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Aburadwan MK, Hayajneh FA. Health Literacy Among Patients With Acute Coronary Artery Diseases: Predictors, Consequences, and Enhancing Strategies: A Review of the Literature. Crit Care Nurs Q 2024; 47:71-82. [PMID: 38031310 DOI: 10.1097/cnq.0000000000000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
The purpose of this study is to integrate evidence on predictors, consequences, in addition to the strategies for enhancing health literacy (HL) for patients with acute coronary artery diseases. An integrative review was conducted by searching four main electronic databases: the Web of Science, PubMed, ScienceDirect, and MEDLINE. Twenty-three studies met the inclusion criteria and were included in the final review process. The review identified the most common predictors, consequences, and relationship of HL with health outcomes in patients with acute coronary artery disease. In addition to the main strategies that enhance HL, patients with or at risk for acute coronary artery disease need a good level of HL to cope with the disease's consequences. It is recommended to include routine assessment and management of HL levels in acute coronary artery disease treatment protocols to improve clinical outcomes.
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Affiliation(s)
- Maha K Aburadwan
- Royal Medical Services/Continuing Professional Development Center, Amman, Jordan (Dr Aburadwan); and School of Nursing, The University of Jordan, Amman, Jordan (Dr Hayajneh)
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Salgado R, Paulo N, Zufferey A, Bucher CO. Patient's learning needs and self-efficacy level after percutaneous coronary intervention: A descriptive study. J Clin Nurs 2023; 32:6415-6426. [PMID: 36823713 DOI: 10.1111/jocn.16656] [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: 06/29/2022] [Revised: 10/27/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
AIMS AND OBJECTIVES Identify and compare learning needs, levels of self-efficacy and their association among inpatients and outpatients of a cardiac care unit with coronary heart disease who have undergone percutaneous coronary intervention (PCI) in a Swiss university hospital. BACKGROUND After primary PCI, 42% of patients will suffer a recurrent ischemic cardiovascular event. Although adherence to therapeutic regimen contributes to prevent recurrence, patient adherence remains low. To strengthen it, learning needs and self-efficacy must be considered when developing effective therapeutic patient education (TPE). METHODS Learning needs and self-efficacy were assessed using the Cardiac Patient Learning Needs Inventory (CPLNI) and the Cardiac Self-Efficacy Scale among inpatients and outpatients. The STROBE checklist for cross-sectional studies was used in reporting this study. RESULTS Ninety-three patients participated in the study with a participation rate of 73.9%. The CPLNI median total score was significantly higher in inpatients than in outpatients: 4.23 (3.82, 4.64) versus 3.67 (3.33, 4.09), p < .001. In both units, participants declared that the most important need was related to 'anatomy and physiology' of the heart. Despite the high score, the least important need was about 'physical activity' for inpatients and 'miscellaneous information' for outpatients. No statistically significant differences were found among patients from both units regarding their self-efficacy level. CONCLUSIONS This study shows that after PCI, patients have high learning needs and moderate levels of self-efficacy that require addressing. RELEVANCE TO CLINICAL PRACTICE Patient's individual learning needs and self-efficacy level must be assessed prior/after PCI. A tailored TPE that considers individual learning needs and self-efficacy is recommended as a preventative measure to reduce recurrent ischemic cardiovascular events. Nurses can play a key role in this process. NO PATIENT OR PUBLIC CONTRIBUTION For feasibility reasons, patients and public were not involved in the design, conduct, reporting or dissemination plans of this research.
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Affiliation(s)
- Ricardo Salgado
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Health Care (IUFRS), Lausanne, Switzerland
| | - Natércia Paulo
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Health Care (IUFRS), Lausanne, Switzerland
| | - Arnaud Zufferey
- Cardiology Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Claudia Ortoleva Bucher
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Zakeri MA, Tavan A, Nadimi AE, Bazmandegan G, Zakeri M, Sedri N. Relationship Between Health Literacy, Quality of Life, and Treatment Adherence in Patients with Acute Coronary Syndrome. Health Lit Res Pract 2023; 7:e71-e79. [PMID: 37053051 PMCID: PMC10104679 DOI: 10.3928/24748307-20230320-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes. OBJECTIVE This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome. METHODS This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis. RESULTS Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = -0.167, p < .01), and quality of life (r = -0.153, p < .01), and a positive association between treatment adherence and quality of life (r = 0.169, p < .01). CONCLUSION The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [HLRP: Health Literacy Research and Practice. 2023;7(2):e71-e79.].
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Affiliation(s)
| | | | | | | | | | - Nadia Sedri
- Address correspondence to Nadia Sedri, MSc, Nursing Research Center, Kerman University of Medical Sciences, Hapht Bagh St. 7616913555, Kerman, Iran;
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Rague JT, Kim S, Hirsch J, Meyer T, Rosoklija I, Larson JE, Swaroop VT, Bowman R, Bowen DK, Cheng EY, Gordon EJ, Holmbeck G, Chu DI, Isakova T, Yerkes EB, Chu DI. The Association of Health Literacy with Health-Related Quality of Life in Youth and Young Adults with Spina Bifida: A Cross-Sectional Study. J Pediatr 2022; 251:156-163.e2. [PMID: 35970239 PMCID: PMC9843738 DOI: 10.1016/j.jpeds.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The objective of the study was to determine if health literacy is associated with health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with spina bifida. STUDY DESIGN Between June 2019 and March 2020, the Patient-Reported Outcome Measurement Information System Pediatric Global Health-7 (PGH-7), a measure of HRQOL, and the Brief Health Literacy Screening Tool (BRIEF) were administered to patients ≥12 years old with a diagnosis of spina bifida seen in our multidisciplinary spina bifida center. Questionnaires were completed at scheduled clinic visits. The primary outcome was the PGH-7 normalized T-score. The primary exposure was the BRIEF score. Demographic and clinical characteristics were obtained from the medical record. Nested, multivariable linear regression models assessed the association between health literacy and the PGH-7 score. RESULTS Of 232 eligible patients who presented to clinic, 226 (97.4%) met inclusion criteria for this study. The median age was 17.0 years (range: 12-31). Most individuals were female (54.0%) and had myelomeningocele (61.5%). Inadequate, marginal, and adequate health literacy levels were reported by 35.0%, 28.3%, and 36.7% of individuals. In univariable analysis, higher health literacy levels were associated with higher PGH-7 scores. In nested, sequentially adjusted multivariable linear regression models, a higher health literacy level was associated with a stepwise increase in the PGH-7 score. In the fully adjusted model, adequate health literacy and marginal health literacy, compared with inadequate health literacy, were associated with increases in a PGH-7 score of 3.3 (95% CI: 0.2-6.3) and 1.1 (95% CI: -2.0 to 4.2), respectively. CONCLUSIONS Health literacy was associated with HRQOL after adjusting for demographic and clinical factors. Strategies incorporating health literacy are needed to improve HRQOL in AYAs with spina bifida.
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Affiliation(s)
- James T Rague
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Soojin Kim
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Josephine Hirsch
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Theresa Meyer
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Ilina Rosoklija
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Jill E Larson
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Vineeta T Swaroop
- Division of Orthopedic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Robin Bowman
- Division of Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Diana K Bowen
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Earl Y Cheng
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Elisa J Gordon
- Department of Surgery-Division of Transplantation, Center of Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Grayson Holmbeck
- Department of Psychology, Loyola University of Chicago, Chicago, IL
| | - Daniel I Chu
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Tamara Isakova
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, and Division of Nephrology and Hypertension, Feinberg School of Medicine at Northwestern University, Chicago, IL
| | - Elizabeth B Yerkes
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - David I Chu
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Low Health Literacy Is Associated with Poorer Physical and Mental Health-Related Quality of Life in Dialysed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13265. [PMID: 36293839 PMCID: PMC9602746 DOI: 10.3390/ijerph192013265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Health-related quality of life (HRQoL) is an important health indicator in chronic diseases like kidney diseases. Health literacy (HL) may strongly affect HRQoL, but evidence is scarce. Therefore, we assessed the associations of HL with HRQoL in dialysed patients. We performed a cross-sectional study in 20 dialysis clinics across Slovakia (n = 542 patients, mean age = 63.6 years, males = 60.7%). We assessed the association of categorised HL (low, moderate, high) with the SF36 physical component score (PCS) and mental component score (MCS) using generalised linear models adjusted for age, gender, education, and comorbidity (Charlson Comorbidity Index, CCI). We found significant associations of HL with PCS and MCS in dialysed patients, adjusted for age, gender, education, and CCI. Low-HL patients had a lower PCS (B = -3.27, 95%-confidence interval, CI: -5.76/-0.79) and MCS (B = -6.05, 95%-CI: -8.82/-3.29) than high-HL patients. Moderate-HL patients had a lower MCS (B = -4.26, 95%-CI: -6.83/-1.69) than high-HL patients. HL is associated with physical and mental HRQoL; this indicates that dialysed patients with lower HL deserve specific attention and tailored care to have their HRQoL increased.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University Bratislava, Mlynské luhy 4, 821 05 Bratislava, Slovakia
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
- II. Internal Clinic Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia
| | - Andrea F. de Winter
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Kanejima Y, Shimogai T, Kitamura M, Ishihara K, Izawa KP. Impact of health literacy in patients with cardiovascular diseases: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2022; 105:1793-1800. [PMID: 34862114 DOI: 10.1016/j.pec.2021.11.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To clarify the impacts of health literacy on mortality, readmission, and quality of life (QOL) in the secondary or tertiary prevention of cardiovascular diseases (CVD) through a meta-analysis. METHODS Six electronic databases were searched on June 11, 2020. Observational studies involving patients with CVD, health literacy as an exposure factor and mortality, readmission, or QOL as outcomes were included in this study. Two researchers screened the retrieved articles and extracted data independently. The meta-analysis calculated the pooled relative risk of mortality and readmission. We also assessed the body of evidence based on Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Following screening of 1616 studies, 16 observational studies were included. The mean rate of low health literacy was 32.8%. All studies focusing on QOL showed significant impacts of health literacy. Pooled relative risk was 1.621 (95% confidence interval: 1.089-2.412) for mortality and 1.184 (95% confidence interval: 1.035-1.355) for readmission, indicating significant effects of health literacy. GRADE assessment showed "LOW" certainty for each outcome. CONCLUSION Low health literacy was significantly associated with increased mortality and hospital readmission and decreased QOL in patients with CVD. PRACTICE IMPLICATIONS Considering low health literacy in clinical practice is very important to improve prognosis of CVD patients.
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Affiliation(s)
- Yuji Kanejima
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Cardiovascular stroke Renal Project (CRP), Kobe, Japan; Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takayuki Shimogai
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Cardiovascular stroke Renal Project (CRP), Kobe, Japan; Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masahiro Kitamura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Cardiovascular stroke Renal Project (CRP), Kobe, Japan; Department of Physical Therapy, Fukuoka Wajiro Professional Training College, Fukuoka, Japan
| | - Kodai Ishihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Cardiovascular stroke Renal Project (CRP), Kobe, Japan; Department of Rehabilitation, Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Cardiovascular stroke Renal Project (CRP), Kobe, Japan.
