZulu-Natal, Howard College Campus, Durban, 4041, South Africa
- Great Zimbabwe University, PO Box 1235, Masvingo, Zimbabwe
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Zhao Q, Yu X, Feng Y, Zhao Y, Lu J, Guo Y, Li X. Patients' and family members' knowledge, attitudes and perceived family support for SMBG in type 2 diabetes: a fuzzy-set qualitative comparative analysis. BMJ Open 2022; 12:e063587. [PMID: 36600335 PMCID: PMC9743366 DOI: 10.1136/bmjopen-2022-063587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIMS AND OBJECTIVES To examine the combined effects of the patient's and family members' knowledge, attitudes and perceived family support on self-monitoring of blood glucose (SMBG) behaviour of patients with type 2 diabetes. DESIGN A cross-sectional design using the framework of knowledge-attitude-behaviour (KAB) combined with family support. SETTING Shanghai, China. PARTICIPANTS Seventy type 2 diabetes patient-family member dyads recruited from 26 residential committees in Shanghai were investigated. Twenty-three health providers were interviewed. PRIMARY OUTCOME MEASURES The knowledge, attitudes and perceived family support of patients' and their family members' data were measured through scales. Combined effects were analysed by a fuzzy-set qualitative comparative analysis (fsQCA) using fsQCA V.3.0. Other analyses and calculations were performed by STATA V.14.0. RESULTS SMBG was very poor (20%), and behaviour was characterised by 'multiple complications,' and 'all paths lead to the same destination' for patients. There were two solution paths toward patients' SMBG (solution coverage=0.4239, solution consistency=0.7604). One path was the combination of 'patients with low risk perception, the patients' and family members' perceived negative support', the other was the combination of 'patients with high risk perception, the patients' perceived negative support'. In both paths, basic knowledge serves as an auxiliary condition. CONCLUSION The study revealed that for patients with high and low risk perceptions that are relatively difficult to change, we could strengthen family support to achieve the desired SMBG behaviour. Knowledge is not a prerequisite to achieving SMBG. Moreover, negative family support plays a crucial role. Perceived family support by patients is more important than perceived family support by family members, which suggests that family members should improve support for patients so that the patients can perceive more family support.
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Affiliation(s)
- Qian Zhao
- Department of Health Policy and Management, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
| | - Xinying Yu
- Department of Health Policy and Management, Fudan University, Shanghai, China
| | - Yuheng Feng
- Department of Health Policy and Management, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
| | - Yuxi Zhao
- Department of Health Policy and Management, Fudan University, Shanghai, China
| | - Jun Lu
- Department of Health Policy and Management, Fudan University, Shanghai, China
| | - Ying Guo
- Wusong Center of Baoshan District, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Xiaohong Li
- Department of Health Policy and Management, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
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Nguyen H, Doherty KV, Eccleston CEA, Bindoff A, Tierney L, Mason R, Robinson A, Vickers J, McInerney F. Consumer Access, Appraisal, and Application of Services and Information for Dementia (CAAASI-Dem): a validation study. Aging Ment Health 2022; 26:2489-2495. [PMID: 34669522 DOI: 10.1080/13607863.2021.1991277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: The Consumer Access, Appraisal, and Application of Services and Information for Dementia (CAAASI-Dem) was developed to examine individuals' self-assessed confidence in their ability to access, appraise and use dementia services and information. The CAAASI-Dem is the only tool to date to measure this crucial component of dementia literacy. This study was designed to validate its structural validity.Method: Data was collected from 3277 participants enrolled in an on-line dementia course. The five-factor structure of the CAAASI-Dem, which was derived from a previous exploratory factor analysis, was evaluated using confirmatory factor analysis. Internal reliability, convergent and divergent validity, and known-groups validity were assessed. Results: The five-factor model demonstrated good fit with the observed data with the removal of 2 items and movement of 1 item across the factors. The resultant 24-item five-factor CAAASI-Dem showed very good sub-scale internal reliability and satisfactory convergent and divergent validity. There was good discrimination between groups of participants with different levels of care experience.Conclusion: The results provided evidence for the 24-item CAAASI-Dem as a valid and reliable five-dimensional scale. Limitations of the study are discussed, and recommendations are made for future research and practice.
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Affiliation(s)
- Hoang Nguyen
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | | | - Claire E A Eccleston
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Aidan Bindoff
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Laura Tierney
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Ron Mason
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Andrew Robinson
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - James Vickers
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Fran McInerney
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, TAS, Australia
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Atoku AC, Nekaka R, Kagoya EK, Ssenyonga LVN, Iramiot JS, Tegu C. Psycho-social challenges faced by caretakers of children and adolescents aged 0-19 years with sickle cell disease admitted in a tertiary hospital in Eastern Uganda. J Pediatr Nurs 2022; 69:e21-e31. [PMID: 36463013 DOI: 10.1016/j.pedn.2022.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Families of children and adolescents living with sickle cell disease face several challenges ranging from psycho-social to social-economic challenges. This study aimed to explore psycho-social challenges experienced by caretakers of children and adolescents aged 0-19 years with SCD and the various coping mechanisms. METHODS A mixed-methods cross-sectional study was carried out among caregivers of children with SCD who were admitted to the pediatric wards of the Mbale Regional Referral Hospital from September 2019 to November 2019. A total of 333 participants were interviewed using a pretested questionnaire and 11 in-depth interviews were conducted. RESULTS Most participants 285(85.59%) reported that they experienced psychological challenges and almost all the participants in this study 297(89.19%) experienced social challenges during the care of their patients. Only 36(10.81%) reported not experiencing any social challenges. Almost all the participants reported coping with the situation in various ways of which, 296(88.89%) used acceptance, 9(2.7%) still lived in denial, while 9(2.7%) used talking with others and getting counseled to reduce the intensity of the feelings experienced. Three themes were generated from the in-depth interviews; knowledge of the child's health condition; common symptoms and care, the experience of psycho-social challenges, and coping strategies. CONCLUSION Sickle cell disease has affected two sets of people; the people living with the disease and those who are caring for their loved ones. Being conscious of this will help health practitioners to be more empathetic to patients and caregivers when treating people living with sickle cell disease. The biggest proportion of caretakers of children and adolescents 0-19 years experienced psycho-social challenges. The main coping strategy used by the caretakers was acceptance.
