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Odzakovic E, Allgurin M, Jonasson LL, Öberg S, Fridlund B, Ulander M, Lind J, Broström A. Experiences of facilitators and barriers for fulfilment of human needs when living with restless legs syndrome: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2348884. [PMID: 38735061 PMCID: PMC11089917 DOI: 10.1080/17482631.2024.2348884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/25/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE Restless Legs Syndrome (RLS) is a widespread condition that affects sleep leading to daytime sleepiness, depression, and reduced quality of life. This study aims to determine and describe how patients with RLS experience their everyday life, with a focus on facilitators and barriers related to Maslow's hierarchical theory of human needs. METHOD Semi-structured interviews were analysed with qualitative content analysis resulting in facilitators and barriers affecting the fulfilment of the five human needs. RESULTS Addressing RLS symptoms through medications and a quiet sleep environment fulfils psychological needs. Control over RLS symptoms, engagement in activities, trust in treatments, and social support meet safety and security needs. Social inclusion, close relationships, and meaningful interactions fulfil a sense of belongingness and love needs despite RLS. Competence in managing RLS, effective self-care strategies, confident communication, and trust-building support esteem needs. Finally, comprehensive understanding through person-centred interventions and coping fulfils the self-actualization needs in managing RLS. CONCLUSION Holistic and person-centred interventions, including facilitators for the fulfilment of physiological, psychological, and social needs could help healthcare professionals to provide holistic care.
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Affiliation(s)
- Elzana Odzakovic
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Monika Allgurin
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Sandra Öberg
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bengt Fridlund
- Centre for Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
| | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
| | - Jonas Lind
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
- Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Anders Broström
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Jiang Y, Gao J, Sun P, Nan J, Zou X, Sun M, Song X. Factors Associated with the e-Health Literacy Among Older Adults with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. Telemed J E Health 2024; 30:e1138-e1147. [PMID: 37851981 DOI: 10.1089/tmj.2023.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: The telemanagement model in chronic diseases needs older patients to have a certain level of e-Health literacy. According to Electronic Health Literacy model, factors associated with the e-Health literacy among older patients could be comprehensively investigated from individual, situational, and environmental aspects. Objectives: To investigate the e-Health literacy levels among older patients with chronic obstructive pulmonary disease (COPD) and explore associated factors. Methods: A cross-sectional study was conducted among older patients with COPD. The e-Health Literacy Scale was used to measure individuals' e-Health literacy. The multiple linear regression was applied to identify factors associated with e-Health literacy. Results: A total of 230 responses were included in the final analysis. The average score of e-Health literacy for older COPD patients was 24.66 (6.86). After adjusting the model, the results of multiple linear regression demonstrated that aging attitudes (B = 0.067, p < 0.001), technophobia (B = -0.285, p < 0.001), and self-efficacy (B = 0.431, p < 0.001) accounted for 68.3% (p < 0.001) of the total variation in e-Health literacy. Conclusion: This study identifies significant correlations of technophobia, aging attitudes, and self-efficacy, respectively, with e-Health literacy, and self-efficacy and technophobia may be constant predictive factors of e-Health literacy. In the future, intervention research on e-Health literacy should be conducted from a social psychology perspective, with particular emphasis on addressing negative aging attitudes and technophobia. That will promote the tele-management model of chronic diseases. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900028563; http://apps.who.int/trialsearch/default.aspx.
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Affiliation(s)
- Yuyu Jiang
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jing Gao
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Pingping Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiang Nan
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xueqiong Zou
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Manyao Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xianjing Song
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
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Singh A, Skolnik E, Miazga E, Nensi A. Impact of Health Literacy on Patient-Reported Outcomes in Benign Gynecology: A Systematic Review. Cureus 2024; 16:e58661. [PMID: 38774160 PMCID: PMC11105969 DOI: 10.7759/cureus.58661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/24/2024] Open
Abstract
The objective of this study was to systematically review the relationship between low health literacy and patient-reported outcomes in patients with benign gynecologic conditions. In this specific population, we also sought to determine the current reported prevalence of low health literacy, examine demographic characteristics that may be related to low health literacy, and collate any health literacy interventions described in the literature. A systematic search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, The Cochrane Library, Web of Science, PubMed, and clinicaltrials.gov was performed on July 12, 2021, and repeated on October 13, 2023, for terms related to health literacy, specific health literacy measures, and benign gynecologic conditions. There were language or publication period restrictions. Inclusion required primary literature to report associations between health literacy and patient-reported outcomes, using validated tools to quantitatively measure each, in adult women with benign gynecologic conditions. Title screening, abstract screening, and full-text review were conducted with Covidence software (Melbourne, Australia) assisting with the review process. Of the 18,701 studies returned using our search strategy, 25 were selected for full-text review. Of these, no studies met inclusion criteria and reported an association between health literacy and patient-reported outcomes. This study identified a large gap in the literature. Future work should be directed at evaluating the association between health literacy and patient-reported outcomes in benign gynecology to inform patient-centered interventions and care provision.
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Affiliation(s)
- Ashmita Singh
- General Surgery, Northern Ontario School of Medicine, Sudbury, CAN
| | - Emma Skolnik
- Obstetrics and Gynecology, University of Toronto, Toronto, CAN
| | - Elizabeth Miazga
- Obstetrics and Gynecology, Trillium Health Partners - Credit Valley Hospital, Mississauga, CAN
| | - Alysha Nensi
- Obstetrics and Gynecology, St. Michael's Hospital, Toronto, CAN
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Li H, Tao S, Sun S, Xiao Y, Liu Y. The relationship between health literacy and health-related quality of life in Chinese older adults: a cross-sectional study. Front Public Health 2024; 12:1288906. [PMID: 38572002 PMCID: PMC10987958 DOI: 10.3389/fpubh.2024.1288906] [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: 09/13/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Background This study aimed to examine the relationship between health literacy and health-related quality of life in older adults. Methods A cross-sectional survey design was used. We used a self-administered questionnaire to assess sociodemographic factors of older adults, the Chinese Citizen Health Literacy Questionnaire (HLQC) and the 36-item Chinese version of the Short Form 36 (SF-36) to measure health literacy and quality of life, respectively, among older adults. Between September 2011 and June 2012, information was collected from 1,396 older adults in 44 nursing homes in four cities through face-to-face interviews. Results The mean health literacy level of older adults in nursing homes was relatively low (71.74 ± 28.35). Health-related quality of life scores were moderate (104.77 ± 16.92). There were statistically significant differences in the effects of health literacy, education level, former occupation (professional), marital status (widowed) and race on health-related quality of life. Conclusion Improving health literacy is considered an important intervention to promote health-related quality of life in older adults in nursing homes.
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Affiliation(s)
- Hui Li
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Simin Tao
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Silu Sun
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Ying Xiao
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Yongbing Liu
- School of Nursing, Yangzhou University, Yangzhou, Jiangsu, China
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Dai H, Sun C, Chen J, Zhou X, Li H, Martin P, Zhang Q. The mediating effect of eHealth literacy on the relationship between health personality and quality of life in community-dwelling older adults. Geriatr Nurs 2024; 56:237-243. [PMID: 38382173 DOI: 10.1016/j.gerinurse.2024.02.002] [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: 10/19/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
AIMS To explore the relationship between health personality and quality of life among community-dwelling older adults and to examine the mediating effect of eHealth literacy on this relationship. METHODS A total of 413 community-dwelling older adults from central China were recruited from September 2022 to January 2023. A cross-sectional investigation was conducted using the Chinese versions of the Health Personality Assessment (HPA), eHealth Literacy Scale (eHEALS), and 12-item Short Form Health Survey (SF-12). Correlations between the three variables were examined by Pearson analysis, and mediation analysis was conducted to explore the direct, indirect, and total effects of the health personality on quality of life vis-à-vis eHealth literacy. RESULTS Health personality factors (including health neuroticism, health openness, and health conscientiousness), eHealth literacy, and quality of life are significantly correlated (P<0.05); eHealth literacy can play a significant mediating role in the relationship between health neuroticism (β= -0.256, 95 %CI: [-0.405, -0.119]), health openness (β = 0.488, 95 % CI: [0.343,0.652]), health conscientiousness (β= 0.489, 95 % CI: [0.354, 0.634]) and quality of life. CONCLUSION This study revealed that the effect of health personality factors (including health neuroticism, health openness, and health conscientiousness) on quality of life in older adults was mediated through eHealth literacy. IMPACT Individual personality is essential to understanding eHealth literacy and quality of life among community-dwelling older adults. It may be helpful to identify the health personality traits of older adults first, then implement targeted interventions accordingly to enhance eHealth literacy and ultimately improve quality of life.