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A structural equation model linking health literacy, self efficacy and quality of life in adults with coronary heart disease. BMC Cardiovasc Disord 2022; 22:285. [PMID: 35739464 PMCID: PMC9229518 DOI: 10.1186/s12872-022-02720-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/13/2022] [Indexed: 12/12/2022] Open
Abstract
Background Cardiovascular disease is the world major cause of death. There is sufficient evidence that patients with coronary heart disease (CHD) experience poor quality of life. Health literacy and self efficacy are modifiable psychosocial factors that could affect quality of life, and these factors should be considered as targets for intervention. As the relationships among health literacy, self efficacy, and quality of life in the CHD population have not been well understood. Thus, we constructed the structure equation model in these valuables. Methods A cross-sectional study of a convenience sample among 200 patients with CHD were participated from outpatient clinics in three tertiary general hospitals in Baoding City in mainland China, from December 2018 to June 2019. Data regarding demographic features, health literacy, self efficacy and quality of life were assessed. A structure equation model was used to construct and validate the pathways. Results The mean age of the study sampled patients was 65.37 years old. The average level of health literacy, self efficacy and quality of life were 9.6 ± 3.5, 28.8 ± 13.9 and 381.8 ± 130.1 respectively. Significant associations were observed from health literacy to quality of life, and self efficacy played a partial mediating role between health literacy and quality of life in the CHD population. Health literacy and self efficacy explained for 59.6% of the variance in quality of life. Conclusions Health literacy had a direct influence on quality of life, and an indirect influence on quality of life via self efficacy in the patients with CHD. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02720-8.
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Bengtsson KR, Rognan SE, Kälvemark Sporrong S, Lie HB, Andersson Y, Mowe M, Mathiesen L. Health literacy in medication communication during hospital discharge: a qualitative study at an internal medicines ward in Norway. BMJ Open 2022; 12:e058473. [PMID: 35680250 PMCID: PMC9185673 DOI: 10.1136/bmjopen-2021-058473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE When discharged from hospital patients are often assumed to have sufficient health literacy (HL) to participate in their medical treatment and manage medical self-care after discharge. However, limited HL is a widespread concern and patient participation during discharge is lacking. In this study, we explore how HL influences medication communication during hospital discharge. DESIGN A qualitative case study, comprising unstructured observations of patient-healthcare personnel (HCP) encounters followed by semistructured interviews. Data were analysed using content analysis. SETTING An internal medicines ward at a university hospital in Norway. PARTICIPANT Fifteen patients aged 40-89 years were included close to the day of discharge. RESULTS The following themes describing dimensions of HL emerged: (1) access, (2) understand, (3) appraise and (4) apply. Most patients sought access to medication information from HCP, while some felt dependent on HCP to provide it. However, their abilities to understand, evaluate and make informed decisions were challenged, partly because HCPs' ability to adapt their communication to the patient's knowledgebase varied. CONCLUSION The results give a broader understanding of how HL influences medication communication during hospital discharge. To consider central dimensions of HL is important to achieve optimal medication communication, as the communication only can be exercised within the frames of the patient's HL. The findings in this study support that HL should be described as a shared responsibility between the patients and HCP. Attention should be focused to the HCP's responsibility to adapt the communication to the patient's knowledgebase.
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Affiliation(s)
| | - Stine Eidhammer Rognan
- Department of Pharmaceutical Services, Oslo Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Oslo, Norway
| | | | | | - Yvonne Andersson
- Hospital Pharmacies Enterprise, South Eastern Norway, Oslo, Norway
| | - Morten Mowe
- General Internal Medicine Ward, the Medical Clinic, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Liv Mathiesen
- Department of Pharmacy, University of Oslo, Oslo, Norway
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Rad MG, Ghanbari-Afra L, Hoseini MHM, Afra MG, Asayesh H. Effectiveness of self-care program on the quality of life in patients with coronary artery disease undergoing cardiac rehabilitation: A Randomized clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:375. [PMID: 34912911 PMCID: PMC8641704 DOI: 10.4103/jehp.jehp_70_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) is a life-threatening condition that causes physical and psychological disorders and decreases patients' quality of life (QoL). Performing proper educational self-care program may lead to higher QoL in these patients. This study was performed to investigate the effectiveness of a self-care educational program on QoL in patients with CAD. MATERIALS AND METHODS This semi-experimental study was performed on 60 patients with CAD referred to the cardiac rehabilitation (CR) center of Vali Asr hospital in Qom, Iran, in 2018-2019. Patients were divided into control and intervention groups by randomized sampling. The self-care educational program was provided through lectures and booklet. Data collection was done using the "demographic and clinical data questionnaire," and "Seattle Angina questionnaire." Questionnaires were completed in both groups, before and at least 1 month after education. Analysis of the obtained data was performed using SPSS software (version 25), central indexes, Mann-Whitney test, and Wilcoxon test. RESULTS No significant differences were observed between the two groups for demographics characteristics and quality of life before the intervention. Before the self-care program, the mean score of the QoL in the intervention and control group were 56.14 ± 9.75 and 58.46 ± 11.71, respectively. After that, the mean score of the QoL in the intervention and control group were 59.25 ± 10.56 and 59.7 ± 13.33, respectively. The statistical analysis showed significant differences in the mean scores of QoL in the intervention group before and after the intervention (P < 0.05). However, no statistically significant differences were seen in the control group before and after the study (P > 0.05). CONCLUSIONS The self-care educational program improved the QoL in patients with CAD. Therefore, lectures and educational booklets should be considered by CR nurses.
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Affiliation(s)
- Mohammad Goudarzi Rad
- Master of Critical Care Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Ghanbari-Afra
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Monireh Ghanbari Afra
- Master of Critical Care Nursing, Shahid Beheshti-Amir Al-Momenin Department, Qom University of Medical Sciences, Qom, Iran
| | - Hamid Asayesh
- Emergency Department, Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
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Ruile S, Meisinger C, Burkhardt K, Heier M, Thilo C, Kirchberger I. Effort-Reward Imbalance at Work and Overcommitment in Patients with Acute Myocardial Infarction (AMI): Associations with Return to Work 6 Months After AMI. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:532-542. [PMID: 33196948 PMCID: PMC8298327 DOI: 10.1007/s10926-020-09942-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/11/2023]
Abstract
Purpose Stress-related factors influence the adaptation to life after acute myocardial infarction (AMI), including return to work. The goal of this study was to investigate the effect of work-related stress, (expressed by the effort-reward imbalance (ERI) model) on return to work after AMI. Methods A longitudinal study with AMI patients was conducted in order to assess associations between the independent variables effort, reward, ERI and overcommitment and the outcome return to work after AMI. Return to work was inquired at 6 months follow-up. Logistic regression models were applied in the analysis. The fully-adjusted model included demographic, clinical, social, stress-related and health-related quality of life (HRQOL) covariables. Results Of the 346 enrolled patients aged 31 to 82 years, 239 (69.1%) were included in the regression analysis. In the unadjusted model ERI presented an odds ratio (OR) of 1.72 (95% confidence interval (CI) 0.86-3.42). Associations for effort and overcommitment were 0.98 (95% CI 0.83-1.15) and 1.09 (95% CI 0.99-1.18). However, reward showed a significantly inverse association with return to work with an OR of 0.90 (95% CI 0.83-0.99). In the fully adjusted model the OR of ERI decreased to 1.20 (95% CI 0.49-2.96). Effort, reward and overcommitment also showed attenuated ORs without significant results in all models. Diabetes mellitus, current smoking, low physical and low mental HRQOL presented significantly negative relations with return to work. Conclusions Work-related stress appears less important than HRQOL and resilience in terms of return to work after AMI.
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Affiliation(s)
- Sarah Ruile
- Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology-IBE, Ludwig-Maximilians-Universität München, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Christine Meisinger
- Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany
- MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Katrin Burkhardt
- Department of Laboratory Medicine and Microbiology, University Hospital of Augsburg, Augsburg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
| | - Christian Thilo
- Department of Internal Medicine I - Cardiology, University Hospital of Augsburg, Augsburg, Germany
| | - Inge Kirchberger
- Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany.
- MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Augsburg, Germany.
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERcv), Madrid, Spain.
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Assessing Frailty in the General Medical Clinic of a Tertiary Hospital in Northern Malaysia: The FRAIL Scale or the Clinical Frailty Scale. Curr Gerontol Geriatr Res 2021; 2021:7570592. [PMID: 34394346 PMCID: PMC8356013 DOI: 10.1155/2021/7570592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background Frailty potentially influences clinicians' decision making on treatment provided they can select the appropriate assessment tools. This study aims to investigate the difference between the FRAIL scale and the Clinical Frailty Scale (CFS) in assessing frailty among community-dwelling older adults attending the General Medical Clinic (GMC) in Seberang Jaya Hospital, Penang, Malaysia. Methods The medical records of 95 older patients (age ≥ 65) who attended the GMC from 16 December 2019 to 10 January 2020 were reviewed. Frailty was identified using the FRAIL scale and the CFS. Patient characteristics were investigated for their association with frailty and their difference in the prevalence of frailty by the FRAIL scale and CFS. Results The CFS identified nonsignificant higher prevalence of frailty compared to the FRAIL scale (21/95; 22.1% vs. 17/95; 17.9%, ratio of prevalence = 1.235, p=0.481). Minimal agreement was found between the FRAIL scale and the CFS (Kappa = 0.272, p < 0.001). Three out of 5 components of the FRAIL scale (resistance, ambulation, and loss of weight) were associated with frailty by the CFS. Higher prevalence of frailty was identified by the CFS in those above 70 years of age. The FRAIL scale identified more patients with frailty in ischaemic heart disease patients. Conclusion Patient characteristics influenced the choice of the frailty assessment tool. The FRAIL scale and the CFS may complement each other in providing optimized care to older patients who attended the GMC.