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Affiliation(s)
| | - Rebecca Nekaka
- Department of Community Health, Division of Community Based Education and Research Services, Faculty of Health Sciences, Busitema University, Uganda
| | - Enid Kawala Kagoya
- Department of Community Health, Division of Community Based Education and Research Services, Faculty of Health Sciences, Busitema University, Uganda
| | - Lydia V N Ssenyonga
- Department of Nursing, Faculty of Health Sciences, Busitema University, Uganda
| | - Jacob Stanley Iramiot
- Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Uganda.
| | - Crispus Tegu
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Busitema University, Uganda
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Dietary Management Tools Improve the Dietary Skills of Patients with T2DM in Communities. Nutrients 2022; 14:nu14214453. [PMID: 36364716 PMCID: PMC9654010 DOI: 10.3390/nu14214453] [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: 09/06/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Dietary management is of paramount importance in the prevention and control of type 2 diabetes mellitus (T2DM). This one-year cluster-randomized controlled trial aims to evaluate the effect of dietary management tools on the dietary skills of patients with T2DM. Twenty-two communities were randomly assigned to an intervention group and a control group, and participants in the intervention group received a food guiding booklet (G) and a dinner set (D). The frequency of dietary management tools usage was collected at baseline and every three months, and different use patterns were identified by a group-based trajectory model. A self-compiled diabetic dietary skills scale and blood glucose were collected at baseline, 3, and 12 months, and a using generalized linear mixed model (GLMM) to explore the influence factors of dietary skills and blood glucose. The finding revealed four dietary tool-usage patterns among the participants: Insist using G/D, Give up gradually G/D, Give up after use G, and Never use G/D. GLMM indicated that dietary skills were higher over time (p < 0.05), and in participants using the guiding booklet (p < 0.001) or dinner set (p < 0.001), or with higher education (p < 0.001). Additionally, blood glucose were lower among participants with higher dietary skills (p = 0.003), higher educational level (p = 0.046), and a 3000−5000 monthly income (p = 0.026). These findings support using food management tools like the guiding booklet and dinner set as a useful strategy in primary health care centers for individuals with T2DM to increase their dietary skills and blood glucose control.
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Ziapour A, Ebadi Fard Azar F, Mahaki B, Mansourian M. Factors affecting the health literacy status of patients with type 2 diabetes through demographic variables: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:306. [PMID: 36438988 PMCID: PMC9683461 DOI: 10.4103/jehp.jehp_1759_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health literacy (HL) is the ability of a person to acquire the process, understand the necessary health information, and make the health services needed for conscious health decisions. Besides, diabetes is the most common metabolic disorder that affects patients' quantity and quality of life. This study focused on determining the factors that affect the HL status of patients with type 2 diabetes (T2D) through the role of the demographic variables. MATERIALS AND METHODS This descriptive-analytical research survey recruited a sample based on 280 patients with T2D at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah in 2020. This study selected patients with T2D using a simple random sampling technique. The study applied the demographic information questionnaire and the Functional, Communicative, and Critical HL Scale to collect data from patients with T2D. This study used the SPSS version 23 on the received data sets to perform statistical analysis, including t-test, analysis of the variance, and multiple regression, to predict the factors affecting HL among diabetes patients. RESULTS The study results showed that the mean age of the participating patients with T2D was 55.80 ± 13.04. The results indicated the mean score and standard deviation of total HL score in patients with T2D 2.70 ± 0.44. The findings specified a statistically significant relationship between HL, gender, education, occupation, income, and place of residence. Results indicated that β-coefficients of the multiple regression analysis and the income variable (β = 0.170), age (β = 0.176), and employment variable (β = 0.157). These are the most predictive of the HL of patients with T2D. CONCLUSION The results of this study specified that the HL rate of individuals with diabetes type 2 is average. The potential communicative and critical HL influence is essential for communication and education for diabetes patients in the primary health-care system settings. The findings indicate that communicative and critical HL related to patients' management and functional HL looks passable in this study.
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Affiliation(s)
- Arash Ziapour
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farbod Ebadi Fard Azar
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Behzad Mahaki
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Morteza Mansourian
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
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Tavousi M, Mohammadi S, Sadighi J, Zarei F, Kermani RM, Rostami R, Montazeri A. Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021. PLoS One 2022; 17:e0271524. [PMID: 35839272 PMCID: PMC9286266 DOI: 10.1371/journal.pone.0271524] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages. METHODS The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021. RESULTS The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies (162 papers introducing an instrument and 199 papers reporting translation and psychometric properties of an original instrument) were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties. CONCLUSION This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.
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Affiliation(s)
- Mahmoud Tavousi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Samira Mohammadi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Jila Sadighi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Fatemeh Zarei
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Ramin Mozafari Kermani
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Rahele Rostami
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran
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13
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Tschamper MK, Wahl AK, Hermansen Å, Jakobsen R, Larsen MH. Parents of children with epilepsy: Characteristics associated with high and low levels of health literacy. Epilepsy Behav 2022; 130:108658. [PMID: 35358855 DOI: 10.1016/j.yebeh.2022.108658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
Abstract
Parents of children with epilepsy play a key role in the management of their child's condition. Their level of health literacy (HL), which refers to their ability to seek, understand, assess, remember, and utilize health information, is essential for handling the child optimally. The aim of this study was to investigate characteristics associated with high and low levels of different dimensions of HL in parents. HL was assessed with the multidimensional Health Literacy Questionnaire (parents' version) and the electronic Health Literacy Scale, using data from a cohort of 254 parents of children <12 years. Bivariate correlation and multiple hierarchal linear regression (STATA version 16 SE) were used to investigate variables associated with HL. Self-efficacy (St. β = 0.14-0.34) was the only variable that predicted higher scores on every HL scale. Being older than 35 years (St. β = 0.18-0.21), level of education (St. β = 0.16-0.27), and the child having a coordinator of services (St. β = 0.16-0.28) were associated with higher scores, while sick leave due to the child's epilepsy (St. β = -0.13 to -0.16), child comorbidities (St. β = -0.15 to -0.19), and higher levels of mental distress (St. β = -0.13 to -0.19) were associated with lower scores in several of the different HL dimensions. A total of 44.8% of the parents scored over the cutoff (≥1.85) predicting a mental disorder on the Hopkins symptom checklist. This is the first study to investigate multidimensional parental HL in a childhood epilepsy context. Our results highlight the need to investigate multiple variables, especially mental distress, to determine characteristics that may predict low parental HL. Further qualitative studies are needed to explore the underlying reasons for the parents' HL scores and to develop inventions tailored to meet different HL needs.