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Affiliation(s)
- Huohuo Dai
- School of Nursing, Wuhan University, Wuhan, China; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Chao Sun
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Jiyu Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Xieting Zhou
- School of Nursing, Wuhan University, Wuhan, China
| | - Hang Li
- School of Nursing, Wuhan University, Wuhan, China
| | - Peter Martin
- Department of Human Development and Family Studies, Iowa State University, USA
| | - Qing Zhang
- School of Nursing, Wuhan University, Wuhan, China.
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Çetin M, Gümüş R. Research into the relationship between digital health literacy and healthy lifestyle behaviors: an intergenerational comparison. Front Public Health 2023; 11:1259412. [PMID: 38074767 PMCID: PMC10699138 DOI: 10.3389/fpubh.2023.1259412] [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: 07/15/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction Digital health literacy wields a pivotal role in individuals' health status in terms of seeking and choosing appropriate and accurate information, and useful services from a vast array of choices. This study is aimed at assessing the validity and reliability of the Turkish version of Digital Health Literacy Instrument (DHLI) and examining the relationship between DHL and the healthy lifestyle behaviors of participants from X, Y, and Z generations. Methods In this study, to conduct a cross-sectional web-based survey, an online self-report questionnaire was built, and a convenience sample with a snowball approach was used. The study was conducted among 1,274 respondents aged between 18 and 64 years. Data collection tools consisted of the Personal Information Form, Lifestyle Behavior Scale II (HLBS II), and DHLI. Cultural validation and psychometric testing of DHLI, exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha test, and bivariate and multivariate regression analysis were used for statistical analysis. Results In the study, the Turkish version of the DHLI tool consisting of six dimensions proved to be valid and reliable, and deemed appropriate for use across all age groups. The average digital health literacy of the respondents was sufficient, but the mean of healthy lifestyle behavior scores was moderate. There was a positive significant relationship between the total mean scores of DHLI and HLBS. Among the subdimensions of DHLI, while the highest mean scores were in DHLI Reliability, DHLI Privacy, and DHLI Search, DHLI Navigation and DHLI Relevance showed the lowest mean scores. DHLI Reliability, DHLI Relevance, and DHLI Adding Content were statistically significant predictors of health-related behaviors of the respondents. Conclusion The most important feature and novelty of this study is that, although the DHLI scale has been widely translated for use in many countries, it has been translated and adapted to Turkish for the first time herein. The study offers crucial evidence about Generation X, Y, and Z's DHL level and its positive relationships with health-related behaviors. Therefore, the community and its partners should lead the way in empowering individuals to understand and use online information in an effective, secure, and health-promoting manner, along with governments.
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Affiliation(s)
- Murat Çetin
- Institute of Social Sciences, Dicle University, Diyarbakır, Türkiye
| | - Rojan Gümüş
- Atatürk Vocational School of Health Services, Dicle University, Diyarbakır, Türkiye
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Sami R, Salehi K, Hashemi M, Haghighat S, Atashi V. Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study. BMJ Open 2023; 13:e073972. [PMID: 37802628 PMCID: PMC10565240 DOI: 10.1136/bmjopen-2023-073972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/01/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES Chronic obstructive pulmonary disease is a chronic disease with numerous complications. Therefore, its effective management depends on home-based pulmonary rehabilitation. The effectiveness of home-based pulmonary rehabilitation programmes in turn depends on patient adherence to them. The aim of this study was to explore the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease. DESIGN Qualitative descriptive design. SETTING The lung care wards of Al-Zahra and Khorshid teaching hospitals and the comprehensive lung care clinic of Khorshid hospital, Isfahan, Iran. PARTICIPANTS Participants patients with chronic obstructive pulmonary disease (n=20), their family caregivers (n=15) and healthcare providers (n=14) recruited via purposive sampling. RESULTS The five main categories of the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease were patient-related barriers, caregivers' caregiving burden, limited support for patients, healthcare providers' limited professional competence and ineffective home-based pulmonary rehabilitation planning. CONCLUSION Different and complex factors related to patients, families and healthcare providers can affect adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease. Healthcare authorities can use the findings of this study to develop strategies to support patients with chronic obstructive pulmonary disease and their family caregivers and thereby reduce the physical and mental complications of Chronic obstructive pulmonary disease.
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Affiliation(s)
- Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Kobra Salehi
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan, Iran
| | - Marzieh Hashemi
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Shila Haghighat
- Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vajihe Atashi
- Nursing and Midwifery Care Research Center, Adult Health Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
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Yilmazel G. Are health promotion activities and preventive health practices predictors of adolescent eHealth literacy? Health Promot Int 2023; 38:daad109. [PMID: 37703395 DOI: 10.1093/heapro/daad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Adolescents' general health status and health behaviors have been closely monitored in recent years. It is estimated that adolescents comprise one-sixth of the world's population. This study examined whether eHealth literacy was predicted via health promotion activities and preventive health practices among Turkish adolescents. This cross-sectional study was conducted between March and May 2022 with 706 adolescents in Çorum, Turkey. A face-to-face questionnaire form was used, including socio-demographic characteristics, preventive health practices, eHealth literacy scale and Adolescent Health Promotion Scale. The data of the research were analyzed with the SPSS 22.0 program. Percentage, mean, Pearson Correlation analysis, and multiple regression analysis were used in the analyzes. The p < 0.05 value was considered statistically significant in the evaluations. In the study, 55.8% were female, and the mean age of the whole group was 16.09 ± 2.63 years. The mean score on the eHealth literacy scale was 29.40 ± 6.29. The mean of the total scores obtained from the Adolescent Health Promotion Scale was 137.97 ± 21.87. There was a significant positive correlation between eHealth literacy and the Adolescent Health Promotion Scale (p < 0.001). Multiple linear regression analysis was performed to predict eHealth literacy using the variables of Adolescent Health Promotion and preventive health practices. eHealth literacy positively and significantly predicts health promotion activities (β = 0.27, t (695) = 7.54, p < 0.001). eHealth literacy increased annual weight measurement by more than 0.13 (β = 0.13), annual blood iron measurement by more than 0.16 (β = 0.16) and annual dental examination by more than 0.11 (β = 0.11). Developing eHealth literacy interventions will be necessary for environments with a high concentration of adolescents (schools and courses). Also, primary health care services should be integrated with the school environment.
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Affiliation(s)
- Gülay Yilmazel
- Public Health, Hitit University, Faculty of Health Science, Çorum, 19100, Türkiye
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Liu AK, Liu YY, Su J, Gao J, Dong LJ, Lv QY, Yang QH. Self-efficacy and self-management mediate the association of health literacy and quality of life among patients with TB in Tibet, China: a cross-sectional study. Int Health 2023; 15:585-600. [PMID: 37317980 PMCID: PMC10472895 DOI: 10.1093/inthealth/ihad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 02/16/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND This study aimed to analyze the relationship between health literacy and quality of life in patients with TB in Tibet and explore the mediating effects of self-efficacy and self-management in the relationship between health literacy and quality of life. METHODS We used a convenience sampling method to select 271 cases of patients with TB in Tibet to conduct a survey of their general information, health literacy, self-management, self-efficacy and quality of life, and to construct structural equation models. RESULTS The total health literacy score of patients with TB in Tibet was 84.28±18.57, while the lowest score was for information acquisition ability (55.99±25.66). Scores for quality of life were generally lower than the norm (patients with chronic diseases from other cities in China) (p<0.01). Moreover, self-efficacy and self-management mediated the relationship between health literacy and quality of life (p<0.05). CONCLUSIONS In Tibet, patients with TB have a low level of health literacy and an average level of quality of life. Emphasis should be placed on improving information access literacy, role-physicals and role-emotional to improve overall quality of life. The mediating roles of self-efficacy and self-management between health literacy and quality of life may provide a basis for further interventions.