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Li S, Cui G, Yin Y, Wang S, Liu X, Chen L. Health-promoting behaviors mediate the relationship between eHealth literacy and health-related quality of life among Chinese older adults: a cross-sectional study. Qual Life Res 2021; 30:2235-2243. [PMID: 33661455 PMCID: PMC8298362 DOI: 10.1007/s11136-021-02797-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The aim of this study was to examine the association between eHealth literacy and health-related quality of life (HRQoL) and explore whether health-promoting behaviors mediate the association between eHealth literacy and HRQoL among Chinese older adults. METHODS An anonymous cross-sectional survey was conducted among 2300 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale, Short-Form Health-Promoting Lifestyle Profile, and Short-Form Health Survey (SF-12) were used to measure eHealth literacy, health-promoting behaviors, and HRQoL. Multivariate linear regression analyses were conducted to test the association between eHealth literacy, health-promoting behaviors, and HRQoL. The mediation analyses, composed of PROCESS analysis and bootstrapping method, were preformed to test both total (c), direct (c'), and indirect effects (a*b) of eHealth literacy on HRQOL through health-promoting behaviors. RESULTS Regression analyses indicated that eHealth literacy (B = 0.487, p < 0.001) was significantly positively associated with health-promoting behaviors, and health-promoting behaviors (B = 0.257, p < 0.001) were associated with HRQoL. The mediation analyses indicated that eHealth literacy had a significant direct (c' = 0.183, p < 0.001) and indirect effect on older adults' HRQoL through health-promoting behaviors (a*b = 0.125, bootstrapped 95% confidence interval (CI) = 0.094-0.157). The indirect effect accounted for 40.6% of the total effect (c = 0.308, bootstrapped 95% CI 0.241-0.376) of eHealth literacy on HRQoL. CONCLUSIONS Health-promoting behaviors mediated the association between eHealth literacy and HRQoL in Chinese older adults. The establishment of interventions focused on health-promoting behavior may be an effective way to help older adults with low eHealth literacy improve their HRQoL.
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Affiliation(s)
- Shaojie Li
- Department of Social Medicine and Health Service Management, Xiangya School of Public Health, Central South University, Changsha, 410078, China
| | - Guanghui Cui
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
| | - Shiyuan Wang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
| | - Xinyao Liu
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Lei Chen
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
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Tilahun D, Abera A, Nemera G. Communicative health literacy in patients with non-communicable diseases in Ethiopia: a cross-sectional study. Trop Med Health 2021; 49:57. [PMID: 34256862 PMCID: PMC8276450 DOI: 10.1186/s41182-021-00345-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Health literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia. Methods A cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations. Result Descriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains. Conclusion The overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.
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Affiliation(s)
- Desalew Tilahun
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Abebe Abera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gugsa Nemera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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The Sociodemographic Determinants of Health Literacy in the Ethnic Hungarian Mothers of Young Children in Eastern Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115517. [PMID: 34063905 PMCID: PMC8196676 DOI: 10.3390/ijerph18115517] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022]
Abstract
Parental health literacy is a decisive factor for child health and quality of life. Children of parents with limited health literacy are at increased risk of illness and longer recovery periods. The research at the Quality of Life Research Centre is aimed at studying the health literacy of ethnic Hungarian mothers in Eastern Europe (Hungary, Slovakia, Romania) as well as at assessing its socioeconomic and demographic antecedents. The sample size is 894 mothers. Our standardized online questionnaire includes the HLS-EU-16 and the BHLS questions, with the latter intended to screen for inadequate health literacy. Predictors of health literacy in mothers are socioeconomic status, age and partnership status. A key finding is the improvement of health literacy with age. Assessing the association of partnership status and health literacy is a novelty in this region. Our analysis reinforces the role of socioeconomic capital, widely recognized to be associated with health literacy in general and with parental health literacy in particular. Results indicate the necessity of improving caregiver health literacy with a range of health promotional activities in Eastern Europe, especially among mothers with low socioeconomic status. The hardships of young mothers and single mothers should also be considered in this respect.
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Enjezab B, Zarehosseinabadi F, Tafti AD, Zarehosseinabadi M. The Relationship between Health Literacy Dimensions and Perceived Risk of Cardiovascular Disease in Middle-Aged Iranian Women. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:279-284. [PMID: 34277381 PMCID: PMC8262544 DOI: 10.4103/ijnmr.ijnmr_104_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/25/2020] [Accepted: 02/01/2021] [Indexed: 11/25/2022]
Abstract
Background: The purpose of the study was to investigate the relationship between health literacy dimensions and the perceived risk of cardiovascular disease in middle-aged Iranian women. Materials and Methods: This is a descriptive-correlational study in which 280 women aged 40–60 years were investigated by random cluster sampling out of seven health centers in Yazd city in 2018. Data collection tools included predesigned demographic information from a standard Health Literacy for Iranian Adults (HELIA), and a standard perceived susceptibility and perceived risk components of the preventive behaviors of cardiovascular disease questionnaire. The data were analyzed using one-way ANOVA, independent t-test, Kruskal-Wallis, and Mann Whitney tests. Results: A significant relationship was identified between demographic information and health literacy (p < 0.001). The mean (SD) scores of the perceived risk of cardiovascular disease and health literacy appeared to be 30.71 (5.10) and 35.62 (15.32), respectively. The perceived risk of cardiovascular disease in the participants turned out to be significantly correlated with the accessibility dimension of health literacy (r = 0.31, p < 0.001), but it failed to have any significant relationship with demographic information, especially obesity. Conclusions: As there is a significant relationship between health literacy and perceived risk of cardiovascular disease, hence increasing the health literacy of middle-aged women, especially in persons with high body mass index through the media and health centers, considered as an important source of health information, can be an appropriate task to augment the perceived risk of cardiovascular diseases.
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Affiliation(s)
- Behnaz Enjezab
- Department of Midwifery, Social Determinants of Health Research Center, Research Center for Nursing and Midwifery Care, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Arefeh Dehghani Tafti
- Department of Biostatics and Epidemiology, The School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mina Zarehosseinabadi
- Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Azlan AA, Hamzah MR, Tham JS, Ayub SH, Ahmad AL, Mohamad E. Associations between Health Literacy and Sociodemographic Factors: A Cross-Sectional Study in Malaysia Utilising the HLS-M-Q18. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094860. [PMID: 34063294 PMCID: PMC8125110 DOI: 10.3390/ijerph18094860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/19/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022]
Abstract
Health literacy is progressively seen as an indicator to describe a nation's health status. To improve health literacy, countries need to address health inequalities by examining different social demographic factors across the population. This assessment is crucial to identify and evaluate the strengths and limitations of a country in addressing health issues. By addressing these health inequalities, a country would be better informed to take necessary steps to improve the nation's health literacy. This study examines health literacy levels in Malaysia and analyses socio-demographic factors that are associated with health literacy. A cross-sectional survey was carried out using the HLS-M-Q18 instrument, which was validated for the Malaysian population. Multi-stage random sampling strategy was used in this study, utilising several sampling techniques including quota sampling, cluster sampling, and simple random sampling to allow random data collection. A total of 855 respondents were sampled. Our results showed that there were significant associations between health literacy and age, health status, and health problems. Our findings also suggest that lower health literacy levels were associated with the younger generation. This study's findings have provided baseline data on Malaysians' health literacy and provide evidence showing potential areas of intervention.
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Affiliation(s)
- Arina Anis Azlan
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (A.A.A.); (A.L.A.)
- HEALTHCOMM UKM x UNICEF C4D Centre, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Mohammad Rezal Hamzah
- Centre of Excellence for Social Innovations and Sustainability, Faculty of Applied and Human Sciences, Universiti Malaysia Perlis, Kangar 01000, Perlis, Malaysia;
| | - Jen Sern Tham
- Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia;
| | - Suffian Hadi Ayub
- Faculty of Communication and Media Studies, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia;
| | - Abdul Latiff Ahmad
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (A.A.A.); (A.L.A.)
| | - Emma Mohamad
- Centre for Research in Media and Communication, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (A.A.A.); (A.L.A.)
- HEALTHCOMM UKM x UNICEF C4D Centre, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- Correspondence:
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Suhail M, Saeed H, Saleem Z, Younas S, Hashmi FK, Rasool F, Islam M, Imran I. Association of health literacy and medication adherence with health-related quality of life (HRQoL) in patients with ischemic heart disease. Health Qual Life Outcomes 2021; 19:118. [PMID: 33849547 PMCID: PMC8045399 DOI: 10.1186/s12955-021-01761-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medication Adherence (MA) and Health Related Quality of Life (HRQoL) are two inter-connected concepts, co-influenced by Health Literacy (HL), with significant impact on patient management and care. Thus, we aimed to estimate the association of HL and MA with HRQoL in IHD patients. METHODS Cross-sectional study of 251 IHD patients recruited from Lahore over 6 months period. HL, MA and HRQoL was assessed using validated questionnaires; 16-items of HL, Morisky Green Levine Scale (MGLS) and SF-12, respectively. Chi-square for significance, logistic-regression for association and linear regression for predictions were used. RESULTS IHD patients; males (p = 0.0001), having secondary-higher education (p = 0.0001), middle/upper class (p = 0.0001) and employed (p = 0.005) had adequate HL, and were more likely to be adherent (OR; 4.3, p = 0.014). Both physical (PCS-12) and mental (MCS-12) component scores of HRQoL for age, gender, education, area of residence, employment and MA were significantly higher in patients with adequate HL. In multinomial regression, improved PCS-12 scores tend to be higher in subjects having secondary-higher education (OR; 3.5, p = 0.067), employed (OR; 6.1, p = 0.002) and adherent (OR; 2.95, p = 0.218), while MCS-12 scores tend to be higher in patients < 65 years (OR; 2.2, p = 0.032), employed (OR; 3, p = 0.002) and adherent (OR; 4, p = 0.004). In adjusted model, HL (β;0.383, p = 0.0001) and MA (β; - 0.133, p = 0.018) were significantly associated with PCS-12, and MCS-12 with MA (β; - 0.161, p = 0.009) only. CONCLUSION Data suggested that adequate HL was significantly associated with adherence and both physical and mental dimensions of HRQoL were higher in IHD patients with adequate HL. Besides, HL and MA are independent predictors of HRQoL in IHD patients.
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Affiliation(s)
- Muzna Suhail
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Hamid Saeed
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Zikria Saleem
- Department of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Saman Younas
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Furqan Khurshid Hashmi
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Islam
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
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Estimating the Economic Burden of Low Health Literacy in the Blacktown Community in Sydney, Australia: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052303. [PMID: 33652730 PMCID: PMC7956806 DOI: 10.3390/ijerph18052303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 11/24/2022]
Abstract
Evidence shows that inadequate or low health literacy (LHL) levels are significantly associated with economic ramifications at the individual, employer, and health care system levels. Therefore, this study aims to estimate the economic burden of LHL among a culturally and linguistically diverse (CALD) community in Blacktown: a local government area (LGA) in Sydney, Australia. This study is a secondary analysis of cross-sectional data from publicly available datasets, including 2011 and 2016 census data and National Health Survey (NHS) data (2017–2018) from the Australian Bureau of Statistics (ABS), and figures on Disease Expenditure in Australia for 2015–2016 provided by the Australian Institute of Health and Welfare (AIHW). This study found that 20% of Blacktown residents reported low levels of active engagement with health care providers (Domain 6 of the Health Literacy Questionnaire (HLQ)), with 14% reporting a limited understanding of the health information required to take action towards improving health or making health care decisions (Domain 9 of the HLQ). The overall extra/delta cost (direct and indirect health care costs) associated with LHL in the Blacktown LGA was estimated to be between $11,785,528 and $15,432,239 in 2020. This is projected to increase to between $18,922,844 and $24,191,911 in 2030. Additionally, the extra disability-adjusted life year (DALY) value in 2020, for all chronic diseases and age-groups—comprising the extra costs incurred due to years of life lost (YLL) and years lived with disability (YLD)—was estimated at $414,231,335. The findings of our study may enable policymakers to have a deeper understanding of the economic burden of LHL in terms of its impact on the health care system and the production economy.