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Affiliation(s)
- Merete K Tschamper
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Norway.
| | - Astrid K Wahl
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Norway
| | - Åsmund Hermansen
- Faculty of Social Sciences, Oslo Metropolitan University, Norway
| | - Rita Jakobsen
- Lovisenberg Diaconal University College, Oslo, Norway
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Wei CJ, Shih CL, Hsu YJ, Chen YC, Yeh JZ, Shih JH, Chiu CH. Development and application of a chronic kidney disease-specific health literacy, knowledge and disease awareness assessment tool for patients with chronic kidney disease in Taiwan. BMJ Open 2021; 11:e052597. [PMID: 34635527 PMCID: PMC8506855 DOI: 10.1136/bmjopen-2021-052597] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aims to develop an assessment tool for health literacy and knowledge specific to chronic kidney disease (CKD) for use in examining the associations between health literacy, disease-specific knowledge and disease awareness among patients with CKD in Taiwan. DESIGN An assessment tool in Mandarin and Taiwanese was developed based on patient input, panel discussions with experts and a literature review, and checked for validity and reliability in a pilot test. Formal data were collected through population-based sampling with a set quota according to region and hospital accreditation level. Cross-sectional data were collected to confirm the reliability and validity of the assessment tool. Levels of health literacy, disease knowledge, and disease awareness were then reported and analysed. SETTING Sample hospitals included 10 medical centres, 18 regional hospitals and 15 local hospitals in Taiwan. Researchers were granted Internal Review Board approval and obtained agreement to collect data in all study settings. PARTICIPANTS Patients at least 20 years old who had been diagnosed with CKD of any stage were eligible to participate. The formal assessment collected 1155 valid questionnaires, yielding an 87.3% response rate. The mean age of participants was 67.48 years (SD=12.87, range 22-98), while 484 (41.95%) were female and 78% were aware they had CKD. RESULTS The self-devised instrument proved to have excellent reliability and validity. Use of the instrument in the main study showed that CKD-specific health literacy was significantly associated with age (β=-0.33, p<0.00), educational attainment and disease awareness (β=0.13, p<0.00). CKD-specific knowledge was also significantly associated with age (β=-0.18, p<0.00), educational attainment and disease awareness (β=0.19, p<0.00). CONCLUSIONS This CKD-specific health literacy and knowledge assessment tool developed for Mandarin and Taiwanese-speaking patients is reliable and well validated. Patients with CKD who are aware of and understand their disease performed better in the assessment.
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Affiliation(s)
- Chung-Jen Wei
- Department of Public Health, Fu Jen Catholic University, Taipei, Taiwan
| | - Chung-Liang Shih
- Deputy Minister Office, Executive Yuan Republic of China Ministry of Health and Welfare, Taipei, Taiwan
| | - Yu-Juei Hsu
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yin-Cheng Chen
- Division of Nephrology, Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Jue-Zong Yeh
- Department of Pharmacy, Tri-Service General Hospital, Taipei, Taiwan
| | - Jia-Hui Shih
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Chiung-Hsuan Chiu
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
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15
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Fields B, Lee A, Piette JD, Trivedi R, Mor MK, Obrosky DS, Heisler M, Rosland AM. Relationship between adult and family supporter health literacy levels and supporter roles in diabetes management. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2021; 39:224-233. [PMID: 33370140 PMCID: PMC8717858 DOI: 10.1037/fsh0000503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Among adults with Type 2 diabetes, low health literacy (HL) is a risk factor for negative health outcomes. Support from family and friends can improve adults' self-management and health-related outcomes. We examined whether supporters provided unique help to adults with diabetes and low HL and whether HL was associated with adults' perception of supporter helpfulness. METHODS We used cross-sectional baseline survey data from 239 adult patients with diabetes enrolled in a randomized controlled trial with a support person. Patients reported level of supporter involvement with self-management roles. HL among patients and supporters was assessed using a validated HL screening tool. Patient perception of supporter helpfulness was assessed with a single item. We used multivariable logistic regression to examine associations of patient and supporter HL levels with supporter roles and patients' perception of supporter helpfulness. RESULTS Patients with low HL were more likely to have a supporter with low HL (39% vs. 26%, p = .04). Patients with low HL had higher odds of receiving supporter help with calling health care providers (adjusted odds ratio [AOR] = 2.09, 95% CI [1.00, 4.39]), remembering medical appointments (AOR = 2.24, 95% CI [1.07, 4.69]), and giving directions when blood sugars were low (AOR = 2.51, 95% CI [1.20, 5.37]). Neither patient nor supporter HL was significantly associated with patients' perception of supporter helpfulness. DISCUSSION Adults with diabetes and low HL reported more supporter involvement with specific self-management tasks than patients with adequate HL. Providers could consider targeted involvement of supporters to assist patients with chronic diseases and low HL, although they should be aware that supporters may be challenged by low HL. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Beth Fields
- Department of Kinesiology, University of Wisconsin-Madison
| | - Aaron Lee
- Department of Psychology, University of Mississippi
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16
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Ydirin CSB. Health literacy and health-promoting behaviors among adults at risk for diabetes in a remote Filipino community. BELITUNG NURSING JOURNAL 2021; 7:88-97. [PMID: 37469942 PMCID: PMC10353656 DOI: 10.33546/bnj.1298] [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: 01/07/2021] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 07/21/2023] Open
Abstract
Background Diabetes risk assessment is an essential preboarding tool before implementing health literacy programs to change an adult's health behavior positively. Research has shown an association between health literacy and health behaviors, but there is a dearth of literature that delineates the difference between the health literacy and health behaviors of adults according to their diabetes risks; high risk vs. low risk. Objective This study aimed to determine the difference between the health literacy and health behaviors of adults and establish the relationship between the two variables when classified according to their diabetes risks. Methods This study utilized a descriptive cross-sectional design with 400 adults in a remote Filipino community in November 2019. Data were gathered using the Health Promoting Lifestyle Profile II (HPLP II) and Health Literacy Survey-Short Form 12 (HLS-SF12) questionnaires. Descriptive statistics, independent t-test, and Pearson's r were used to analyze the data. Results There is a significant difference between the health literacy index scores (p < .05); but no significant difference between the health behavior mean scores (p > .05) of adults when grouped according to their diabetes risks. Health literacy is significantly (p < .05) correlated with health behaviors of adults, with a moderate positive correlation in the high-risk group (r = .43), and both weak positive correlation in the low-risk group (r = .13) and entire group (r = .17). Conclusion All adult inclusion efforts in promoting health literacy, with emphasis on the high-risk group, are needed to improve awareness of the degree of diabetes risks. Nurses should take an active role in the assessment of diabetes risks, evaluation of results, and implementation of interventions that could increase health literacy to facilitate the development of healthy behaviors. Stakeholders are urged to advance the availability of evidence-based lifestyle interventions to reduce the growth in new cases of diabetes.