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Affiliation(s)
- An-kang Liu
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Yu-yao Liu
- Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
- Internal Medicine, Nyingchi People's Hospital, Nyingchi, Tibet Autonomous Region, 860000, China
| | - Jin Su
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Jing Gao
- Nursing Department, Nyingchi People's Hospital, Nyingchi, Tibet Autonomous Region, 860000, China
| | - Li-juan Dong
- Internal Medicine, Nyingchi People's Hospital, Nyingchi, Tibet Autonomous Region, 860000, China
| | - Qi-yuan Lv
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Qiao-hong Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
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Shao Y, Hu H, Liang Y, Hong Y, Yu Y, Liu C, Xu Y. Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. PATIENT EDUCATION AND COUNSELING 2023; 114:107829. [PMID: 37270933 DOI: 10.1016/j.pec.2023.107829] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This study was conducted to determine the effectiveness and impact of health literacy interventions for patients with chronic diseases. METHODS We searched PubMed, Web of Science, Embase, Scopus, and EBSCO CINAHL from inception through March 2022. Eligible chronic diseases include diabetes, heart disease, cancer, and chronic obstructive pulmonary disease. RCTs were included in eligible studies to assess health literacy and other relevant health outcomes. Two investigators selected studies, extracted data, and assessed the methodological quality of included studies independently. RESULTS A total of 18 studies involving 5384 participants were included in the final analysis. The implementation of health literacy interventions exhibited a significant improvement in the health literacy level of individuals diagnosed with chronic diseases (SMD = 0.75, 95% CI = 0.40-1.10). Analysis of heterogeneity sources indicated statistically significant variations in the effects of interventions across different diseases and age groups (P < 0.05). However, no significant impact was observed on patients with chronic obstructive pulmonary disease (COPD), interventions with a follow-up duration exceeding three months, or application-based interventions on the health literacy level of individuals with chronic diseases. Remarkably, our findings revealed that health literacy interventions exerted a positive influence on health status (SMD = 0.74, 95% CI = 0.13-1.34), depression and anxiety (SMD = 0.90, 95% CI = 0.17-1.63), as well as self-efficacy (SMD = 0.28, 95% CI = 0.15-0.41) among patients diagnosed with chronic diseases. Furthermore, a specific analysis was conducted to evaluate the effects of these interventions on hypertension and diabetes control. The results demonstrated that health literacy interventions were more effective in enhancing hypertension control compared to diabetes control. CONCLUSION Health literacy interventions have demonstrated effectiveness in improving the health of patients with chronic diseases. The importance of emphasizing the quality of these interventions cannot be overstated, as factors such as appropriate intervention tools, extended intervention duration, and reliable primary care services play crucial roles in their efficacy.
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Affiliation(s)
- Yingshan Shao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Huaqin Hu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yaxin Liang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yangyang Hong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yiqing Yu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, China.
| | - Yihua Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China.
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Seboka BT, Negashe M, Yehualashet DE, Kassawe C, Namaro M, Yigeremu M. Health literacy and health information sources in relation to foodborne and waterborne diseases among adults in Gedeo zone, southern Ethiopia, 2022: A community-based cross-sectional study. Heliyon 2023; 9:e15856. [PMID: 37215875 PMCID: PMC10196801 DOI: 10.1016/j.heliyon.2023.e15856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Foodborne and waterborne illnesses affect billions of people each year and impose a significant burden on public health globally. To reduce the prevalence of foodborne and waterborne illness in resource-constrained settings like Ethiopia, it is essential to recognize and address the factors that influence health literacy and the sources of health information. We explored health literacy and health information sources regarding foodborne and waterborne illnesses among adults in the Gedeo zone. Methods A community-based quantitative study was undertaken between March and April 2022 in the Gedeo zone in southern Ethiopia. A semi-structured, pretested, and interviewer-administered questionnaire was used to collect data from 1,175 study participants selected through a systematic sampling technique. Data were entered in Epidata version 4.6 and analyzed in STATA version 14.2. Data were analyzed using descriptive statistics and the Chi-square test, and multivariate logistic regression analysis was used to assess the associations between variables at a significance level of 0.05. Further, a structural equation model or path analysis was also used in the data analysis. Result 1,107 (about 51% men) study participants were included in the analysis. About 25.5% of the participants had a foodborne or waterborne illness in the last six months before the survey. Family members and/or close friends were the most-used channel of health information (43.3%), and the internet or online sources were the least-used (14.5%). The result of path analysis shows that seeking health information, having adequate health literacy, and foodborne and waterborne literacy were significantly associated with lower incidences of foodborne or waterborne illness. Conclusion Our findings showed that individuals with a higher level of health literacy and foodborne and waterborne illness literacy had a lower incidence of foodborne and waterborne illness. Similarly, obtaining health information is positively associated with lowering the incidence of foodborne and waterborne illnesses. Importantly, our findings show mass media has the potential to reach a large audience when educating adults about foodborne and waterborne illnesses.
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Affiliation(s)
| | - Misrak Negashe
- Department of Psychiatry, Dilla University, Dilla, Ethiopia
| | | | | | | | - Mahlet Yigeremu
- Department Obstetrics and Gynecology, College of Health Sciences, Addis Ababa University, Ethiopia
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da Costa AC, da Conceição AP, Butcher HK, Butcher RDCGES. Factors that influence health literacy in patients with coronary artery disease. Rev Lat Am Enfermagem 2023; 31:e3878. [PMID: 36995856 PMCID: PMC10077861 DOI: 10.1590/1518-8345.6211.3878] [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: 05/02/2022] [Accepted: 11/06/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.
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Affiliation(s)
- Ana Caroline da Costa
- Faculdade Wenceslau Braz, Departamento de Enfermagem, Itajubá, MG, Brasil
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Ana Paula da Conceição
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Instituto Dante Pazzanese de Cardiologia, Departamento de Enfermagem, São Paulo, SP, Brasil
| | - Howard Karl Butcher
- Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, Estados Unidos da América
| | - Rita de Cassia Gengo e Silva Butcher
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, Estados Unidos da América
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Versluis A, Le TM, Houben GF, Knulst AC, Van Os-Medendorp H. Accidental allergic reactions to food in adolescents and adults: An overview of the factors involved and implications for prevention. FRONTIERS IN ALLERGY 2023; 4:1062049. [PMID: 36970066 PMCID: PMC10036762 DOI: 10.3389/falgy.2023.1062049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
Accidental allergic reactions to food are one of the major problems in adult patients diagnosed with food allergy. Such reactions occur frequently, are often severe and are associated with higher medical and non-medical costs. The aim of this Perspective is to provide insight into the different factors involved in the occurrence of accidental allergic reactions and to present an overview of practical implications for effective preventive measures. Several factors affect the occurrence of accidental reactions. These factors are related to the patient, health care, or food. The most important patient-related factors are age, social barriers to disclosing their allergy and non-adherence to the elimination diet. With regards to healthcare, the degree to which clinical practice is tailored to the individual patient is an important factor. The major food-related factor is the absence of adequate precautionary allergen labeling (PAL) guidelines. Since many factors are involved in accidental allergic reactions, different preventive strategies are needed. It is highly recommended that health care be tailored to the individual patient, with regard to education about the elimination diet, support on behavioral and psychosocial aspects, usage of shared decision-making and taking into account health literacy. In addition, it is crucial that steps are taken to improve policies and guidelines for PAL.