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Lidin M, Hellenius ML, Rydell Karlsson M, Ekblom-Bak E. Effects of Structured Lifestyle Education Program for Individuals With Increased Cardiovascular Risk Associated With Educational Level and Socioeconomic Area. Am J Lifestyle Med 2021; 15:28-38. [PMID: 33447169 PMCID: PMC7781060 DOI: 10.1177/1559827620951143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background. Differences in socioeconomic status contribute to inequalities in lifestyle habits and burden of noncommunicable diseases. We aimed to examine how the effects of a 1-year structured lifestyle education program associate with the participant’s educational level and socioeconomic area (SEA) of residence. Methods. One hundred individuals (64% women) with high cardiovascular risk were included. Education level (nonuniversity vs university degree) was self-reported and SEA (low vs high) defined by living in different SEAs. Lifestyle habits and quality of life were self-reported, cardiovascular risk factors and Framingham 10-year cardiovascular disease risk were measured at baseline and after 1 year. Results. Sedentary behavior decreased in both nonuniversity degree and low SEA group over 1 year, with a significantly greater improvement in daily activity behavior in low- compared with high-SEA group. Abdominal obesity decreased significantly more in the nonuniversity compared with the university degree group. Cardiovascular risk and quality of life improved in all groups, however, with greater discrimination when using educational level as the dichotomization variable. Conclusion. The results are clinically and significantly relevant, suggesting that low socioeconomic status measured both as educational level and SEA are no barriers for changing unhealthy lifestyle habits and decreasing cardiovascular risk after participation in a lifestyle program.
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Affiliation(s)
- Matthias Lidin
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Mai-Lis Hellenius
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Monica Rydell Karlsson
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Elin Ekblom-Bak
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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Moylett S, Hevey D. Testing threat-to-efficacy ratios in health communications about cardiovascular disease among an older population. Health Promot Int 2020; 35:255-266. [PMID: 30879077 DOI: 10.1093/heapro/daz019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To test threat-to-efficacy ratios within health communications about cardiovascular disease (CVD) for older individuals. Participants were randomly assigned to one of six messages: (i) 'standard' message with 1/1 threat-to-efficacy ratio, (ii) 'low efficacy' message with 1/0 threat-to-efficacy ratio, (iii) 'low threat' message with 0/1 threat-to-efficacy ratio, (iv) 'high efficacy' message with 1/2 threat-to-efficacy ratio; (v) 'high threat' message with 2/1 threat-to-efficacy ratio and (vi) 'overload' message with 2/2 threat-to-efficacy ratio. Participants had to be of 60 years of age or older (N = 242, Male = 92, Age: M = 68.29, SD = 6.71). Advanced univariate analyses and multiple regression modelling were conducted to examine associations between the message groups, and danger- and fear-control processes, as well as the impact of threat and efficacy appraisals on the relationship between the message groups and behavioural intentions. No differences were found between the message groups for danger-control processes. Those who received the 'overload' message did report higher levels of fear, nervousness and anxiety in comparison to the 'standard' message group. For physical activity, it was found that efficacy impacted the relationship between the message groups and behavioural intentions, as participants' levels of efficacy increased and if these individuals received high levels of efficacy information, their behavioural intentions for physical activity increased. Results from this study were dissimilar to those of previous research. However, they highlighted the impact of efficacy and negative emotional reactions when communicating to older individuals about CVD and the associated health behaviours.
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Affiliation(s)
- Sinéad Moylett
- School of Psychology, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
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The relationship between job stress and health literacy with the quality of work life among Iranian industrial workers: The moderating role of social support. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00782-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial. BMC Health Serv Res 2020; 20:60. [PMID: 31973765 PMCID: PMC6979365 DOI: 10.1186/s12913-020-4901-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/09/2020] [Indexed: 12/29/2022] Open
Abstract
Background Improving the training of physicians about communication skills and patient health literacy (HL) is a major priority that remains an open question. We aimed to examine the effectiveness of communication skills training for physicians on the hypertension outcomes and the health literacy skills, self-efficacy and medication adherence in patients with uncontrolled blood pressure (BP). Methods A randomized, controlled trial method was conducted on 240 hypertensive patients and 35 physicians presenting to healthcare clinics in the Mashhad, Iran, from 2013 to 2014. Using stratified blocking with block sizes of 4 and 6, eligible patients with uncontrolled blood pressure were randomly allocated to the intervention and control groups. Physicians in the intervention group received educational training over 3 sessions of Focus –Group Discussion and 2 workshops. The control group received the routine care. The primary outcome was a reduction in systolic and diastolic BP from baseline to 6 months. The secondary outcome was promoting HL skills in hypertensive patients. Data were analyzed using the regression model and bivariate tests. Results After the physician communication training, there was a significant improvement in physicians-patient communication skills, hypertension outcomes, medication adherence, and self-efficacy among the patients being managed by the physicians receiving training, compared to the control group. Conclusion The educational intervention leads to better BP control; it may have been sufficient training of physicians change to impact counseling, HL and self-efficacy and adherence. The quality of physician-patient communication is an important modifiable element of medical communication that may influences health outcomes in hypertensive Iranian patients. Trial registration Iranian Registry of Clinical Trials (IRCT), IRCT20160710028863N24. Registered April 4, 2018 [retrospectively registered].
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Health Literacy among People in Cardiac Rehabilitation: Associations with Participation and Health-Related Quality of Life in the Heart Skills Study in Denmark. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020443. [PMID: 31936506 PMCID: PMC7013951 DOI: 10.3390/ijerph17020443] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 12/31/2022]
Abstract
Health literacy (HL) is a dynamic determinant of health and a promising target of health equity interventions in noncommunicable disease prevention. Among people referred to a cardiac rehabilitation program, we examined the associations between (1) HL and participation in cardiac rehabilitation and (2) HL and health-related quality of life (HRQoL). Using a cross-sectional design, we invited 193 people referred to cardiac rehabilitation in Randers Municipal Rehabilitation Unit, Denmark, to respond to a questionnaire in 2017. Of these, 150 people responded (77.7%). HL was measured using the nine scales of the Health Literacy Questionnaire (HLQ), while HRQoL was measured using the Short Form Health Survey 12 (version 2) (SF-12). The mean age of respondents was 67.0 years; 71.3% of the sample were men. Nonrespondents had significantly lower educational attainment and more often lived alone than respondents. Using multiple regression analyses, we found no significant associations between HL and participation in cardiac rehabilitation. There were significant positive associations between several aspects of HL and physical and mental HRQoL. HL could be a factor of interest in initiatives aimed at improving participation and outcomes of cardiac rehabilitation.
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Cho M, Lee H, Lee YM, Lee JY, Min H, Kim Y, Kim S. Psychometric properties of the Korean version of the Health Literacy on Social Determinants of Health Questionnaire (K-HL-SDHQ). PLoS One 2019; 14:e0224557. [PMID: 31738802 PMCID: PMC6860445 DOI: 10.1371/journal.pone.0224557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
The association between the social determinant of health (SDH) and sustainable development goals, has directed attention toward the influence of SDH. However, there is a lack of evidence regarding the instruments used to assess SDH. Thus, this study was conducted to assess the validity and reliability of the Korean Version of the Health Literacy on Social Determinants of Health Questionnaire (K-HL-SDHQ). A total of 660 workers in Korea participated in an online survey. The K-HL-SDHQ measures four dimensions (Access, Understand, Appraise, and Apply) with 33 items. The HL-SDHQ was translated into Korean using the forward-back translation method. To test the validity and reliability of the Korean translated HL-SDHQ, item analysis for the 33 items was conducted. Internal consistency was examined using Cronbach's α, an exploratory factor analysis, and a confirmatory factor analysis. The scale-level content validity index (S-CVI)/universal agreement of this study was .12 and S-CVI/average was .83 (item-CVI range = .50-1.00). The goodness of fit determined through a confirmatory factor analysis of the four dimensions was acceptable (χ2 (489) = 1475.054, p < .001, RMSEA = .06, CFI = .87, TLI = .85). The K-HL-SDHQ also demonstrated satisfactory internal consistency reliability (Cronbach's α = .92). The findings indicate that the K-HL-SDHQ is a valid and reliable tool that can be used to assess the SDH of workers in Korea. It is suggested that this tool can be applied through repeated research with workers and non-workers for health promotion, and to enhance researchers' understanding of the different levels of the HL-SDHQ.
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Affiliation(s)
- Mikyeong Cho
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, South Korea
- * E-mail:
| | - Young-Me Lee
- School of Nursing, DePaul University, Chicago, Illinois, United States of America
| | - Ja-yin Lee
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Haeyoung Min
- College of Nursing, Gyeongsang National University, Jinju, South Korea
| | - Youlim Kim
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Sookyung Kim
- Mo-Im Kim Nursing Research institute, College of Nursing, Yonsei University, Seoul, South Korea
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Rababah JA, Al-Hammouri MM, Drew BL, Aldalaykeh M. Health literacy: exploring disparities among college students. BMC Public Health 2019; 19:1401. [PMID: 31664973 PMCID: PMC6819582 DOI: 10.1186/s12889-019-7781-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 10/14/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Health literacy is a multidimensional concept that is considered a primary public health concern. This concept is often neglected in research, and the evidence regarding health literacy in college students is limited. The aim of this study was two-fold: to determine the needs and limitations of health literacy among college students and to explore the relationships among the nine dimensions of health literacy and sociodemographic factors, including age, gender, nationality, year of study, field of study, smoking status, history of chronic diseases, use of on-campus gym, and the intention to exercise on-campus. METHODS This study was conducted using a cross-sectional approach. A total of 520 college students participated in this study. The average age was 21.03 years (SD = 2.29), with 47.5% males and 52.5% females. Data were collected using a demographics questionnaire and the Health Literacy Questionnaire (HLQ). In addition to descriptive statistics, multivariate analysis of variance (MANOVA) and follow-up analyses were performed to explore any statistically significant mean differences among levels of health literacy and sociodemographic factors. RESULTS The levels of health literacy on the nine HLQ scales were lower than the levels reported in the literature. Multivariate analysis showed a significant effect of age, gender, smoking status, year of study, and field of study on the level of health literacy. Follow-up analyses revealed that female students, students from the health-related faculties, and those who do not smoke have higher levels of health literacy compared to their counterparts. A detailed comparison between the levels of the HLQ scales was made based on students' demographic characteristics. The field of study had the most prominent effect on the level of college students' health literacy; mean differences were statistically significant (p < .001), and effect sizes were large (ranging from .66 to 1.35 for the nine scales of the HLQ). CONCLUSION College students' health literacy is influenced by demographic characteristics. Such variations could amplify some of the existing health disparities. The implications of the findings on health, health promotion, and interprofessional education are discussed.