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Klinovszky A, Papp-Zipernovszky O, Buzás N. Building a House of Skills-A Study of Functional Health Literacy and Numeracy among Patients with Type 2 Diabetes in Hungary. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041547. [PMID: 33561956 PMCID: PMC7915100 DOI: 10.3390/ijerph18041547] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/23/2021] [Accepted: 02/03/2021] [Indexed: 12/11/2022]
Abstract
The purpose of this study is to explore functional health literacy (FHL) and numeracy skills in an insulin-treated, type 2 diabetes mellitus (T2DM) patient population, and their impact on diabetes self-care activities. A non-experimental, cross-sectional quantitative design was used for this study. The sample consisted of 102 T2DM patients on insulin therapy, including 42 males and 60 females, with a mean age of 64.75 years (SD = 9.180) and an average diabetes duration of 10.76 years (SD = 6.702). Independent variables were sociodemographic variables (e.g., age, educational level, etc.) and diabetes and health-related factors (e.g., duration of diabetes (years), the frequency of blood glucose testing/day, etc.). For this study, the participants completed the reading comprehension exercise from the Short Test of Functional Health Literacy (S-TOFHLA) and the Shortened Version of the Diabetes Numeracy Test (DNT-15), which specifically evaluates the numeracy skills of patients living with diabetes. The associations between the variables were examined with Spearman’s rank correlation. Multivariate regression analysis was performed to examine whether measured FHL skills impact diabetes self-care activities. We found that DNT-15 test (β = 0.174, t(96) = 2.412, p < 0.018) had significant effect on the frequency of blood glucose testing/day. Moreover, the problem areas for patients with T2DM mostly included multi-step calculations according to food label interpretations, and adequate insulin dosage based on current blood glucose levels and carbohydrate intake. The results of regression analyses and Spearman’s rank correlation indicated that limited FHL and diabetes numeracy skills not only influenced the participants’ behaviors related to self-management, but they also affected their health outcomes. Thus, besides the personalization of insulin treatment, it is indispensable to provide more precise information on different types of insulin administration and more refined educational materials based on medical nutrition therapy.
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Affiliation(s)
- Andrea Klinovszky
- Department of Health Economics, University of Szeged, 6724 Szeged, Hungary;
- Correspondence:
| | | | - Norbert Buzás
- Department of Health Economics, University of Szeged, 6724 Szeged, Hungary;
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Shah JM, Ramsbotham J, Seib C, Muir R, Bonner A. A scoping review of the role of health literacy in chronic kidney disease self-management. J Ren Care 2021; 47:221-233. [PMID: 33533199 DOI: 10.1111/jorc.12364] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/02/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic kidney disease is a serious health condition and is increasing globally. Effective self-management could slow disease progression and improve health outcomes, although the contribution of health literacy and knowledge for self-management is not well known. AIM To investigate the recent evidence of health literacy and the relationship between health literacy, knowledge and self-management of chronic kidney disease. METHODS Arksey and O'Malley's framework informed this scoping review. Eligible studies involving adults with any grade of chronic kidney disease, measuring all dimensions of health literacy (i.e., functional, communicative, and critical), disease-specific knowledge and self-management, published in English between January 2005 and March 2020, were included. RESULTS The scoping review found 12 eligible studies, with 11 assessing all dimensions of health literacy. No study examined health literacy, knowledge and self-management. When individuals had greater health literacy, this was associated with greater knowledge about the disease. Communicative health literacy was a significant predictor of medication, diet and fluid adherence, and overall self-management behaviours. CONCLUSION This scoping review shows that disease-specific knowledge is important for health literacy and that health literacy is essential for effective self-management of chronic kidney disease. The implications of these relationships can inform strategies for the development of evidence-based patient education to support increased self-management. There is also a need for further research to explore these associations.
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Affiliation(s)
- Jennifer M Shah
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Joanne Ramsbotham
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Rachel Muir
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia.,Kidney Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Tsai YC, Wang SL, Tsai HJ, Chen TH, Kung LF, Hsiao PN, Hsiao SM, Hwang SJ, Chen HC, Chiu YW. The interaction between self-care behavior and disease knowledge on the decline in renal function in chronic kidney disease. Sci Rep 2021; 11:401. [PMID: 33432037 PMCID: PMC7801646 DOI: 10.1038/s41598-020-79873-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 11/26/2020] [Indexed: 11/09/2022] Open
Abstract
Multidisciplinary care can improve the outcomes of chronic kidney disease (CKD), however the contribution of self-care behavior and knowledge about CKD is unclear. This study enrolled 454 participants with CKD stages 1-5 not on dialysis. Structured questionnaires were used to evaluate self-care behavior and kidney disease knowledge. Rapid decline in renal function was defined as the decline in estimated filtration rate > 3 ml/min per 1.73 m2/year within 1-year prior to enrollment. The mean age of all study participants was 65.8 ± 12.1 years and 55.9% were male. The elderly had better self-care behavior while younger participants had better disease knowledge. Both high self-care and high disease knowledge scores were significantly associated with and had a synergistic effect on decreasing the risk of rapid decline in renal function. CKD patients with better self-care behavior and better kidney disease knowledge had lower risk of rapid decline in renal function.
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Affiliation(s)
- Yi-Chun Tsai
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 TzYou 1st Road, Kaohsiung, 807, Taiwan.,Division of General Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Li Wang
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Ju Tsai
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tzu-Hui Chen
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lan-Fang Kung
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Ni Hsiao
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Ming Hsiao
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 TzYou 1st Road, Kaohsiung, 807, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Chun Chen
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 TzYou 1st Road, Kaohsiung, 807, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Wen Chiu
- Department of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 TzYou 1st Road, Kaohsiung, 807, Taiwan. .,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan. .,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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20
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Ku EJ, Lee DH, Jeon HJ, Park F, Oh TK. Psychometric Analysis Regarding the Barriers to Providing Effective Insulin Treatment in Type 2 Diabetic Patients. Diabetes Ther 2021; 12:159-170. [PMID: 33098564 PMCID: PMC7843692 DOI: 10.1007/s13300-020-00947-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/10/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION A psychometric analysis on type 2 diabetic (T2D) patients was performed to assess whether glycated hemoglobin (HbA1c) levels were dependent upon either the psychologic or economic attitude toward the use of insulin as a treatment for their diabetic condition. METHODS A cross-sectional study was designed using 271 patients with T2D who regularly visited a tertiary referral hospital in South Korea from June 2019 to December 2019. Each patient enrolled in this protocol was treated with insulin for at least 6 months, had recordings of their plasma HbA1c measurement, and completed validated questionnaires consisting of items focusing on patient attitudes toward insulin use [Insulin Treatment Appraisal Scale (ITAS)] and cost-related issues related to diabetic supply purchase. Multiple regression analyses were performed to determine the association between their HbA1c and each item on the questionnaires. RESULTS In both males and females, there was a significant association (P < 0.05) between HbA1c levels and multiple items on the ITAS questionnaire, which are generally regarded as a negative perception (ITAS 1 "personal failure" and ITAS 2 "illness severity" in males and ITAS 12 "expected harm" and ITAS 15 "restrictiveness" in females). In females, however, not all perceptions were negative, since one item (ITAS 8 "anticipated effect") was correlated with the measurement of a lower HbA1c level (- 0.495 ± 0.211, P < 0.05). There was no association between the levels of HbA1c and the cost of insulin or associated diabetic supplies. Since only a few patients in this study chose to reduce their drug dosing because of cost, the resistance to using insulin is likely not driven by economic reasons. CONCLUSION The psychometric results of the ITAS suggested that HbA1c levels were directly associated with a positive attitude of the patient to willingly use insulin for therapy. The cost of the insulin therapy was not associated with HbA1c levels. These findings in the Korean population suggest that continued education is needed to ensure that T2D patients have a reinforced positive psychology toward the use of insulin in the control of their glycemia.