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Affiliation(s)
- Astrid Versluis
- Department of Dermatology and Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- Correspondence: Astrid Versluis Harmieke Van Os-Medendorp
| | - Thuy-My Le
- Department of Dermatology and Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- Center for Translational Immunology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
| | - Geert F. Houben
- Center for Translational Immunology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- TNO, Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - André C. Knulst
- Department of Dermatology and Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- Center for Translational Immunology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
| | - Harmieke Van Os-Medendorp
- School of Health, Saxion University of Applied Sciences, Enschede, Netherlands
- Correspondence: Astrid Versluis Harmieke Van Os-Medendorp
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Use of Information and Communication Technology among Patients with Chronic Obstructive Pulmonary Disease Who Smoke: A Mixed Methods Study. Ann Am Thorac Soc 2023; 20:381-389. [PMID: 36351079 DOI: 10.1513/annalsats.202208-740oc] [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: 11/11/2022] Open
Abstract
Rationale: Although overall use is on the rise, certain patient populations have persistently low technology use. Objectives: To inform the creation of a proactive tobacco treatment program, we assessed access to, use of, and barriers surrounding information and communication technology (ICT) among patients with chronic obstructive pulmonary disease (COPD) who currently smoke, examining associations between key predictors and electronic health (e-health) literacy. Methods: Single-center mixed-methods study of veterans with COPD who smoke. Eligible participants who smoked were identified by the e-health record and mailed a survey. E-health literacy was assessed by the eHEALS (Electronic Health Literacy Scale; 8-40). Low technology use was defined as no Internet-capable device and use of ICT less than monthly. Qualitative participants were purposively selected from survey respondents and interviewed using a semistructured guide. Interviews were transcribed and analyzed using directed content analysis. We used a Bayesian three-component joint model to identify predictors of low technology use and low eHEALS. Results: Participants (N = 204) were older (mean age, 65.8), primarily White (76.4%), men (87.1%), and with low income (44.9% income under $20,000). Low technology use was reported by 25.5%, and many reported low use of specific types of ICT. For example, only 36.3% had reliable in-home Internet, fewer than half (46.6%) accessed e-mail at least weekly, 58.3% texted at least weekly, and few used the secure patient portal (13.2% accessed it monthly). The mean eHEALS was 24.6 (±8.7), indicating low to moderate e-health literacy. In the Bayesian analysis, low technology use was associated with lower eHEALS (estimate: -8.5 [95% confidence interval, -12.13 to -4.81]). Attainment of at least a college graduate-level education was associated with higher eHEALS (3.83 [0.43-7.24]). Participants reported barriers to use of ICT, including struggles navigating account security, frequently lost login information, mistrust of providing personal information to the Internet, and lack of familiarity with processes. Many perceived ICT as not useful or necessary. Conclusions: Many patients with COPD who smoke report barriers to engagement with health promotion programs offered electronically, which may perpetuate health disparities. Health promotion programs must account for the low use of ICT and e-health literacy to ensure equitable access across the population.
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Refahi H, Klein M, Feigerlova E. e-Health Literacy Skills in People with Chronic Diseases and What Do the Measurements Tell Us: A Scoping Review. Telemed J E Health 2023; 29:198-208. [PMID: 35671526 DOI: 10.1089/tmj.2022.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Use of electronic health (e-Health) technologies has increased in the past decade and inadequate e-Health literacy may lead to health-related social inequality. This is especially true for patients living with chronic diseases who are often involved in self-care. However, the measurement of e-Health literacy represents several challenges. Among available instruments, the e-Health Literacy Scale (eHEALS) is the only instrument with available psychometric properties. Aim: To identify studies measuring e-Health literacy in adults living with chronic disease and its relationship to health-related behaviors and other perceptions such as quality of life, self-efficacy, or specific disease biomarkers, and studies analyzing the impact of educational intervention on e-Health literacy. Methods: The authors searched MEDLINE, the Cochrane Library, and Web of Science databases to identify studies published in English language until April 2022. Results: Seventeen studies involving 4,877 participants were included. A majority of the studies were cross-sectional with a lack of appropriate controls. Five of the included studies were experimental, involving 758 participants. All of them reported positive effects of educational interventions on the improvements in self-reported e-Health literacy skills. However, most studies were at risk of bias. Conclusion: Despite these limitations, the findings of this review indicate the positive relationship between e-Health literacy and various health care processes in adults with chronic diseases and highlights a need for prospective controlled studies. Promoting e-Health literacy might give better opportunities for the active involvement of people with chronic diseases in self-care and for the implementation of online interventions into existing system of care.
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Affiliation(s)
- Hélène Refahi
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France
| | - Marc Klein
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France
| | - Eva Feigerlova
- Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Universitaire and Medical Faculty, Université de Lorraine, Nancy, France.,INSERM UMR_S 1116-DCAC, Université de Lorraine, Nancy, France.,Centre Universitaire d'Enseignement par SIMulation (CUESim), Hôpital Virtuel de Lorraine (HVL), Medical Faculty, Université de Lorraine, Nancy, France
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Arsenović S, Trajković G, Pekmezović T, Gazibara T. Association of health literacy with physical and mental health in people with chronic diseases. Rev Epidemiol Sante Publique 2023; 71:101419. [PMID: 36563616 DOI: 10.1016/j.respe.2022.101419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/06/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE to explore the association of health literacy domains with physical and mental quality of life in people with selected chronic diseases. METHODS Community-dwelling people with selected chronic diseases planned for immunization against influenza in 2017/2018 were included in the study. All non-vaccinated people and the corresponding number of randomly selected vaccinated people matched on town of residence were included. Data were collected by means of socio-demographic questionnaire, Health Literacy Questionnaire (HLQ) and Short Form-36 (SF-36). The Physical and Mental Composite Scores as well as their domains were observed as the study outcomes. RESULTS A total of 295 people were studied. The adjusted logistic regression showed that Physical and Mental composite scores were associated with all HLQ domains except 5) Appraisal of health information. Better Physical Functioning was associated with higher scores on 1) Feeling understood and supported by healthcare providers, 6) Ability to actively engage with healthcare providers, 7) Navigating the healthcare system and 8) Ability to find good health information. Better scores on Vitality, Social Functioning, Role Emotional and Mental Health were associated with higher scores on all HLQ domains except 5) Appraisal of health information. CONCLUSION Health literacy is important for physical and mental quality of life among people with chronic diseases. Health care providers and other stakeholders should continuously work to improve health literacy of their patients.
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Affiliation(s)
- Sladjana Arsenović
- Public Health Institute of Republic of Srpska, Regional Center Foča, Njegoševa 15, 73301 Foča, Republic of Srpska, Bosnia and Herzegovina
| | - Goran Trajković
- Institute of Medical Statistics and Informatics, Dr Subotica 15, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia
| | - Tatjana Pekmezović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Višegradska 26A, 11 000 Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Višegradska 26A, 11 000 Belgrade, Serbia.
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Zhu X, Yang F. The association among eHealth literacy, depressive symptoms and health-related quality of life among older people: A cross-section study. Int J Older People Nurs 2023; 18:e12497. [PMID: 35945904 DOI: 10.1111/opn.12497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 07/12/2022] [Accepted: 07/25/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND eHealth literacy can facilitate the uptake of benefits of health for older persons. The aim of this study was to examine the association of eHealth literacy with depression, health-related quality of life (HRQoL) among older persons. METHODS A survey of 6183 participants (aged 60 years and above) from 17 communities was conducted in June 2019. Participants answered questions related to basic information, eHealth literacy scale (eHEALS), geriatric depression scale and the short-form health survey (SF-36). Mediation model and a linear regression analysis were performed to explore the association between the eHEALS scores and related factors. RESULTS The mean score of eHEALS was 21.17 (SD = 8.25). eHEALS was significant higher in men, those with living in the city, those with high educated and stable income and those with living with children, as compared to their counterparts, respectively. Moreover, chronic diseases and depressive symptoms negatively associated with eHEALS, while actively obtaining health information and physical activity positively influenced eHEALS. Furthermore, depressive symptoms had direct and indirect effects on HRQoL, as mediated by eHealth literacy. CONCLUSIONS The eHEALS acts as a mediator between depressive symptoms and HRQoL. As eHealth literacy is a protector for older people, efforts to improve the older persons' eHealth literacy could help to maintain health status. Therefore, healthcare providers formulate effective programs to improve eHealth literacy for older persons, which can bring benefits for health ageing.