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Affiliation(s)
- Jehad A. Rababah
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110 Jordan
| | - Mohammed M. Al-Hammouri
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Mohammed Aldalaykeh
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Lin CY, Ganji M, Griffiths MD, Bravell ME, Broström A, Pakpour AH. Mediated effects of insomnia, psychological distress and medication adherence in the association of eHealth literacy and cardiac events among Iranian older patients with heart failure: a longitudinal study. Eur J Cardiovasc Nurs 2019; 19:155-164. [DOI: 10.1177/1474515119873648] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Given the importance of improving health for patients with heart failure, the present study examined the temporal associations between eHealth literacy, insomnia, psychological distress, medication adherence, quality of life and cardiac events among older patients with heart failure. Methods: With a longitudinal design older patients with echocardiography verified heart failure ( N=468; 50.4% New York Heart Association class II, mean age 69.3±7.3 years; 238 men) in need of cardiac care at seven Iranian university outpatient clinics went through clinical examinations and completed the following questionnaires at baseline: eHealth literacy scale (eHEALS, assessing eHealth literacy); 5-item medication adherence report scale (MARS-5, assessing medication adherence); Minnesota living with heart failure questionnaire (MLHFQ, assessing quality of life); insomnia severity index (ISI, assessing insomnia); and hospital anxiety and depression scale (HADS, assessing psychological distress). All the patients completed the ISI and HADS again 3 months later; and the MARS-5 6 months later. Also, their cardiac events were collected 18 months later. Three mediation models were then conducted. Results: eHealth literacy had direct and indirect effects (through insomnia and psychological distress) on medication adherence and quality of life. Moreover, eHealth literacy had protecting effects on cardiac events (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.37, 0.65) through the mediators of insomnia (HR 0.19; 95% CI 0.15, 0.26), psychological distress (HR 0.08; 95% CI 0.05, 0.12) and medication adherence (HR 0.05; 95% CI 0.04, 0.08). Conclusion: As eHealth literacy was a protector for patients with heart failure, healthcare providers may plan effective programmes to improve eHealth literacy for the population. Additional benefits of improving eHealth literacy in heart failure may be decreased insomnia and psychological distress, improved quality of life, as well as decreased cardiovascular events.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Maryam Ganji
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Nottingham Trent University, UK
| | | | - Anders Broström
- Department of Nursing, Jönköping University, Sweden
- Department of Clinical Neurophysioloy, Linköping University Hospital, Sweden
| | - Amir H Pakpour
- Department of Nursing, Jönköping University, Sweden
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Iran
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Hu Z, Qin L, Xu H. Association between diabetes-specific health literacy and health-related quality of life among elderly individuals with pre-diabetes in rural Hunan Province, China: a cross-sectional study. BMJ Open 2019; 9:e028648. [PMID: 31462471 PMCID: PMC6720152 DOI: 10.1136/bmjopen-2018-028648] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To examine the association between diabetes-specific health literacy (DSHL) and health-related quality of life (HRQoL) among elderly individuals with pre-diabetes in rural China. DESIGN, SETTING AND PARTICIPANTS This cross-sectional study included 434 elderly individuals with pre-diabetes from 42 villages in rural China. MAIN OUTCOME MEASURES HRQoL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. DSHL was measured by a validated questionnaire in China. Differences in HRQoL between groups with and without high DSHL were tested by multivariate analysis of covariance (MANCOVA). RESULTS The prevalence of pre-diabetes was 21.5%. The average age of participants (n=434) was 69.4±6.4 years, and 58.5% were female. Bivariate analysis showed that those with high DSHL had increases of 2.9 points in the physical health component score and 4.4 points in the mental health component score (MCS) compared with those without. After adjustment for potential confounders, a significant MANCOVA model (Wilks' λ=0.974, F=5.63, p=0.004) indicated that individuals with pre-diabetes who had high DSHL reported higher MCS (Mdiff=3.5, 95% CI 1.8 to 6.3, effect size=0.38). This remained significant across subscales: general health (p=0.028), vitality (p=0.014), social functioning (p=0.017) and mental health (p=0.005). CONCLUSIONS Low DSHL was associated with worsening HRQoL among elderly individuals with pre-diabetes in rural China, particularly in the mental health components. TRIAL REGISTRATION NUMBER ChiCTR-IOR-15007033.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Lulu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Bollars C, Sørensen K, de Vries N, Meertens R. Exploring health literacy in relation to noncommunicable diseases in Samoa: a qualitative study. BMC Public Health 2019; 19:1151. [PMID: 31438907 PMCID: PMC6704563 DOI: 10.1186/s12889-019-7474-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/12/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Samoa is suffering from alarming rates of noncommunicable diseases (NCDs). To address this epidemic, tackling health literacy is important. A qualitative study was conducted with the aim to explore health literacy in Samoa in relation to NCDs. METHODS Six focus groups were conducted, with a total sample size of 73 participants aged over 18 years. The semi-structured interview guide was based on the conceptual model of the European Health Literacy project (HLS-EU). Data was translated, transcribed, coded, and categorized as part of the qualitative analysis. RESULTS The analysis resulted in one overarching category and seven sub-categories based on 19 themes. It revealed that health literacy in Samoa is strongly influenced by the culture. Personal responsibility is lacking. The family circle is central to health in a community where support is provided through the church and local groupings. Basic knowledge of NCDs was present in the population, but a deeper understanding of chronic disease implications was lacking. Difficulties with regards to medication adherence for chronic diseases arose as a topic, and traditional healers are still strongly embedded in the local society. Finally, the health system's performance, especially primary care services at the local level, is suffering from the high burden of NCDs and has been challenged to respond to the needs of the community it serves. CONCLUSION The findings of this study show how health literacy in Samoa is influenced by culture and suggest employing participatory, culture-sensitive, public health interventions which address the family as a whole, building on health literacy to address major public health problems like NCDs and remove barriers in the health system.
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Affiliation(s)
- Caroline Bollars
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), and Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands.
| | | | - Nanne de Vries
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), and Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands
| | - Ree Meertens
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), and Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands
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Höfelmann DA, Gonzalez-Chica DA, Peres KG, Boing AF, Peres MA. Chronic diseases and socioeconomic inequalities in quality of life among Brazilian adults: findings from a population-based study in Southern Brazil. Eur J Public Health 2019; 28:603-610. [PMID: 29294001 DOI: 10.1093/eurpub/ckx224] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background To evaluate the association between sociodemographic conditions and the quality of life (QoL) in adults and investigate whether these inequalities are greater among individuals with long-lasting chronic health conditions. Methods Cross-sectional analysis of the second wave (2012) of the EpiFloripa Study, a population-based cohort of 1720 adults living in Southern Brazil. QoL domains (physical, psychological, social relationships and environmental) were evaluated using the WHOQoL-BREF. Unadjusted and adjusted means of QoL according to socioeconomic and demographic variables were estimated and stratified by the presence of long-lasting chronic conditions (heart disease, stroke, diabetes, hypertension, chronic kidney disease, cirrhosis, tendinitis, arthritis, rheumatism and/or fibromyalgia) were peformed in 2016. Results Among 1222 interviewed adults (56.6% females, mean age 41.7 ± 11.4 years; follow-up rate 71.1%), the prevalence of 1+ long-lasting chronic disease was 37.3% (95%CI: 34.4-40.3). Their effect on the QoL was four times higher on the physical component (-9.6; 95%CI -12.1; -7.1) than on the other domains. Adults aged 40+ years with black skin colour or lower educational level had a lower physical QoL score only when any chronic disease was present. Among those with some chronic illness, the psychological domain was also lower among those aged 40+ years and with a lower family income. No interaction between sociodemographic variables and chronic diseases was observed for the other QoL domains. Conclusions The occurrence of long-lasting chronic diseases is associated with inequalities in QoL (physical and psychological domains), with stronger adverse effects among older adults, blacks and individuals with lower income or educational levels.
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Affiliation(s)
- Doroteia A Höfelmann
- Post-Graduate Program in Public Health, Department of Nutrition, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - David A Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA, Australia
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Antonio Fernando Boing
- Post-Graduate Program in Public Health, Department of Public Health, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Marco Aurelio Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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Tabari-Khomeiran R, Bayazidi Y, Nikfar S, Homaie Rad E, Varmaghani M, Kokabisaghi F. Inequity in Access of Statins in Iran: A Panel Study Using Provincial Data. CASPIAN JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.29252/cjhr.4.2.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Elbashir M, Awaisu A, El Hajj MS, Rainkie DC. Measurement of health literacy in patients with cardiovascular diseases: A systematic review. Res Social Adm Pharm 2019; 15:1395-1405. [PMID: 30709731 DOI: 10.1016/j.sapharm.2019.01.008] [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] [Received: 06/20/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND While many instruments have been developed, validated, and used to assess health literacy skills, their use and appropriateness among patients with cardiovascular diseases (CVDs) are not widely studied. OBJECTIVE To identify, appraise, and synthesize available health literacy assessment instruments used in patients with CVDs. METHODS Electronic databases were searched for studies that used validated measures to assess health literacy in patients with CVDs. Included studies were assessed for risk of bias and the identified instruments were evaluated based on their psychometric properties. Data were synthesized using a narrative approach. RESULTS Forty-three studies were included in the review, of which 20 were cross-sectional studies and 12 were randomized controlled trials. Eleven health literacy assessment instruments were identified, of which only one was disease-specific. The Abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) (n = 19) and the Rapid Estimate of Adult Literacy in Medicine (REALM) (n = 13) were found to be the most commonly used instruments to assess health literacy in CVDs. CONCLUSIONS The S-TOFHLA and the REALM are the most widely used instruments to evaluate health literacy in CVD population. More CVD-specific health literacy screening instruments are warranted. Assessment of health literacy should be a standard of care in patients with CVDs and effective interventions should be developed to improve the impact of limited health literacy on health outcomes in this population.
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Affiliation(s)
| | - Ahmed Awaisu
- College of Pharmacy, Qatar University, Doha, Qatar.