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Affiliation(s)
- Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-si, Republic of Korea
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju-si, Republic of Korea
| | - Dong-Hwa Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-si, Republic of Korea
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju-si, Republic of Korea
| | - Hyun Jeong Jeon
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-si, Republic of Korea
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju-si, Republic of Korea
| | - Frank Park
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA
| | - Tae Keun Oh
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-si, Republic of Korea.
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju-si, Republic of Korea.
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21
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Crespo TS, Andrade JMO, Lelis DDF, Ferreira AC, Souza JGS, Martins AMEDBL, Santos SHS. Adherence to medication, physical activity and diet among older people living with diabetes mellitus: Correlation between cognitive function and health literacy. IBRO Rep 2020; 9:132-137. [PMID: 33336106 PMCID: PMC7733141 DOI: 10.1016/j.ibror.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Diabetes mellitus (DM) is a public health problem, which requires enhanced self-care in order to avoid complications. However, cognitive impairment can reduce these abilities and may affect health literacy (HL) of patients in terms to understand and apply information. Therefore, this study evaluated the correlation between cognitive condition and HL related to medication adherence, physical activity and nutritional status among people living with DM. Methods A cross-sectional study was carried out among elderly people (≥ 60 years old) with DM. The cognitive condition was evaluated using the Mini-Mental State Examination (MMSE) and the HL using the following questionnaires: Literacy Assessment for Diabetes (LAD-60), Nutritional Literacy among People with Diabetes (NLD), Health Literacy on the Practice of Physical Activities among Diabetics (HLPPA - D), and Health Literacy regarding Drug Adherence among Diabetics (HLDA-D). Sociodemographic and biochemical profile was also evaluated. Spearman correlation was used (p < 0.05). Results 187 individuals with DM were included. Regarding laboratory analyses, insulin dosage had a mean value of 12.3 microUI/mL (SD: ±15.7), mean blood glucose was 148.1 mg/dl (SD: ±59.7) and mean HbA1c was 7.54 % (SD: ±1.8). In the correlation analysis, higher age and lower income were weakly correlated with lower cognitive level. No correlation was identified for biochemical variables and cognitive condition. A positive and weak correlation between cognition and HL was observed in the studied population. Conclusions In older people living with DM the cognitive condition is correlated to specific topics of HL (nutritional status, physical activity and medication adherence).
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Affiliation(s)
- Thaísa Soares Crespo
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Physiopathology, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - João Marcus Oliveira Andrade
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Nursing, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - Deborah de Farias Lelis
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - Alice Crespo Ferreira
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | | | - Andréa Maria Eleutério de Barros Lima Martins
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Dentistry, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - Sérgio Henrique Sousa Santos
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Dentistry, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Institute of Agricultural Sciences. Food Engineering College, Federal University of Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
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22
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Liddelow C, Mullan B, Boyes M. Adherence to the oral contraceptive pill: the roles of health literacy and knowledge. Health Psychol Behav Med 2020; 8:587-600. [PMID: 34040887 PMCID: PMC8114408 DOI: 10.1080/21642850.2020.1850288] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/10/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The oral contraceptive pill is the most widely used method of contraception and when adhered to perfectly is 99% effective at preventing pregnancy. However, adherence to the pill is relatively low. Knowledge has shown to be important in continuation of the pill, and previous research shows the importance of health literacy in adhering to medication in chronic illnesses, but its role has yet to be explored in this behavior. METHODS This cross-sectional study examined the associations between health literacy, knowledge of the pill and adherence, as well as the predictive ability of these two variables and their interaction, in predicting adherence. Recruited through CloudResearch, 193 women (M age = 32.63 years, SD = 5.98) residing in the United States completed the Health Literacy Skills Instrument - Short Form, a previously validated measure of oral contraceptive pill knowledge and the Medication Adherence Report Scale. RESULTS Results showed a strong positive correlation between health literacy and adherence (r = .76) and moderate associations between health literacy and knowledge (r = .42), and knowledge and adherence (r = .42). The final model of the hierarchical multiple regression accounted for 59.8% of variance in adherence, with health literacy (β = .69) and length of time taking the pill (β = .13) the only significant predictors of adherence. CONCLUSION Family planning clinics should consider assessing the patient's health literacy skills before prescribing the pill to ensure patients fully understand the requirements.
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Affiliation(s)
- Caitlin Liddelow
- Health Psychology and Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia
| | - Barbara Mullan
- Health Psychology and Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia
| | - Mark Boyes
- Health Psychology and Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia
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23
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Doherty KV, Nguyen H, Eccleston CEA, Tierney L, Mason RL, Bindoff A, Robinson A, Vickers J, McInerney F. Measuring consumer access, appraisal and application of services and information for dementia (CAAASI-Dem): a key component of dementia literacy. BMC Geriatr 2020; 20:484. [PMID: 33213386 PMCID: PMC7678312 DOI: 10.1186/s12877-020-01891-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ability to locate, navigate and use dementia services and information, either for oneself or in providing care for others, is an essential component of dementia literacy. Despite dementia literacy being understood to be inadequate in many settings, no validated instrument exists to measure these elements. Here we describe the development and preliminary validation of the Consumer Access, Appraisal and Application of Services and Information for Dementia (CAAASI-Dem) tool. METHODS Items were adapted from existing health literacy tools and guided by discussion posts in the Understanding Dementia Massive Open Online Course (UDMOOC). Following expert review and respondent debriefing, a modified CAAASI-Dem was administered to UDMOOC participants online. On the basis of descriptive statistics, inter-item and item total correlations and qualitative feedback, this was further refined and administered online to a second cohort of UDMOOC participants. Exploratory factor analysis identified underlying factor structure. Items were retained if they had significant factor loadings on one factor only. Each factor required at least three items with significant factor loadings. Internal consistency of factors in the final model was evaluated using Cronbach's alpha coefficients. RESULTS From a pool of 70 initial items with either a 5-point Likert scale (Not at all confident - Extremely confident; or Strongly agree - Strongly disagree) or a binary scale (Yes - No), 65 items were retained in CAAASI-Dem-V1. Statistical and qualitative analysis of 1412 responses led to a further 34 items being removed and 11 revised to improve clarity. The 31 item CAAASI-Dem-V2 tool was subsequently administered to 3146 participants, one item was removed due to redundancy and EFA resulted in the removal of an additional 4 items and determination of a five factor structure: Evaluation and engagement; Readiness; Social supports; Specific dementia services; and Practical aspects. CONCLUSIONS The five factors and 26 constituent items in CAAASI-Dem align with functional, critical, and communicative aspects of dementia health literacy from the perspective of the carer. As a screening tool for people living with dementia and their carers, CAAASI-Dem potentially provides a means to determine support needs and may be a key component of the dementia literacy assessment toolbox.