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Affiliation(s)
- Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
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18
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Influences of Heider Balance on Knowledge, Attitude, Practice, and Quality of Life in Bladder Cancer Patients after Urinary Diversion. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5635971. [PMID: 36561371 PMCID: PMC9767729 DOI: 10.1155/2022/5635971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 12/15/2022]
Abstract
Objective To explore the influences of Heider balance on knowledge, attitude, practice (KAP), and quality of life in bladder cancer patients after urinary diversion. Methods A set of bladder cancer patients after urinary diversion in our hospital from January 2016 to December 2020 were included in this study. Patients who received out-hospital intervention based on Heider balance were included in the observation group (85 cases). Meanwhile, patients who received routine out-hospital intervention were included in the control group (85 cases), and these patients matched with the observation group by gender, age, and education level. The scores of KAP, WHO quality of life-100 (WHOQOL-100) before discharge and at 6 months after discharge, and the rate of complications were compared in the two groups. Results At 6 months after discharge, the score of these items of KAP including basic knowledge of disease, procedure of pouch replacement, dealing with pouch leakage, skin care of stoma, purchase and storage of pouch, dealing with stoma complications, optimistic mentality for disease, optimistic mentality for stoma, trust in medical staff, willingness to correct bad habits, confidence in maintaining health behavior, maintaining in health dietary habit, maintaining in health behavior, learning from relevant books, learning from relevant videos, experienced in pouch replacement, and experienced in care of stoma of the observation group were significantly higher than those of the control group (t = 6.144, 9.366, 3.129, 3.809, 4.173, 5.923, 2.788, 8.871, 3.291, 10.797, 7.067, 7.805, 3.828, 9.454, 2.827, 4.059, and 8.662, respectively, all P < 0.05). The scores of 16 items of WHOQOL-100 such as energy and fatigue, sleep and rest, positive feelings, thinking, learning, memory and concentration, self-esteem, body image and appearance, negative feelings, mobility, activities of daily living, dependence on medical support, personal relationships, social support, health and social care: availability and quality, opportunities to get new information/skills, opportunities for recreation and leisure, and quality of life from viewpoint in the observation group were significantly higher than those in the control group (t = 2.666, 2.571, 2.961, 3.453, 4.279, 2.781, 3.775, 4.807, 5.850, 4.194, 3.324, 3.873, 5.118, 3.244, 2.956, and 4.218, respectively, all P < 0.05). The rate of complications of the observation group was significantly lower than that of the control group (x 2 = 5.829, P < 0.05). Conclusion The Heider balance can help to reduce the rate of complications, improve knowledge, attitude, practice, and quality of life in urinary diversion patients. These merits make it an attractive approach in guidance of out-hospital intervention.
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Borge CR, Larsen MH, Osborne RH, Engebretsen E, Andersen MH, Holter IA, Wahl AK. How to co-design a health literacy-informed intervention based on a needs assessment study in chronic obstructive pulmonary disease. BMJ Open 2022; 12:e063022. [PMID: 36302571 PMCID: PMC9621159 DOI: 10.1136/bmjopen-2022-063022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To develop a co-designed health literacy (HL)-informed intervention for people with chronic obstructive pulmonary disease (COPD) that enables them to find, understand, remember, use and communicate the health information needed to promote and maintain good health. DESIGN This study used a co-design approach informed by the programme logic of the Ophelia (Optimising Health Literacy and Access) process. The co-design included workshops where possible solutions for an HL-informed intervention were discussed based on an HL needs assessment study. SETTINGS Five workshops were performed in a local community setting in the specialist and municipality healthcare services in Oslo, Norway. PARTICIPANTS People with COPD, multidisciplinary healthcare professionals (HCPs) from the municipality and specialist healthcare services, and researchers (n=19) participated in the workshops. The co-designed HL-informed intervention was based on seven focus groups with people with COPD (n=14) and HCPs (n=21), and a cross-sectional study of people with COPD using the Health Literacy Questionnaire (n=69). RESULTS The workshop co-design process identified 45 action points and 51 description points for possible intervention solutions to meet the HL needs of people with COPD. The final recommendation for an HL-informed intervention focused on tailored follow-up after hospitalisation, which uses motivational interviewing techniques, is based on the individual's HL, self-management and quality of life needs and is implemented in cooperation with HCPs in both the specialist and municipality healthcare services. CONCLUSION During the codesign process, the workshop group generated several ideas for how to help patients find, understand, remember, use and communicate health information in order to promote and maintain good health. People with COPD need tailored follow-up based on their individual HL needs by HCPs that have knowledge of COPD and are able to motivate them for self-management tasks and help them to improve their quality of life (QOL) and decrease hospitalisation.
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Affiliation(s)
- Christine Råheim Borge
- Department of Interdisciplinary Health Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
- Research Department, Lovisenberg Diakonale Hospital, Oslo, Norway
| | | | - Richard H Osborne
- Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Eivind Engebretsen
- Department of Interdisciplinary Health Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
- Division of Cancer Medicine, Surgery and Transplantation, Oslo Universitetssykehus, Oslo, Norway
| | | | - Astrid K Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
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Stellefson M, Kinder C, Boyd I, Elijah O, Naher S, McFadden N. COPD Self-Management for Adults Living in Rural Areas: Systematic Review of Telehealth and Non-Telehealth Interventions. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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21
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Li S, Cui G, Zhou F, Liu S, Guo Y, Yin Y, Xu H. The Longitudinal Relationship Between eHealth Literacy, Health-Promoting Lifestyles, and Health-Related Quality of Life Among College Students: A Cross-Lagged Analysis. Front Public Health 2022; 10:868279. [PMID: 35875048 PMCID: PMC9304771 DOI: 10.3389/fpubh.2022.868279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives This study aimed to explore the longitudinal associations between eHealth literacy, health-promoting lifestyles, and health-related quality of life (HRQoL) among college students. Methods From December 2019 (T1) to December 2020 (T2), we administered the eHealth literacy scale, Short-Form Health Survey (SF-12), and Short-Form Health-Promoting Lifestyle Profile Scale to 1,181 college students in Jinan, China. Participants were recruited for 12 months for the two-stage survey. Results Stable positive correlations were shown between eHealth literacy, health-promoting lifestyles, and HRQoL across time. The cross-lagged analysis showed that eHealth literacy at T1 predicted health-promoting lifestyles at T2 (β = 0.080, P = 0.006); however, health-promoting lifestyles at T1 did not predict eHealth literacy at T2 (β = −0.026, P = 0.499). HRQoL at T1 predicted health-promoting lifestyles at T2 (β = 0.147, P < 0.001); however, similar to the eHealth literacy finding, health-promoting lifestyles at T1 did not predict HRQoL at T2 (β = 0.045, P = 0.142). eHealth literacy was also bi-directionally associated with HRQoL, and the prediction effect of eHealth literacy at T1 to HRQoL at T2 (β = 0.078, P = 0.008) was slightly higher than the prediction effect of HRQoL at T1 to eHealth literacy at T2 (β = 0.074, P = 0.023). Conclusion eHealth literacy and HRQoL may be antecedents for college students' health-promoting lifestyles. There may be significant bi-directional relationships between eHealth literacy and HRQoL.
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Affiliation(s)
- Shaojie Li
- Shandong University of Traditional Chinese Medicine, Jinan, China
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Guanghui Cui
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Feixiang Zhou
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Siyue Liu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yicong Guo
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China
- *Correspondence: Yongtian Yin
| | - Huilan Xu
- Xiangya School of Public Health, Central South University, Changsha, China
- Huilan Xu
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22
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Raddadi Y, Adib-Hajbaghery M. Health literacy and quality of life in Iranian persons with COPD. Heart Lung 2022; 54:61-67. [PMID: 35349857 DOI: 10.1016/j.hrtlng.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease is a progressive disorder with significant physical, psychological, and social consequences and adversely affects the persons' quality of life (QOL). OBJECTIVES This study aimed to determine the health literacy (HL) and QOL of persons with COPD and some of the contributing factors. METHODS A cross-sectional study was conducted from May to December 2019 on 270 persons with COPD referring to Shahid-Beheshti Hospital of Kashan, Iran. Data were collected using a demographic questionnaire, the 33-item Health Literacy Questionnaire of the Urban Population of Iran (with a total score ranging from 33 to 165, higher score indicates higher HL) and the 50-item St. George's Respiratory Questionnaire for assessing the QOL (with a total score ranging from zero to 100, greater score means lower QOL). Descriptive statistics, Pearson and Spearman correlation coefficient, Chi-square test, t-test, analysis of variance, and linear regression analysis were used to analyze the data. RESULTS The mean age and the mean duration of COPD were 59.48±13.31 and 3.85±3.47 years, respectively. The mean HL score and the mean QOL were 81.44±23.89 and 57.41±10.70, respectively. A significant correlation was found between HL and QOL (r=-0.21, p<0.001). CONCLUSION Participants had moderate levels of HL and QOL. There was a significant correlation between HL and QOL. Health care providers are recommended to take effective steps to improve the HL of persons with COPD by developing comprehensive educational programs for them.