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Linden M, Wasilewski J. Better patient knowledge and worse treatment outcome after written patient information in inpatient cognitive behaviour therapy as compared to non-informed patients. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1612825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Michael Linden
- Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Berlin, Germany
| | - Janice Wasilewski
- Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Berlin, Germany
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Khodabakhshi-koolaee A, Flasafinejad MR, Mayeli Khezerloo Z, Mohamadi F. Correlation of Health Literacy with Quality of Life in Athletic Disabled Women. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2018. [DOI: 10.21859/jech.5.3.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Stocks NP, González-Chica DA, Woods RL, Lockery JE, Wolfe RSJ, Murray AM, Kirpach B, Shah RC, Nelson MR, Reid CM, Ernst ME, McNeil JJ. Quality of Life for 19,114 participants in the ASPREE (ASPirin in Reducing Events in the Elderly) study and their association with sociodemographic and modifiable lifestyle risk factors. Qual Life Res 2018; 28:935-946. [PMID: 30411180 DOI: 10.1007/s11136-018-2040-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 01/21/2023]
Abstract
PURPOSE To explore the relationship between sociodemographic and lifestyle variables with health-related quality of life (HRQoL) of a large cohort of 'healthy' older individuals. METHODS The sample included individuals aged 65+ years from Australia (N = 16,703) and the USA (N = 2411) enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) multicentre placebo-controlled trial study and free of cardiovascular disease, dementia, serious physical disabilities or 'fatal' illnesses. The associations with the physical (PCS) and mental component scores (MCS) of HRQoL (SF-12 questionnaire) were explored using multiple linear regression models from data collected at baseline (2010-2014). RESULTS The adjusted PCS mean was slightly higher in the USA (49.5 ± 9.1) than Australia (48.2 ± 11.6; p < 0.001), but MCS was similar in both samples (55.7 ± 7.5 and 55.7 ± 9.6, respectively; p = 0.603). Males, younger participants, better educated, more active individuals, or those currently drinking 1-2 alcoholic drinks/day showed a better HRQoL (results more evident for PCS than MCS), while current heavy smokers had the lowest physical HRQoL in both countries. Neither age, walking time, nor alcohol intake was associated with MCS in either cohort. CONCLUSIONS Baseline HRQoL of ASPREE participants was higher than that reported in population-based studies of older individuals, but the associations between sociodemographic and lifestyle variables were consistent with the published literature. As the cohort ages and develops chronic diseases, ASPREE will be able to document HRQoL changes.
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Affiliation(s)
- Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Level 1, Helen Mayo North, Frome Road, North Tce Campus, Adelaide, SA, 5005, Australia.
| | - David A González-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Level 1, Helen Mayo North, Frome Road, North Tce Campus, Adelaide, SA, 5005, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jessica E Lockery
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rory S J Wolfe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Brenda Kirpach
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Mark R Nelson
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Michael E Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Ran M, Peng L, Liu Q, Pender M, He F, Wang H. The association between quality of life(QOL) and health literacy among junior middle school students: a cross-sectional study. BMC Public Health 2018; 18:1183. [PMID: 30340479 PMCID: PMC6194633 DOI: 10.1186/s12889-018-6082-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 10/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background Lower health literacy is associated with poor quality of life (QOL) among patients with chronic disease; little is known about this relationship among the general population, especially for child and adolescent. To fill this gap, this paper aimed to investigate the association between health literacy and QOL in junior middle school students, and explore how QOL varies by health literacy. Methods An anonymous cross-sectional survey was conducted among junior middle school students (aged 12–15) from Shapingba district, Chongqing in China, and participants were recruited using stratified cluster sampling. Health literacy and QOL were measured using two validated scales, and quantified using a five-point Likert scale with health literacy classified as low, medium, or high. We used multivariable logistic regression to test adjusted association between health literacy and QOL. Results A total of 1774 junior middle school students were evaluated, with the mean age was 13.8 ± 1.0 and of whom 905 (51.0%) were male. About 25.5% of the research subjects had a low health literacy. When controlling for age, grade, family structure and other covariates, highest discrimination was found among participants with low to high health literacy. Overall, Students who equipped with higher health literacy was associated with greater QOL (P < 0.01), and this discrimination remained significant in subscales: physiological well-being (P < 0.01), mental well-being (P < 0.01), social well-being (P < 0.01) and pubertal well-being (P < 0.01). Conclusions The prevalence of low health literacy among junior middle school students in Chongqing area was relatively high, and inadequate health literacy may contribute to poorer QOL among junior middle school students. It merits further longitudinal studies to confirm the impact of health literacy on QOL. Overall, to improve students’ QOL, public health efforts for further improving awareness and enhancing effective promotion and education are urgently needed in junior middle school students, especially for low health literacy populations.
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Affiliation(s)
- Min Ran
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Linli Peng
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Qin Liu
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, China.,Duke Global Health Institute, Duke University, Durham, NC, 27708, USA
| | - Michelle Pender
- Duke Global Health Institute, Duke University, Durham, NC, 27708, USA
| | - Fang He
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Hong Wang
- School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
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Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081761. [PMID: 30115831 PMCID: PMC6121278 DOI: 10.3390/ijerph15081761] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/06/2018] [Accepted: 08/14/2018] [Indexed: 11/16/2022]
Abstract
As with all other chronic noncommunicable diseases, adequate health literacy plays a key role in making the right decisions in the treatment of heart failure. Patients with heart failure and a lower health literacy have a reduced quality of life. A cross-sectional study among 200 patients with heart failure was conducted at a state university hospital in Belgrade, Serbia. The European Health Literacy Questionnaire, HLS-EU-Q47, was used to assess health literacy. Quality of life was measured with the generic SF-36 and the Minnesota Living with Heart Failure Questionnaire. Descriptive and analytical statistical analysis was applied. More than half of the respondents (64%) had limited health literacy. The lowest mean health literacy index (28.01 ± 9.34) was within the disease prevention dimension, where the largest number of respondents showed limited health literacy (70%). Our patients had a poorer quality of life in the physical dimension, and the best scores were identified in the emotional role and social functioning. Health literacy was highly statistically significant and an independent predictor of quality of life (physical, mental, and total quality of life). Improving health literacy can lead to better decisions in the treatment of disease and quality of life in heart failure patients.
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Caceres VDM, Stocks N, Adams R, Haag DG, Peres KG, Peres MA, González-Chica DA. Physical activity moderates the deleterious relationship between cardiovascular disease, or its risk factors, and quality of life: Findings from two population-based cohort studies in Southern Brazil and South Australia. PLoS One 2018; 13:e0198769. [PMID: 29879229 PMCID: PMC5991645 DOI: 10.1371/journal.pone.0198769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022] Open
Abstract
Background Few studies have investigated the relationship between physical activity (PA) of low intensity and duration with quality of life (QoL) among individuals at risk or with cardiovascular disease (CVD). Objectives To investigate whether PA of different intensity and duration moderates the relationship between CVD and its risk factors (obesity, hypertension, diabetes, dyslipidaemia) and QoL in adults. Methods Population-based cross-sectional studies using data from the EpiFloripa Cohort Study (Southern Brazil; n = 1,220, 38.8±12.0 years, 48.2% males) and the North West Adelaide Health Study (NWAHS, South Australia; n = 1,661, 43.7±11.1 years, 49.7% males). The physical and psychological domains of QoL were assessed using the WHOQOL-Bref (EpiFloripa) or the SF-36 (NWAHS) questionnaires. The diagnosis of CVD and its risk factors were self-reported. PA was self-reported and quantified by its intensity [“walking” or moderate/vigorous (MVPA)] and duration (none, 1–150, ≥150 min/week). Both studies were analysed separately, and results were adjusted for sociodemographic variables. Results Participants at risk or with CVD from both studies showed a lower QoL than ‘healthy’ individuals with a stronger relationship for the physical domain. PA duration showed a direct-trend relationship with QoL, but the associations were stronger for MVPA in both studies. However, when stratified by health status, the magnitude of the association between “walking” duration and a higher physical QoL was greater among those at risk or with CVD compared to ‘healthy’ individuals. Conversely, among Australians with CVD, MVPA was associated with a better physical QoL only when its duration was ≥150 min/week. All associations were stronger in the NWAHS than in the Brazilian study. Conclusions “Walking” was more prevalent than MVPA and was consistently associated with a better physical QoL among those at risk or with CVD. These findings should be considered in the design of public health interventions designed to increase PA and improve QoL.
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Affiliation(s)
- Viviane de Menezes Caceres
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
- Postgraduate Program in Rehabilitation Sciences, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert Adams
- The Health Observatory, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Dandara Gabriela Haag
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
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Rajabi M, Safarpoor G, Borzou SR, Farhadian M, Arabi A, Moeinipour A, Manafi B. Association between incidence of atrial fibrillation and duration of cardiopulmonary bypass in coronary artery bypass graft surgery (CABG): a cohort study. Electron Physician 2018; 10:6624-6630. [PMID: 29881524 PMCID: PMC5984016 DOI: 10.19082/6624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/22/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Open heart surgery is one of the most common and valuable treatment methods for cardiovascular diseases, a common side effect of which is atrial fibrillation that occurs due to various reasons. OBJECTIVE To determine the relationship between incidence of atrial fibrillation (AF) and duration of cardiopulmonary bypass (CPB) in patients after open heart surgery. METHODS The present retrospective cohort study was conducted on 330 patients in Farshchian Heart Center through census. The required data were collected from medical records of the patients undergoing coronary bypass surgery using data collection between April 2015 and March 2015. Then, data analysis was performed using SPSS software (ver.16) at error level of p<0.05. The tests used in this study included independent-samples t-test, Mann-Whitney, and chi-squared tests. RESULTS Based on the results, mean age of the patients was 61.76±9.2, the majority of the patients (70.1%) were male. The association between Incidence of Atrial Fibrillation and cardiopulmonary pump time (minute) was not meaningful. Incidence of atrial fibrillation had statistically significant relationship with variables of mean age, BMI, PAC, PVC, creatinine and duration of hospitalization (p<0.05); on the other hand, variables of gender, cross clamp time (minute), intubation time (hour), and clinical history had no effect on atrial fibrillation incidence rate (p>0.05). CONCLUSION Since the pathogenesis of AF after cardiac surgery is believed to be multifactorial, including clinical variables and technical intraoperative factors, the relation between incidence of AF with mean age, BMI, PAC, PVC, creatinine and duration of hospitalization was significant. But AF was not related to cardiopulmonary pump time (minute). It is necessary to conduct further research on factors affecting incidence of atrial fibrillation.