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Affiliation(s)
- Kathleen Veronica Doherty
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia.
| | - Hoang Nguyen
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Claire E A Eccleston
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Laura Tierney
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Ron L Mason
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Aidan Bindoff
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Andrew Robinson
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - James Vickers
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Fran McInerney
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, 7001, Australia
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24
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Afaya RA, Bam V, Azongo TB, Afaya A. Knowledge of chronic complications of diabetes among persons living with type 2 diabetes mellitus in northern Ghana. PLoS One 2020; 15:e0241424. [PMID: 33112906 PMCID: PMC7592765 DOI: 10.1371/journal.pone.0241424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/14/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Diabetes mellitus is a complex disease that affects many organ systems, leading to concerns about deteriorating population health status and ever-increasing healthcare expenditure. Many people with diabetes do not achieve optimal glycaemic control and other metabolic indices, leading to a heightened risk of developing complications. Adequate knowledge of diabetes complications is a prerequisite for risk-factor reduction and prevention of the consequences of the disease. Therefore, this study aimed to evaluate the knowledge of chronic complications of diabetes among persons living with type 2 diabetes mellitus in northern Ghana. Method A descriptive cross-sectional study was conducted among 320 patients with type 2 diabetes mellitus in northern Ghana. The consecutive sampling technique was employed to recruit participants from September to November 2018. Data analysis was performed using IBM statistical package for social science version 23. Descriptive statistics such as frequencies and percentages were used. Both bivariate and multivariate logistic regression analysis were employed to determine associations between knowledge of diabetes complications and demographic/clinical characteristics of participants, at 95% confidence interval with statistical significance at P<0.05. Results The majority of participants (54.1%) had inadequate knowledge and 45.9% had adequate knowledge of diabetes complications. The factors associated with inadequate level of knowledge were female gender [AOR = 0.29 (95%CI: 0.14–0.56), p<0.001], older age [AOR = 0.45 (95%CI:0.20–0.99), p = 0.049], primary education [AOR = 0.13 (95%CI: 0.03–0.51), p = 0.004], no formal education [AOR = 0.16 (95%CI: 0.05–0.50), p = 0.002], rural dwellers [AOR = 0.50 (95%CI: 0.27–0.95), p = 0.033] and unknown family history diabetes [AOR = 0.38 (95%CI: 0.17–0.82), p = 0.014]. Conclusion More than half of the studied population had inadequate knowledge of diabetes complications. Female gender, rural dwellers, and low education level were factors positively associated with inadequate knowledge of diabetes complications. A multisectoral approach is needed, where the government of Ghana together with other sectors of the economy such as the health, education and local government sectors work collaboratively in the development of locally tailored diabetes education programmes to promote healthy self-care behaviours relevant for the prevention of diabetes and its complications.
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Affiliation(s)
- Richard Adongo Afaya
- Department of Surgery, Tamale West Hospital, Tamale, Ghana
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail:
| | - Victoria Bam
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas Bavo Azongo
- Department of Public Health, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- College of Nursing, Yonsei University, Seoul, Republic of South Korea
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25
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Abed MA, Khalifeh AH, Khalil AA, Darawad MW, Moser DK. Functional health literacy and caregiving burden among family caregivers of patients with end-stage renal disease. Res Nurs Health 2020; 43:529-537. [PMID: 32757227 DOI: 10.1002/nur.22060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 07/21/2020] [Indexed: 01/11/2023]
Abstract
Family caregivers of patients with end-stage renal disease (ESRD) experience significant caregiver-related burden, yet the contribution of their functional health literacy (FHL) to caregiving burden has not been elucidated. We investigated the magnitude of FHL and caregiving burden and their association in a descriptive, correlational cross-sectional study of family caregivers of Jordanian patients with ESRD (N = 88). The short versions of the FHL for Adults and the Zarit Burden Interview were used for assessment of caregivers. Demographic and clinical information of patients and their family caregivers were self-reported. Of family caregivers, 41% had limited FHL and 38% experienced high caregiver burden. FHL and history of comorbidity in family caregivers predicted caregiving burden independent of demographic and clinical factors. Consideration of FHL in support interventions for family caregivers may minimize some of the high perceived caregiving burden, but clinical trials of such interventions are needed to confirm this conclusion.
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Affiliation(s)
- Mona A Abed
- Department of Adult Health Nursing, College of Nursing, Hashemite University, Zarqa, Jordan
| | - Anas H Khalifeh
- Department of Nursing, Prince Hamzah Hospital, Ministry of Health, Amman, Jordan.,Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, Jordan
| | - Amani A Khalil
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, Jordan
| | - Muhammad W Darawad
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, Jordan
| | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, Kentucky
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26
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Ranjbaran S, Shojaeizadeh D, Dehdari T, Yaseri M, Shakibazadeh E. Using health action process approach to determine diet adherence among patients with Type 2 diabetes. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:170. [PMID: 32953901 PMCID: PMC7482647 DOI: 10.4103/jehp.jehp_175_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Diet adherence may cause diabetes complications to be diminished. OBJECTIVES This study aimed at identifying determinants of diet adherence among patients with Type 2 diabetes based on the health action process approach (HAPA). METHODS In this cross-sectional study, 734 patients with Type 2 diabetes, attending to South Tehran health centers, were recruited during June-December 2018. The dietary regimen scale (nine items) and a researcher-designed questionnaire consisting of HAPA constructs were used to gather the data. Data were analyzed using the Mann-Whitney test, Pearson Chi-squared test, Fisher's exact test, and linear regression test. All statistical tests were assessed using SPSS (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY, USA: IBM Corp.). RESULTS The level of nonadherence to diet was 91.1%. Diet adherence was significantly associated with family income (P = 0.005), level of education (P < 0.001), and age (P = 0.009). The linear regression showed that 55% of the variance of diet adherence was determined by HAPA variables. Diet adherence was associated with intention (P < 0.001), action planning (P = 0.005), and barriers (P = 0.003). CONCLUSION Most of the patients did not adhere to their diet. Appropriate programs should be designed to promote diet adherence among the patients, especially those with low literacy and patients living in poor communities.