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Affiliation(s)
- Yasaman Raddadi
- Medical Surgical Nursing Department, Faculty of Nursing, Kashan University of Medical Sciences, Kashan, Iran
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Korn S, Böttcher MD, Busse TS, Kernebeck S, Breucha M, Ehlers J, Kahlert C, Weitz J, Bork U. Use and Perception of Digital Health Technologies by Surgical Patients in Germany in the Pre-COVID-19 Era: Survey Study. JMIR Form Res 2022; 6:e33985. [PMID: 35594072 PMCID: PMC9166644 DOI: 10.2196/33985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This survey study investigates surgical patients' use and perception of digital health technologies in Germany in the pre-COVID-19 era. OBJECTIVE The objective of this study was to relate surgical patients' characteristics to the use and perception of several digital health technologies. METHODS In this single-center, cross-sectional survey study in the outpatient department of a university hospital in Germany, 406 patients completed a questionnaire with the following three domains: general information and use of the internet, smartphones, and general digital health aspects. Analyses were stratified by age group and highest education level achieved. RESULTS We found significant age-based differences in most of the evaluated aspects. Younger patients were more open to using new technologies in private and medical settings but had more security concerns. Although searching for information on illnesses on the web was common, the overall acceptance of and trust in web-based consultations were rather low, with <50% of patients in each age group reporting acceptance and trust. More people with academic qualifications than without academic qualifications searched for information on the web before visiting physicians (73/121, 60.3% and 100/240, 41.7%, respectively). Patients with academic degrees were also more engaged in health-related information and communication technology use. CONCLUSIONS These results support the need for eHealth literacy, health literacy, and available digital devices and internet access to support the active, meaningful use of information and communication technologies in health care. Uncertainties and a lack of knowledge exist, especially regarding telemedicine and the use of medical and health apps. This is especially pronounced among older patients and patients with a low education status.
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Affiliation(s)
- Sandra Korn
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Maximilian David Böttcher
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Theresa Sophie Busse
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Sven Kernebeck
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Michael Breucha
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jan Ehlers
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Christoph Kahlert
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Weitz
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT/UCC) Dresden, German Cancer Research Center (DKFZ), Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
| | - Ulrich Bork
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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24
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Xie L, Zhang S, Xin M, Zhu M, Lu W, Mo PKH. Electronic health literacy and health-related outcomes among older adults: A systematic review. Prev Med 2022; 157:106997. [PMID: 35189203 DOI: 10.1016/j.ypmed.2022.106997] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
This review aims to identify, appraise, and synthesize research evidence of the association between electronic health (eHealth) literacy and health outcomes in older adults. English-written articles that presented the relationships between eHealth literacy and health-related outcomes in older adults were identified by searching five scientific databases (Web of Science, PubMed, Cochrane Library, APA PsycInfo, and EMBASE) hand-searching reference lists. Searches yielded 2993 studies after duplicates were removed, of which 24 publications were included in the final review. eHealth literacy was relatively low in older adults, and the eHealth Literacy Scale, developed by Norman and Skinner in 2006, was the most frequently used instrument in the included studies (21/24, 87.5%). The health-related outcomes associated with eHealth literacy were grouped into four categories: physical, behavioral, psychosocial, and cognitive. For behavioral (e.g., health-promoting behaviors, self-care, and medication adherence) and cognitive (e.g., health knowledge and health decision making) outcomes, the evidence was mostly consistent that eHealth literacy was positively associated with better outcomes. For physical (e.g., health-related quality of life) and psychosocial outcomes (e.g., anxiety and self-efficacy), the associations were less consistent, with some studies showing significant associations while others showed no associations. Most included studies were assessed as moderate quality. Overall, higher eHealth literacy is associated with more positive health behaviors and better health knowledge and attitude in older adults, however, the associations with some physical and psychosocial outcomes are less consistent. Clarifying the pathways of the relationships between eHealth literacy and some health-related outcomes is needed for further exploring their underlying mechanisms.
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Affiliation(s)
- Luyao Xie
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Shuxian Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Meiqi Xin
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Weiyi Lu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Phoenix Kit-Han Mo
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China.
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25
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Truong M, Fenton SH. Understanding the Current Landscape of Health Literacy Interventions within Health Systems. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2022; 19:1h. [PMID: 35692852 PMCID: PMC9123532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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26
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Yi QF, Yang GL, Yan J. Self-Efficacy Intervention Programs in Patients with Chronic Obstructive Pulmonary Disease: Narrative Review. Int J Chron Obstruct Pulmon Dis 2021; 16:3397-3403. [PMID: 34955635 PMCID: PMC8694112 DOI: 10.2147/copd.s338720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/14/2021] [Indexed: 11/23/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common chronic disease whose development is irreversible, which leads to more than six million deaths each year. There is no treatment confirmed effective for the improvement of impaired lung function, but the combination of drug therapy with non-drug therapy such as pulmonary rehabilitation training has demonstrated a great potential in reducing the occurrence of complications and delaying the progression of COPD. Self-efficacy is the core of cognitive theory, which is crucial for chronic disease management. It has been proposed as an important component of disease management to help people develop skills to manage diseases more effectively. This study reviewed the development of self-efficacy and its application in patients with COPD, with the purpose of providing a better clinical reference for the treatments of COPD.
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Affiliation(s)
- Qi-Feng Yi
- Nursing Teaching and Research Department, Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Guo-Li Yang
- Department of Respiration, Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Jin Yan
- The Nursing Department, Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
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27
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Song S, Xue X, Zhao YC, Li J, Zhu Q, Zhao M. Short-Video Apps as a Health Information Source for Chronic Obstructive Pulmonary Disease: Information Quality Assessment of TikTok Videos. J Med Internet Res 2021; 23:e28318. [PMID: 34931996 PMCID: PMC8726035 DOI: 10.2196/28318] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/23/2021] [Accepted: 11/18/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has become one of the most critical public health problems worldwide. Because many COPD patients are using video-based social media to search for health information, there is an urgent need to assess the information quality of COPD videos on social media. Recently, the short-video app TikTok has demonstrated huge potential in disseminating health information and there are currently many COPD videos available on TikTok; however, the information quality of these videos remains unknown. OBJECTIVE The aim of this study was to investigate the information quality of COPD videos on TikTok. METHODS In December 2020, we retrieved and screened 300 videos from TikTok and collected a sample of 199 COPD-related videos in Chinese for data extraction. We extracted the basic video information, coded the content, and identified the video sources. Two independent raters assessed the information quality of each video using the DISCERN instrument. RESULTS COPD videos on TikTok came mainly from two types of sources: individual users (n=168) and organizational users (n=31). The individual users included health professionals, individual science communicators, and general TikTok users, whereas the organizational users consisted of for-profit organizations, nonprofit organizations, and news agencies. For the 199 videos, the mean scores of the DISCERN items ranged from 3.42 to 4.46, with a total mean score of 3.75. Publication reliability (P=.04) and overall quality (P=.02) showed significant differences across the six types of sources, whereas the quality of treatment choices showed only a marginally significant difference (P=.053) across the different sources. CONCLUSIONS The overall information quality of COPD videos on TikTok is satisfactory, although the quality varies across different sources and according to specific quality dimensions. Patients should be selective and cautious when watching COPD videos on TikTok.