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Affiliation(s)
- Maryam Rajabi
- M.Sc. in Nursing, Nursing and Midwifery School, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Gholamreza Safarpoor
- Assistant Professor, Department of Cardiac Surgery, Faculty of Medical Sciences, Farshchian Heart Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Seyed Reza Borzou
- Assistant Professor, Department of Medical Surgical Nursing, Member of Chronic Disease (Home Care) Research Center, School of Nursing and Midwifery, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Maryam Farhadian
- Assistant Professor of Biostatistics, Modeling of Non Communicable Diseases Research Center, Department of Biostatistics, School of Public Health, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Arezo Arabi
- Master of Epidemiology, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Aliasghar Moeinipour
- Assistant Professor of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Babak Manafi
- Assistant Professor of Cardiovascular Surgery, Faculty of Medicine, Hamedan University of Medical Sciences. Iran
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Sahebalzamani M, Mostaedi Z, Farahani H, Sokhanvar M. Relationship between Health Literacy and Sexual Function and Sexual Satisfaction in Infertile Couples Referred to The Royan Institute. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2018; 12:136-141. [PMID: 29707930 PMCID: PMC5936611 DOI: 10.22074/ijfs.2018.5185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 09/17/2017] [Indexed: 11/24/2022]
Abstract
Background Health science and technology today is a rapidly growing field. Health is a multifaceted concept influ-
enced by several factors, and health literacy is essential to deal properly with the current situation. In this study, the
association between health literacy and sexual function and sexual satisfaction were investigated in 2016. Materials and Methods This descriptive and correlational study was conducted on 193 couples in the Royan Insti-
tute, Tehran. Data collection instruments were three standard questionnaires which included the Test of Functional
Health Literacy, the Female Sexual Function Index (FSFI) and the International Index of Erectile Function, and the
Iranian version of the Sexual Satisfaction Scale. The data were analyzed using SPSS-v23 software at a significance
level of 0.05. Results Marginal health literacy, 49.7% among men and 44.1% among women, was more common than adequate
or inadequate health literacy. Erectile function for the majority of men was appropriate (53.3%), compared to 16.6%
who had perfect function and 30.1% for whom function was less than appropriate. The majority of women (57.0%)
had sexual dysfunction. One hundred and three (53.3%) men had appropriate sexual function and 57% of women had
normal sexual function. The greater proportion of men (50.8%) and women (46.1%) had good, rather than very good
or less than good, sexual satisfaction. The results of chi-square tests indicated that greater health literacy was associ-
ated with higher levels of sexual function and sexual satisfaction among men and women. However, application of the
Cramer’s V test indicates that the strength of these associations is moderate to weak. Conclusion Health literacy was marginal among most couples and its adverse impacts on sexual function and sexual
satisfaction were confirmed. Accordingly, it is recommended that plans be developed to promote health literacy among
infertile couples.
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Affiliation(s)
- Mohammad Sahebalzamani
- Department of Management, Tehran Medical Sciences Branch Islamic Azad University, Tehran, Iran
| | - Zahra Mostaedi
- Department of Nursing and Midwifery, Tehran Medical Sciences Branch Islamic Azad University, Tehran, Iran
| | - Hojjatollah Farahani
- Department of Psychology, Tehran Medical Sciences Branch Islamic Azad University, Tehran, Iran. Electronic Address:
| | - Mobin Sokhanvar
- Iranian Center of Excellence in Health Management (IceHM), Tabriz University of Medical Sciences, Tabriz, Iran
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Soto Mas F, Schmitt CL, Jacobson HE, Myers OB. A Cardiovascular Health Intervention for Spanish Speakers: The Health Literacy and ESL Curriculum. J Community Health 2018; 43:717-724. [PMID: 29428986 DOI: 10.1007/s10900-018-0475-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Spanish speakers in the United States are in need of effective interventions that address both cardiovascular disease (CVD) and health literacy. However, the literature lacks interventions that have used and evaluated a strategies that focus on both, particularly at the community level. The aim of this study was to explore the effect of a health literacy curriculum on cardiovascular health behavior among Spanish speaking adults. It used a randomized controlled pre-posttest design. Participants included Hispanic adults with a low-to-intermediate level of English proficiency. The intervention group received the health literacy and English as a second language (ESL) Curriculum with CVD specific content, while the control group received a conventional ESL curriculum. Tools included the Spanish Cardiovascular Health Questionnaire (CSC), the test of functional health literacy in adults (TOFHLA), and the Combined English Language Skills Assessment. Analysis of change scores included independent sample t test and multiple linear regression. A total of 155 participants completed the study. There was a significant greater improvement for the intervention group in change of CSC score from pretest to posttest (P = 0.049) compared to controls. The study also found significantly improved TOFHLA (P = 0.011), however it did not find a relationship between changes in CVD behavior and health literacy or English proficiency. The Health Literacy and ESL Curriculum constitutes a valuable resource for addressing the cardiovascular health, literacy, and language needs of Spanish-speaking adults. Interventions that take a multilevel education and health approach may be more effective in addressing the needs of immigrants. Research should further explore the interactions between CVD behavior, health literacy, and English proficiency.
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Affiliation(s)
- Francisco Soto Mas
- College of Population Health MSC09 5070, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
| | - Cheryl L Schmitt
- School of Medicine, Family & Community Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Holly E Jacobson
- Department of Linguistics, University of New Mexico, Albuquerque, NM, USA
| | - Orrin B Myers
- School of Medicine, Family & Community Medicine, University of New Mexico, Albuquerque, NM, USA
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Tavakoly Sany SB, Peyman N, Behzhad F, Esmaeily H, Taghipoor A, Ferns G. Health providers' communication skills training affects hypertension outcomes. MEDICAL TEACHER 2018; 40:154-163. [PMID: 29183178 DOI: 10.1080/0142159x.2017.1395002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Hypertension is a common cardiovascular risk factor within the Iranian population, and this may be improved through changes in lifestyle. We aimed at improving hypertension outcomes and health literacy skills among hypertensive patients through communication skills training targeting health providers. METHODS A randomized controlled trial method was used to enroll 35 health providers and 240 hypertensive patients attending community-based healthcare practices in the Mashhad, Iran. We evaluated the effects of a communication skills intervention for primary care providers compared to usual care controls, on the hypertension outcomes, patient medication adherence, and self-efficacy, assessed at baseline and post-intervention. Bivariate analysis and the regression model were used to assess whether the health provider training improved outcomes. RESULTS Majority of participating patients were female (77.3%), less than high school education (80.3%), married (82.3%), and low income (82.3%), with mean age of 37 years. Following the educational intervention, there was a significant improvement (p < 0.05) in patient communication skills, self-efficacy, adherence to medication, and hypertension outcomes in the intervention compared to the control group. CONCLUSIONS The brief communication skills training for health care providers appear to be an efficient way to improve patient-provider communication skills and hypertension outcome among patients with uncontrolled BP.
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Affiliation(s)
- Seyedeh Belin Tavakoly Sany
- a Social Determinants of Health Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
- b Department of Health Education and Health Promotion, School of Health , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Nooshin Peyman
- a Social Determinants of Health Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
- b Department of Health Education and Health Promotion, School of Health , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Fatemeh Behzhad
- a Social Determinants of Health Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
- b Department of Health Education and Health Promotion, School of Health , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Habibollah Esmaeily
- a Social Determinants of Health Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
- c Department of Biostatistics and Epidemiology, School of Health , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Ali Taghipoor
- a Social Determinants of Health Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
- c Department of Biostatistics and Epidemiology, School of Health , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Gordon Ferns
- d Brighton and Sussex Medical School , Division of Medical education, Falmer , Brighton, Sussex , UK
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Ghisi GLDM, Chaves GSDS, Britto RR, Oh P. Health literacy and coronary artery disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2018; 101:177-184. [PMID: 28899710 DOI: 10.1016/j.pec.2017.09.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/25/2017] [Accepted: 09/04/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Identify health literacy (HL) screening instruments available to CAD patients; describe the prevalence of low HL; explore the predictors of low HL; and, identify the association between HL, health behaviors, and outcomes among these patients. METHODS A literature search of electronic databases was conducted for published articles from database inception to February 2017. Eligible articles included the assessment of HL in CAD patients. Health behaviors and outcomes included diet, exercise, smoking, medication use, hospital readmission, knowledge, health-related quality of life (HRQoL), and psychosocial indicators. RESULTS Overall, ten articles were included, of which two were RCTs, and seven were considered "good" quality. The most used screening instruments were REALM and TOFHLA. The average prevalence of low HL was 30.5%. Low HL participants were more likely to be older, male, from a non-white ethnic group, have many CVD comorbidities, lower educational level, disadvantaged socioeconomic position, and less likely to be employed. Low HL was consistently associated with hospital readmissions, low HRQoL, higher anxiety and lower social support. CONCLUSION The literature on HL in CAD patients is very limited. PRACTICE IMPLICATIONS Healthcare providers should start adopting strategies that can potentially mitigate the impact of low HL in the care of CAD patients.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto Rehabilitation Institute, Toronto, Canada.
| | | | | | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto Rehabilitation Institute, Toronto, Canada
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Panagioti M, Skevington SM, Hann M, Howells K, Blakemore A, Reeves D, Bower P. Effect of health literacy on the quality of life of older patients with long-term conditions: a large cohort study in UK general practice. Qual Life Res 2018; 27:1257-1268. [PMID: 29322478 PMCID: PMC5891567 DOI: 10.1007/s11136-017-1775-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 12/21/2022]
Abstract
Purpose The levels of health literacy in patients with long-term conditions (LTCs) are critical for better disease management and quality of life (QoL). However, the impact of health literacy on QoL in older adults with LTCs is unclear. This study examined the association between health literacy and domains of QoL in older people with LTCs, investigating key socio-demographic and clinical variables, as confounders. Methods A prospective cohort study was conducted on older adults (n = 4278; aged 65 years and over) with at least one LTC, registered in general practices in Salford, UK. Participants completed measures of health literacy, QoL, multi-morbidity, depression, social support, and socio-demographic characteristics. Multivariate linear regressions were performed to examine the effects of health literacy on four QoL domains at baseline, and then changes in QoL over 12 months. Results At baseline, poor health literacy was associated with lower scores in all four QoL domains (physical, psychological, social relationships and environment), after adjusting for the effects of multi-morbidity, depression, social support and socio-demographic factors. At 12-month follow-up, low health literacy significantly predicted declines in the physical, psychological and environment domains of QoL, but not in social relationships QoL. Conclusions This is the largest, most complete assessment of the effects of health literacy on QoL in older adults with LTCs. Low health literacy is an independent indicator of poor QoL older patients with LTCs. Interventions to improve health literacy in older people with LTCs are encouraged by these findings.