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Affiliation(s)
- Soheila Ranjbaran
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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27
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Asril NM, Tabuchi K, Tsunematsu M, Kobayashi T, Kakehashi M. Predicting Healthy Lifestyle Behaviours Among Patients With Type 2 Diabetes in Rural Bali, Indonesia. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2020; 13:1179551420915856. [PMID: 32341670 PMCID: PMC7171987 DOI: 10.1177/1179551420915856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 03/06/2020] [Indexed: 12/13/2022]
Abstract
Background Type 2 diabetes is a lifelong metabolic disease closely related to unhealthy lifestyle behaviours. This study aimed to identify factors explaining the healthy lifestyle behaviours of patients with type 2 diabetes in rural Indonesia. The extended health belief model, demographic characteristics, clinical lifestyle factors and diabetes knowledge were investigated to provide a complete description of these behaviours. Method A sample of 203 patients with type 2 diabetes representing a cross-section of the population were recruited from community health centres in the rural areas of Bali province. The data were collected through questionnaires. Descriptive statistics and a hierarchical regression test were employed. Results This study showed demographic characteristics, clinical and lifestyle factors, diabetes knowledge and the extended health belief model accounted for 71.8% of the variance in healthy lifestyle behaviours of patients with type 2 diabetes in rural Indonesia. The significant demographic factors were age, education level, employment status and traditional beliefs. The significant clinical and lifestyle factors were alcohol use, diabetic medicine and duration of symptoms. Finally, the significant extended health belief model factors were perceived severity, susceptibility, barriers, family support, bonding social capital and chance locus of control. Conclusions The extended health belief model forms an adequate model for predicting healthy lifestyle behaviours among patients with diabetes in rural Indonesia. The contribution of this model should be strengthened in developing the diabetes management.
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Affiliation(s)
- Nice Maylani Asril
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.,Faculty of Education, Ganesha University of Education, Bali, Indonesia
| | - Keiji Tabuchi
- Department of Health Promotion and Development Science, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Miwako Tsunematsu
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Toshio Kobayashi
- Department of General Internal Medicine, Ishii Memorial Hospital, Yamaguchi, Japan
| | - Masayuki Kakehashi
- Department of Health Informatics, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
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28
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AlShayban DM, Naqvi AA, Alhumaid O, AlQahtani AS, Islam MA, Ghori SA, Haseeb A, Ali M, Iqbal MS, Elrggal ME, Ishaqui AA, Mahmoud MA, Khan I, Jamshed S. Association of Disease Knowledge and Medication Adherence Among Out-Patients With Type 2 Diabetes Mellitus in Khobar, Saudi Arabia. Front Pharmacol 2020; 11:60. [PMID: 32153397 PMCID: PMC7045035 DOI: 10.3389/fphar.2020.00060] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/22/2020] [Indexed: 12/13/2022] Open
Abstract
Objective The study aimed to evaluate the association between disease knowledge and medication adherence in patients with type 2 diabetes mellitus. Methods A cross-sectional study was conducted for three months, in patients with type 2 diabetes who visited three community pharmacies located in Khobar, Saudi Arabia. Patients' disease knowledge and their adherence to medications were documented using Arabic versions of the Michigan Diabetes Knowledge Test and the General Medication Adherence Scale respectively. Data were analyzed through SPSS version 23. Chi-square test was used to report association of demographics with adherence. Spearman's rank correlation was employed to report the relationship among HbA1c values, disease knowledge and adherence. Logistic regression model was utilized to report the determinants of medication adherence and their corresponding adjusted odds ratio. Study was approved by concerned ethical committee (IRB-UGS-2019-05-001). Results A total of 318 patients consented to participate in the study. Mean HbA1c value was 8.1%. A third of patients (N = 105, 33%) had high adherence and half of patients (N = 162, 50.9%) had disease knowledge between 51% - 75%. A significantly weak-to-moderate and positive correlation (ρ = 0.221, p < 0.01) between medication adherence and disease knowledge was reported. Patients with >50% correct answers in the diabetes knowledge test questionnaire were more likely to be adherent to their medications (AOR 4.46, p < 0.01). Conclusion Disease knowledge in most patients was average and half of patients had high-to-good adherence. Patients with better knowledge were 4 to 5 times more likely to have high adherence. This highlights the importance of patient education and awareness regarding medication adherence in managing diabetes.
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Affiliation(s)
- Dhfer Mahdi AlShayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Atta Abbas Naqvi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Othman Alhumaid
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali Saad AlQahtani
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Md Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Syed Azizullah Ghori
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Majid Ali
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mahmoud E Elrggal
- Pharmaceutical Research Center, Deanship of Scientific Research, Umm Al Qura University, Makkah, Saudi Arabia
| | - Azfar Athar Ishaqui
- Department of Pharmacy, King Abdulaziz Hospital, National Guard Health Authority, Alahsa, Saudi Arabia
| | - Mansour Adam Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Irfanullah Khan
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Shazia Jamshed
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia.,Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
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Yao J, Wang H, Yin X, Yin J, Guo X, Sun Q. The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes. PLoS One 2019; 14:e0224869. [PMID: 31710631 PMCID: PMC6844544 DOI: 10.1371/journal.pone.0224869] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/23/2019] [Indexed: 11/18/2022] Open
Abstract
Background Self-management is the cornerstone of diabetes care, however, despite the numerous recommendations available for self-management, type-2 diabetes mellitus (T2DM) patients’ performance is suboptimal in China. This study aimed to explore the association between self-efficacy and self-management behaviors among Chinese T2DM patients, which might provide evidence to inform effective self-management interventions for these patients. Methods A cross-sectional survey was conducted using a multi-stage stratified randomized sampling in Shandong Province, China. The Diabetes Empowerment Scale-Short Form (DES-SF) was used to measure patients’ self-efficacy to manage diabetes. Latent class analysis (LCA) was used to explore the observed classes of self-management behaviors (dietary control, physical exercise, regular medication and self-monitoring of blood glucose). A two-class solution for self-management behaviors was tested to be the fittest based on LCA; we labelled active and inactive self-management groups. Univariate and multivariate logistic regression analysis were used to examine the associations between self-efficacy and self-management behaviors. Results A total of 2166 T2DM patients were included in the analysis. The mean DES-SF score was 31.9 (standard deviation: 5.2). The estimated proportions of T2DM in the active and inactive groups were 54.8% and 45.2%, respectively. The multivariate logistic regression showed that higher DES-SF score was significantly associated with higher possibility of active self-management behaviors (odds ratio = 1.06; 95% confidence interval: 1.04–1.08). Conclusions Self-efficacy in managing diabetes is associated with self-management behaviors among Chinese T2DM patients. To improve self-management behaviors, multiple strategies should be conducted to improve patients’ self-efficacy.