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Affiliation(s)
- Shijie Song
- Business School, Hohai University, Nanjing, China
| | - Xiang Xue
- School of Information Management, Nanjing University, Nanjing, China
| | - Yuxiang Chris Zhao
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | - Jinhao Li
- Sino-French Engineer School, Nanjing University of Science and Technology, Nanjing, China
| | - Qinghua Zhu
- School of Information Management, Nanjing University, Nanjing, China
| | - Mingming Zhao
- Department of Pulmonary and Critical Care Medicine, Gaochun People's Hospital, Nanjing, China
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28
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Paige SR, Wilczewski H, Casale TB, Bunnell BE. Using a computer-tailored COPD screening assessment to promote advice-seeking behaviors. World Allergy Organ J 2021; 14:100603. [PMID: 34820051 PMCID: PMC8585644 DOI: 10.1016/j.waojou.2021.100603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality, despite evidence there is a high proportion of underdiagnosis. Online screening assessments are low-cost solutions to identify high-risk adults who may benefit from confirmatory screening (ie, spirometry test). Little evidence exists to support whether high-risk adults seek advice after completing COPD screening assessments and from whom. The purpose of this study is to examine how the perceived quality of an online screening assessment influences high-risk adults to seek advice from a healthcare provider or other online resources. Methods Adults without a prior COPD diagnosis (N = 199) completed an online survey that included a computer-tailored assessment programmed with the clinically validated COPD Population Screener (COPD-PS). Results An elevated COPD risk score was associated with expectations to talk with a healthcare provider (P < 0.05) or go on the Internet (P < 0.05) to get advice, controlling for statistically significant covariates. Positive perceptions about the quality of the risk score was associated with strengthened expectations to speak with a healthcare provider, but only among high-risk adults (P < 0.01). Conclusions Results of this study support the use of computer-tailored screening assessments as a scalable solution to encourage high-risk adults to learn more about COPD. Strengthened perceptions about the quality of an online COPD screening assessment increased the likelihood that high-risk adults will speak with their healthcare provider about the condition. Implications are discussed for leveraging telehealth solutions, such as conversational agents (ie, chatbots), to disseminate COPD screening assessments and alleviate its underdiagnosis. Trial registration not applicable
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Affiliation(s)
- Samantha R Paige
- Doxy.me Research, Doxy.me Inc, Rochester, NY, USA.,College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | | | - Thomas B Casale
- Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Brian E Bunnell
- Doxy.me Research, Doxy.me Inc, Rochester, NY, USA.,Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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29
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Xu RH, Zhou LM, Wong ELY, Wang D. The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study. J Med Internet Res 2021; 23:e26721. [PMID: 34559062 PMCID: PMC8501410 DOI: 10.2196/26721] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/06/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background Although previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being. Objective This study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being. Methods The data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics. Results A total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM≥61 years=88.6 vs SSDM16-30 years=84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM (β=.22; P<.001) and well-being (β=.26; P<.001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables. Conclusions This study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.,JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ling-Ming Zhou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
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30
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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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31
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Shreffler-Grant J, Nichols EG, Weinert C. Community-based Skill Building Intervention to Enhance Health Literacy Among Older Rural Adults. West J Nurs Res 2021; 43:668-676. [PMID: 32940145 PMCID: PMC8363136 DOI: 10.1177/0193945920958014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this article is to report the outcomes of a skill building intervention to improve general health literacy and health literacy about complementary and alternative therapies (CAM) among older rural adults. The intervention was implemented in eight rural communities. Descriptive statistics and general linear modeling were used for analysis. A total of 127 older adults completed the initial session and Time 1 questionnaire, 67 (51%) completed the intervention sessions and Time 2 questionnaire, and 52 (40.9%) completed the Time 3 questionnaire five months later. CAM health literacy scores and scores on one general health literacy measure were significantly higher at Time 2 compared to Time 1 and 3. The decline in scores over time suggests a need for continuing strategies to support older adults' health literacy. Assisting older adults to make safe health care choices is a critical role for investigators, nurses, and other health care providers.
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Affiliation(s)
- Jean Shreffler-Grant
- Professor Emerita & Research Scientist, College of Nursing, Montana State University, Bozeman, MT, USA
| | - Elizabeth G. Nichols
- Professor Emerita & Research Scientist, College of Nursing, Montana State University, Bozeman, MT, USA
| | - Clarann Weinert
- Professor Emerita & Research Scientist, College of Nursing, Montana State University, Bozeman, MT, USA
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32
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Yang E, Chang SJ, Ryu H, Kim HJ, Jang SJ. Comparing Factors Associated With eHealth Literacy Between Young and Older Adults. J Gerontol Nurs 2021; 46:46-56. [PMID: 32936926 DOI: 10.3928/00989134-20200707-02] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/16/2020] [Indexed: 12/29/2022]
Abstract
The purpose of the current study was to compare the factors associated with adults' eHealth literacy, which is vital for health consumers. A secondary data analysis was conducted with data collected from November 2017 to February 2018 for a project on the development of a Korean version of the eHealth Literacy Scale. Participants were recruited through an online survey for young adults (n = 210, mean age = 25.5 [SD = 4.7] years) and a face-to-face survey for older adults (n = 187, mean age = 73.2 [SD = 4.8] years). Hierarchical multiple regression analyses were used to analyze data and determine eHealth literacy predictors. Older adults held more positive attitudes toward internet health information than young adults (mean = 16.49 [SD = 2.54] and 17.04 [SD = 2.41], respectively; p = 0.029); however, eHealth literacy levels were comparable (mean = 30.50 [SD = 4.62] and 30.95 [SD = 4.17], respectively; p = 0.305). Attitude toward internet health information was a significant predictor of eHealth literacy in both groups, and age was only a predictor among young adults. These results elucidate predictors of eHealth literacy and inform strategies to improve eHealth literacy among young and older adults. [Journal of Gerontological Nursing, 46(8), 46-56.].
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33
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Neter E, Brainin E, Baron-Epel O. Group differences in health literacy are ameliorated in ehealth literacy. Health Psychol Behav Med 2021; 9:480-497. [PMID: 34104571 PMCID: PMC8158255 DOI: 10.1080/21642850.2021.1926256] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Heath literacy and eHealth literacy are skills that enable individuals to seek, understand and use information in ways which promote and maintain health. The present study examined group differences (ethnicity, immigration) in both literacies and whether there exists an association between the literacies and potential outcomes/gains in health behaviors, health care utilization, perceived health and perceived outcomes of Internet search. METHODS Participants included 819 Israeli men and women who responded to a nationally representative random-digital-dial (RDD) telephone survey. Respondents were veteran Jews, immigrants from the Former Soviet Union, and Palestinian Citizens of Israel. RESULTS Significant differences between the groups were found in health literacy, especially in higher ordered skills, so that the immigrant group was the lowest, after accounting for demographic variables. No significant group differences were found in eHealth literacy. Health literacy was found to be significantly associated with healthcare utilization, perceived health and perceived outcomes of Internet search while eHealth literacy was associated with perceived health and perceived outcomes of Internet search. No interaction was found between group and literacies in the prediction of the outcomes. CONCLUSIONS Immigration hampers health literacy but differences are ameliorated in eHealth literacy. Finding on association between literacies and outcomes replicated previous ones and the absence of moderation by group attests to the robustness of the models on health literacies.
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Affiliation(s)
- Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Esther Brainin
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Orna Baron-Epel
- Faculty of Social Welfare and Health, School of Public Health, University of Haifa, Haifa, Israel
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34
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Marklund S, Tistad M, Lundell S, Östrand L, Sörlin A, Boström C, Wadell K, Nyberg A. Experiences and Factors Affecting Usage of an eHealth Tool for Self-Management Among People With Chronic Obstructive Pulmonary Disease: Qualitative Study. J Med Internet Res 2021; 23:e25672. [PMID: 33929327 PMCID: PMC8122287 DOI: 10.2196/25672] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/23/2021] [Accepted: 03/18/2021] [Indexed: 01/08/2023] Open
Abstract
Background Self-management strategies are regarded as highly prioritized in chronic obstructive pulmonary disease (COPD) treatment guidelines. However, individual and structural barriers lead to a staggering amount of people with COPD that are not offered support for such strategies, and new approaches are urgently needed to circumvent these barriers. A promising way of delivering health services such as support for self-management strategies is the use of eHealth tools. However, there is a lack of knowledge about the usage of, and factors affecting the use of, eHealth tools over time in people with COPD. Objective This study aimed, among people with COPD, to explore and describe the experiences of an eHealth tool over time and factors that might affect usage. Methods The eHealth tool included information on evidence-based self-management treatment for people with COPD, including texts, pictures, videos as well as interactive components such as a step registration function with automatized feedback. In addition to the latter, automated notifications of new content and pedometers were used as triggers to increase usage. After having access to the tool for 3 months, 16 individuals (12 women) with COPD were individually interviewed. At 12 months’ access to the tool, 7 (5 women) of the previous 16 individuals accepted a second individual interview. Data were analyzed using qualitative content analysis. User frequency was considered in the analysis, and participants were divided into users and nonusers/seldom users depending on the number of logins and minutes of usage per month. Results Three main categories, namely, ambiguous impact, basic conditions for usage, and approaching capability emerged from the analysis, which, together with their subcategories, reflect the participants’ experiences of using the eHealth tool. Nonusers/seldom users (median 1.5 logins and 1.78 minutes spent on the site per month) reported low motivation, a higher need for technical support, a negative view about the disease and self-management, and had problematic health literacy as measured by the Communicative and Critical Health Literacy Scale (median [range] 154 [5-2102]). Users (median 10 logins and 43 minutes per month) felt comfortable with information technology (IT) tools, had a positive view on triggers, and had sufficient health literacy (median [range] 5 [5-1400]). Benefits including behavior changes were mainly expressed after 12 months had passed and mainly among users. Conclusions Findings of this study indicate that the level of motivation, comfortability with IT tools, and the level of health literacy seem to affect usage of an eHealth tool over time. Besides, regarding behavioral changes, gaining benefits from the eHealth tool seems reserved for the users and specifically after 12 months, thus suggesting that eHealth tools can be suitable media for supporting COPD-specific self-management skills, although not for everyone or at all times. These novel findings are of importance when designing new eHealth tools as well as when deciding on whether or not an eHealth tool might be appropriate to use if the goal is to support self-management among people with COPD. Trial Registration ClinicalTrials.gov NCT02696187; https://clinicaltrials.gov/ct2/show/NCT02696187 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2017-016851
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Affiliation(s)
- Sarah Marklund
- Section of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Malin Tistad
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sara Lundell
- Section of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Lina Östrand
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ann Sörlin
- Section of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Carina Boström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Solna, Sweden
| | - Karin Wadell
- Section of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Andre Nyberg
- Section of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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35
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Wahl AK, Osborne RH, Larsen MH, Andersen MH, Holter IA, Borge CR. Exploring health literacy needs in Chronic obstructive pulmonary disease (COPD): Associations between demographic, clinical variables, psychological well-being and health literacy. Heart Lung 2021; 50:417-424. [PMID: 33618148 DOI: 10.1016/j.hrtlng.2021.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The World Health Organization (WHO) points to health literacy as an important factor in prevention and control of non-communicable diseases (NCDs), including COPD. OBJECTIVE To investigate associations between selected demographic and clinical variables, psychological well-being and health literacy. METHODS Health literacy was measured using the nine domain Health Literacy Questionnaire (HLQ) and one domain from the eHealth Literacy Questionnaire (eHLQ). Using data from a cross-sectional sample of 158 people with COPD, recruited from a hospital-based patient list period (2014-2016), multiple regression analyses were performed. RESULTS The strongest associated variables with health literacy were psychological well-being, measured by the WHO-5 well-being index and education, indicating that higher psychological well-being and educational level are associated with higher levels of health literacy. CONCLUSION The present study highlights the importance of specifically looking to psychological factors in determining potentially health literacy needs among people with COPD.