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Affiliation(s)
- Maria Panagioti
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Suzanne M. Skevington
- Division of Psychological Sciences and Mental Health, Manchester Centre for Health Psychology and International Hub for Quality of Life Research, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Mark Hann
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Kelly Howells
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Amy Blakemore
- Division of Nursing, Social Work and Midwifery, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - David Reeves
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Peter Bower
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL UK
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González-Chica DA, Hill CL, Gill TK, Hay P, Haag D, Stocks N. Individual diseases or clustering of health conditions? Association between multiple chronic diseases and health-related quality of life in adults. Health Qual Life Outcomes 2017; 15:244. [PMID: 29268792 PMCID: PMC5740772 DOI: 10.1186/s12955-017-0806-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 11/22/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Chronic diseases are highly prevalent and cluster in individuals (multimorbidity). This study investigated the association between multimorbidity and Health-Related Quality of Life (HRQoL), assessing the combination of chronic diseases highly correlated with this outcome. METHODS We conducted a household survey in 2015 in a random sample of 2912 South Australian adults (48.9 ± 18.1 years; 50.9% females), obtaining information on sociodemographics, lifestyle, and 17 chronic conditions clustered in four different groups (metabolic, cardiovascular, gastrointestinal, and musculoskeletal). Information on physical (PCS) and mental components scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Multivariable linear regression models considering individual diseases (mutually adjusted) and clusters within- and between-groups were used to test the associations. RESULTS Only 41% of the sample was negative for all the investigated diseases. The most prevalent conditions were osteoarthritis, obesity and hypertension, which affected one in every four individuals. PCS was markedly lower among those reporting stroke, heart failure, and osteoarthritis, but they were not associated with MCS. Direct-trend relationships were observed between the number of chronic conditions (clusters within- and between-groups) and PCS, but not with MCS. The strongest association with PCS was for musculoskeletal conditions (difference between those affected by 2+ conditions and those free of these conditions -6.7 95%CI -8.5;-5.4), and lower PCS were observed in any combination of clusters between-group including musculoskeletal diseases. CONCLUSION In the context of multimorbidity, musculoskeletal diseases are a key determinant group of PCS, amplifying the association of other chronic conditions on physical but not on mental health.
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Affiliation(s)
- David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Hughes Building, Level 8, Room 813, Adelaide, SA, 5005, Australia.
| | - Catherine L Hill
- Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Tiffany K Gill
- Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Phillipa Hay
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Hughes Building, Level 8, Room 813, Adelaide, SA, 5005, Australia
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Kim Y, Hogan K, D'Onofrio G, Chekijian S, Safdar B. Patient Ethnicity Predicts Poor Health Access and Gaps in Perception of Personal Cardiovascular Risk Factors. Crit Pathw Cardiol 2017; 16:147-157. [PMID: 29135623 DOI: 10.1097/hpc.0000000000000132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Focus of health literacy campaigns has centered around raising awareness. It is unknown whether awareness of coronary artery disease risk factors accurately reflects personalization of one's own cardiovascular risk. METHODS A cross-sectional survey was performed in consecutive patients presenting with chest pain admitted to an observation unit of a tertiary care hospital. A 32-item questionnaire in English or Spanish examined knowledge of coronary artery disease risk factors. Separately, the personalization of coronary risk factors was determined by having patients list their individual risk factors for having a heart attack. Primary outcome was the evaluation of ethnic disparities in awareness of cardiovascular risk factors and the patient's misperceptions on personal risk factors. Secondary outcome was the assessment of access to information in the same population by gender and ethnicity. RESULTS Between October 2006 and April 2008, 1584 consecutive patients were screened, and 1051 patients were enrolled. Participants were 57.5% female and 62.8% self-identified White, 22.5% Black, and 11.5% Hispanic. Misperception about personal risk was significantly higher in non-White compared with the White participants for diabetes (in Blacks [odds ratio (OR), 2.22; 95% confidence interval (CI), 1.08-5.57] and Hispanics [OR, 3.50; 95% CI, 1.49-8.20]) and for hyperlipidemia (in Hispanics [OR, 2.21; 95% CI, 1.19-4.10]). Although the majority (85%) had a primary care physician, Blacks and Hispanics were less likely to have access to information (OR, 0.25; 95% CI, 0.10-0.49; and OR, 0.71; 95% CI, 0.37-1.04, respectively). CONCLUSIONS There are major gaps between awareness and personalization of risk in major modifiable coronary artery disease risk factors in different ethnic groups.
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Affiliation(s)
- Yeunjung Kim
- From the *Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven CT; †Department of Emergency Medicine, Albany Medical Center, Albany, NY; and ‡Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT
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Aaby A, Friis K, Christensen B, Rowlands G, Maindal HT. Health literacy is associated with health behaviour and self-reported health: A large population-based study in individuals with cardiovascular disease. Eur J Prev Cardiol 2017; 24:1880-1888. [PMID: 28854822 PMCID: PMC5680908 DOI: 10.1177/2047487317729538] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Health literacy may constitute a modifiable determinant of health behaviour and affect cardiovascular disease prevention. This study investigates the associations between health literacy and health behaviour as well as health status. Design A cross-sectional study on a population-based sample of people with acute myocardial infarction, angina pectoris or stroke (N = 3116). Methods Health literacy was assessed using two dimensions from the Health Literacy Questionnaire: ‘understanding health information’ and ‘engaging with healthcare providers’. Health behaviour included physical activity, dietary habits, smoking, alcohol consumption and body mass index. Health status was examined using Short Form Health Survey 12 version 2 (four-week recall) (physical and mental components). We used regression analyses to examine the associations. Results ‘Understanding health information’ was inversely associated with physical inactivity (odds ratio (OR) 0.48 (0.39;0.59), unhealthy diet (OR 0.64 (0.47;0.88)), underweight (OR 0.43 (0.21;0.89)) and obesity (OR 0.79 (0.63;0.99)). ‘Engaging with healthcare providers’ was inversely associated with physical inactivity (OR 0.64 (0.53;0.77)), less than healthy diet (OR 0.79 (0.64;0.96)) and daily smoking (OR 0.81 (0.66;1.0)). An increase in ‘understanding health information’ as well as ‘engaging with healthcare providers’ was associated with an increase in both physical and mental health status. Conclusions The findings suggest that aspects of health literacy are associated with health status and health behaviour in cardiovascular patients and should be considered in interventions regarding cardiovascular disease prevention.
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Affiliation(s)
- Anna Aaby
- 1 Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Denmark
| | | | - Bo Christensen
- 3 Section for General Practice, Department of Public Health, Aarhus University, Denmark
| | - Gill Rowlands
- 1 Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Denmark.,4 Institute for Health and Society, Newcastle University, UK
| | - Helle Terkildsen Maindal
- 1 Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Denmark.,5 Steno Diabetes Centre Copenhagen, Health Promotion Research, Denmark
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González-Chica DA, Dal Grande E, Bowden J, Musker M, Hay P, Stocks N. Are we reducing the risk of cardiovascular disease and improving the quality of life through preventive health care? Results of a population-based study in South Australia. Prev Med 2017; 99:164-170. [PMID: 28219783 DOI: 10.1016/j.ypmed.2017.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/19/2017] [Accepted: 02/13/2017] [Indexed: 10/20/2022]
Abstract
This study investigated the achievement of lifestyle recommendations and use of preventive medication in people who 1) are obese, 2) or have metabolic risk factors (hypertension, dyslipidaemia, and/or diabetes), 3) or have cardiovascular disease (CVD), 4) or are healthy, and the impact this preventive health care had on their 'Health-Related Quality of Life' (HRQoL). Cross-sectional survey conducted in 2015 with 2379 South Australian adults (57.1±14years; 51.7% females). Physical (PCS) and mental components scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Although adequate fruit/vegetable intake was lower among individuals with CVD (29.8%; p=0.049), this behaviour was associated with a better MCS. Adequate physical activity level was lower among those with metabolic risk factors (29.5%) or CVD (31.0%; p=0.008), but independent of their clinical condition, this behaviour was associated with a higher PCS. Individuals with CVD were less likely to have adequate alcohol consumption (63.4%; p=0.026), but those achieving this recommendation had poorer PCS. Non-smoking was similar in all groups (85%; p=0.768) and was associated with a better MCS only among healthy individuals and those with CVD. In all the groups, individuals achieving all the lifestyle recommendations had a better PCS. Only 48.2% of individuals with CVD reported combined use of antithrombotic, antihypertensive, and antilipidemic drugs, but the use of these medications was not associated with HRQoL. In conclusion, the vast majority of individuals at risk of or with CVD did not achieve preventive recommendations, and only the adequacy of uptake of all recommended lifestyle behaviours showed consistent benefits for PCS and MCS.
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Affiliation(s)
- David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA, Australia.
| | - Eleonoral Dal Grande
- Population Research and Outcome Studies, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health & Medical Research Institute, Adelaide, SA, Australia
| | - Michael Musker
- Mind & Brain Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia
| | - Phillipa Hay
- Centre for Health Research, School of Medicine, University of Western Sydney, Sydney, NSW, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA, Australia
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González-Chica DA, Adams R, Dal Grande E, Avery J, Hay P, Stocks N. Lower educational level and unemployment increase the impact of cardiometabolic conditions on the quality of life: results of a population-based study in South Australia. Qual Life Res 2017; 26:1521-1530. [PMID: 28190132 DOI: 10.1007/s11136-017-1503-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate if sociodemographic characteristics increase the adverse effects of cardiovascular diseases (CVD) and cardiometabolic risk factors (CMRF) on health-related quality of life (HRQoL). METHODS Cross-sectional, face-to-face survey investigating 2379 adults living in South Australia in 2015 (57.1 ± 14 years; 51.7% females). Questions included diagnosis of CMRF (obesity, diabetes, hypertension, dyslipidaemia) and CVD. Physical and mental HRQoL were assessed using the SF-12v1 questionnaire. Multiple linear regression models including confounders (sociodemographic, lifestyle, use of preventive medication) and interaction terms between sociodemographic variables and cardiometabolic conditions were used in adjusted analysis. RESULTS The prevalence of CMRF (one or more) was 54.6% and CVD was 13.0%. The physical HRQoL reduced from 50.8 (95%CI 50.2-51.4) in healthy individuals to 45.1 (95%CI 44.4-45.9) and 39.1 (95%CI 37.7-40.5) among those with CMRF and CVD, respectively. Adjustment for sociodemographic variables reduced these differences in 33%, remaining stable after controlling for lifestyle and use of preventive medications (p < 0.001). Differences in physical HRQoL according to cardiometabolic conditions were twice as high among those with lower educational level, or if they were not working. Among unemployed, having a CMRF or a CVD had the same impact on the physical HRQoL (9.7 lower score than healthy individuals). The inverse association between cardiometabolic conditions and mental HRQoL was subtle (p = 0.030), with no evidence of disparities due to sociodemographic variables. CONCLUSIONS A lower educational level and unemployment increase the adverse effects of cardiometabolic conditions on the physical HRQoL. Targeted interventions for reducing CMRF and/or CVD in these groups are necessary to improve HRQoL.
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Affiliation(s)
- David Alejandro González-Chica
- Discipline of General Practice, School of Medicine, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, 178 North Terrace, Level 11, MDP DX 650 550, Adelaide, SA, 5005, Australia.
| | - Robert Adams
- The Health Observatory, Discipline of Medicine, The University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA, Australia
| | - Eleonora Dal Grande
- Population Research and Outcome Studies, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Jodie Avery
- Population Research and Outcome Studies, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Phillipa Hay
- Centre for Health Research, School of Medicine, University of Western Sydney, Sydney, NSW, Australia
| | - Nigel Stocks
- Discipline of General Practice, School of Medicine, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, 178 North Terrace, Level 11, MDP DX 650 550, Adelaide, SA, 5005, Australia
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