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Affiliation(s)
- Jingjing Yao
- School of Health Care management, NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Haipeng Wang
- School of Health Care management, NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiao Yin
- Jinan Central Hospital, Jinan, China
| | - Jia Yin
- School of Health Care management, NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Qiang Sun
- School of Health Care management, NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
- * E-mail:
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30
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Larsen MH, Strumse YS, Andersen MH, Borge CR, Wahl AK. Associations between disease education, self-management support, and health literacy in psoriasis. J DERMATOL TREAT 2019; 32:603-609. [PMID: 31692398 DOI: 10.1080/09546634.2019.1688233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patients' ability to perform self-management may be compromised if they are unable to fully comprehend their diagnosis and treatments. Weaknesses in health literacy (HL) pose a considerable health concern and may negatively influence SM, as well as interactions with health care professionals (HCP) and peers. OBJECTIVES To investigate possible associations between comprehensive HL and psoriasis education from HCPs in a cohort of patients with psoriasis. Another aim was to examine essential sources for psoriasis information and how these are evaluated. METHODS Cross-sectional questionnaire data, including the comprehensive Health Literacy Questionnaire (HLQ) from 825 patients with psoriasis who had participated in Climate Helio Therapy (CHT). RESULTS Participants having received HCP education scored significantly better in all HLQ scales compared to participants who did not receive such education (Cohen's effect size: 0.24 to 0.44). The CHT program, peers, and dermatologists were the most important sources of psoriasis information. People having participated more than once in CHT presented better HL scores and also higher self-management (skill and technique acquisition) and more psoriasis knowledge (effect-size: 0.75). CONCLUSIONS Psoriasis education by HCP seems important for HL and psoriasis knowledge. Patients may need multiple approaches and repetitions over time to be health literate and effective self-managers.
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Affiliation(s)
- Marie Hamilton Larsen
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Christine Raaheim Borge
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.,Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Chou CW, Kung PT, Chou WY, Tsai WC. Pay-for-performance programmes reduce stroke risks in patients with type 2 diabetes: a national cohort study. BMJ Open 2019; 9:e026626. [PMID: 31619415 PMCID: PMC6797306 DOI: 10.1136/bmjopen-2018-026626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES A pay-for-performance (P4P) programme is a management strategy that encourages healthcare providers to deliver high quality of care. In Taiwan, the P4P programme has been implemented for diabetes, and certified diabetes physicians voluntarily enrol patients with diabetes into the P4P programme. The objectives of this study were to compare the risk of stroke and its related factors in patients with type 2 diabetes who were enrolled in a P4P programme compared with those who were not. STUDY DESIGN This study is a natural experiment in Taiwan. A retrospective cohort investigation was conducted from 2002 to 2013, which included 459 726 patients with type 2 diabetes, who were grouped according to P4P enrolment status following a propensity score matching process. METHODS We reviewed patients ≥45 years of age newly diagnosed with type 2 diabetes mellitus (DM) from the National Health Insurance Research Database in Taiwan. A Cox proportional hazards model was used to compare the relative risk of stroke between patients with type 2 DM enrolled in the P4P programme and those who were not enrolled. RESULTS Compared with the patients not enrolled, there was a significantly lower stroke risk in P4P participants (HR=0.97, 95% CI 0.95 to 0.99). Although a significantly lower risk of haemorrhagic stroke was observed (HR=0.87, 95% CI 0.82 to 0.93) in P4P participants, no statistically significant difference for the risk of ischaemic stroke between P4P and non-P4P patients (HR=0.99, 95% CI 0.97 to 1.02) was found. Following stratification analysis, a significantly reduced stroke risk was observed in male patients with type 2 diabetes, but not in women. CONCLUSIONS Participants in Taiwan's Diabetes P4P programme displayed a significantly reduced stroke risk, especially haemorrhagic stroke. We recommend the continual promotion of this programme to the general public and to physicians.
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Affiliation(s)
- Chien-Wen Chou
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Nantou Hospital, Ministry of Health and Welfare, Nantou, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Yu Chou
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
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Huang HY, Kuo KM, Lu IC, Wu H, Lin CW, Hsieh MT, Lin YC, Huang RY, Liu IT, Huang CH. The impact of health literacy on knowledge, Attitude and decision towards hospice care among community-dwelling seniors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e724-e733. [PMID: 31215097 DOI: 10.1111/hsc.12791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 03/24/2019] [Accepted: 05/28/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community-dwelling elderly participants. This cross-sectional study enrolled 990 community-dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer-administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.
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Affiliation(s)
- Hsiang-Yun Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
| | - Kuang-Ming Kuo
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan, R.O.C
| | - I-Cheng Lu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
- School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, R.O.C
| | - Hsing Wu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
- Department of Information Management, National Yunlin University of Science and Technology, Yunlin County, Taiwan, R.O.C
| | - Chi-Wei Lin
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
- School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, R.O.C
| | - Ming-Ta Hsieh
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
| | - Yu-Ching Lin
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
| | - Ru-Yi Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
- School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, R.O.C
- Center for International Medical Education, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
| | - I-Ting Liu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
- School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, R.O.C
- Institute of Gerontology, National Cheng Kung University, Tainan City, Taiwan, R.O.C
| | - Chi-Hsien Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C
- School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, R.O.C
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Factors Affecting Self-Care Behavior Levels among Elderly Patients with Type 2 Diabetes: A Quantile Regression Approach. ACTA ACUST UNITED AC 2019; 55:medicina55070340. [PMID: 31277522 PMCID: PMC6681195 DOI: 10.3390/medicina55070340] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/29/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022]
Abstract
Background and objectives: Identifying factors that affect self-care according to low, middle, and high self-care levels among elderly patients with diabetes is the best way to prevent various life-threatening complications, and this can be accomplished by using an individualized approach to improve self-care. A quantile regression model is beneficial for estimating such factors because it allows the consideration of the entire conditional distribution of a dependent variable as it relates to independent variables. The objective of this study was to identify factors that affect self-care among elderly patients with diabetes using quantile regression. Materials and Methods: A cross-sectional survey of elderly patients with diabetes was conducted using the Self-Care Scale and six other related scales at three medical health centers in South Korea. Results: In the 10% quantile, the factors affecting self-care were age, smoking within the past six months, being educated about diabetes, depression, knowledge related to diabetes, self-efficacy, diabetes distress, and family support. Additional factors were as follows: age, smoking within the past six months, self-efficacy, and diabetes distress in the 25% quantile; age, self-efficacy, perceived health status, and diabetes distress in the 50% quantile; age, self-efficacy, perceived health status, and diabetes distress in the 75% quantile; and self-efficacy and perceived health status in the 90% quantile. Conclusions: Based on the results of this study, suggestions include providing education for sub-groups incapable of self-care, teaching stress management strategies, and increasing family support. In addition, for individuals capable of self-care, simplified programs that consist of self-efficacy improvement and stress control strategies are necessary.
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