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Affiliation(s)
- Astrid K Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway.
| | - Richard H Osborne
- Centre of Global Health and Equity, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
| | - Marie H Larsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway
| | - Marit H Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Christine R Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal Hospital, Oslo, Norway
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Guo SHM, Hsing HC, Lin JL, Lee CC. Relationships Between Mobile eHealth Literacy, Diabetes Self-care, and Glycemic Outcomes in Taiwanese Patients With Type 2 Diabetes: Cross-sectional Study. JMIR Mhealth Uhealth 2021; 9:e18404. [PMID: 33544088 PMCID: PMC7895642 DOI: 10.2196/18404] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/30/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background Understanding how people with diabetes seek online health information and use health applications is important to ensure these electronic tools are successfully supporting patient self-care. Furthermore, identifying the relationship between patient mobile eHealth literacy (mobile eHL) and diabetes outcomes can have far-reaching utility, for example, in the design of targeted interventions to address mobile eHL limitations. However, only limited studies have explored the impact of mobile eHL in a population with diabetes. Objective This study aims to present data about online information-seeking behavior and mobile health (mHealth) app usage, investigate the factors related to mobile eHL in Taiwanese patients with type 2 diabetes, and flesh out the relationship between eHealth literacy (eHL), mobile health literacy (mHL), and health outcomes. Methods Subjects were recruited from January 2017 to December 2017 in the outpatient departments of 3 hospitals in Taiwan. A total of 249 Taiwanese patients with diabetes voluntarily completed a cross-sectional survey assessing sociodemographic characteristics; diabetes status; knowledge and skills of computers, the internet, and mobile apps; mobile eHL; and patient outcomes (self-care behaviors, self-rated health, HbA1c). Structural equation modeling analyses examined the model fit of mobile eHL scores and the interrelationships between latent constructs and observable variables. Results Of the 249 patients with diabetes, 67% (164/249) reported they had searched for online diabetes information. The participants with smartphones had owned them for an average of 6.5 years and used them for an average of 4.5 (SD 3.81) hours per day. Only 1.6% (4/249) of the patients used health apps. Some demographic factors affecting mobile eHL included age, education, and duration of type 2 diabetes. Mobile eHL was related to self-care behaviors as well as knowledge and skills of computers, the internet, and mobile technology, but only had a weak, indirect effect on self-rated health. The final model had adequate goodness-of-fit indexes: chi-square (83)=149.572, P<.001; comparative fit index (CFI)=0.925; root mean square of approximation (RMSEA)=0.057 (90% CI 004-006); chi-square/df=1.082. Mobile eHL had a weak, indirect effect on self-rated health through the variables of knowledge with skills. Conclusions Our study reveals that although people with diabetes who rated their health conditions as moderate were confident in using mobile eHealth and technology, few adopted these tools in their daily lives. The study found that mobile eHL had a direct effect on self-care behavior as well as knowledge and skills of computers, the internet, and mobile technology, and had an indirect effect on health outcomes (glycemic control and self-rated health status). Information about this population's experiences and the role mobile eHL plays in them can spur necessary mobile eHealth patient education.
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Affiliation(s)
| | - Hung-Chun Hsing
- Department of Nursing, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
| | - Jiun-Lu Lin
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chun-Chuan Lee
- Division of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan
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Wang J, She Y, Wang M, Zhang Y, Lin Y, Zhu X. Relationships among hope, meaning in life, and post-traumatic growth in patients with chronic obstructive pulmonary disease: A cross-sectional study. J Adv Nurs 2020; 77:244-254. [PMID: 33058188 DOI: 10.1111/jan.14605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 08/18/2020] [Accepted: 09/28/2020] [Indexed: 01/10/2023]
Abstract
AIM This study aimed to investigate the relationships among hope, meaning in life, and post-traumatic growth (PTG) in patients with chronic obstructive pulmonary disease. DESIGN A cross-sectional study design. METHODS Between October 2018-September 2019, 221 chronic obstructive pulmonary disease patient completed the questionnaires including sociodemographic information, Chinese Version of Herth Hope Index, Meaning in Life Questionnaire, and Post-traumatic Growth Inventory. Descriptive analysis, Spearman's correlation analysis, the Kruskal-Wallis H test, the Mann-Whitney U test, and the ridge regression analysis were used for analysis. RESULTS Spearman's correlation analysis showed that hope and meaning in life were positively interrelated with PTG (r = 0.20-0.45, r = 0.36-0.54, p < 0.01). Ridge regression analysis results showed that hope, meaning in life, time since diagnosis, habitation, medical insurance, and monthly income could explain 47.30% of the variance in PTG (F = 33.863, p < 0.001). CONCLUSION Chinese patients with chronic obstructive pulmonary disease experienced a slightly positive change in meaning in life and a moderate degree of hope and PTG. Results suggested that hope and meaning in life were positively connected with PTG. Therefore, enhancing hope and meaning in life might be crucial for patients with chronic obstructive pulmonary disease to promote PTG. IMPACT The findings added better understanding of relationships among hope, meaning in life, and post-traumatic growth in patients with chronic obstructive pulmonary disease which can help nurse give interventions in the early stage of disease diagnosis.
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Affiliation(s)
- Jizhe Wang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Yiying She
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Meiya Wang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Yuting Zhang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Yuanxin Lin
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Xiuli Zhu
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
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Li X, Liu Q. Social Media Use, eHealth Literacy, Disease Knowledge, and Preventive Behaviors in the COVID-19 Pandemic: Cross-Sectional Study on Chinese Netizens. J Med Internet Res 2020; 22:e19684. [PMID: 33006940 PMCID: PMC7581310 DOI: 10.2196/19684] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/10/2020] [Accepted: 09/23/2020] [Indexed: 01/17/2023] Open
Abstract
Background Since its outbreak in January 2020, COVID-19 has quickly spread worldwide and has become a global pandemic. Social media platforms have been recognized as important tools for health-promoting practices in public health, and the use of social media is widespread among the public. However, little is known about the effects of social media use on health promotion during a pandemic such as COVID-19. Objective In this study, we aimed to explore the predictive role of social media use on public preventive behaviors in China during the COVID-19 pandemic and how disease knowledge and eHealth literacy moderated the relationship between social media use and preventive behaviors. Methods A national web-based cross-sectional survey was conducted by a proportionate probability sampling among 802 Chinese internet users (“netizens”) in February 2020. Descriptive statistics, Pearson correlations, and hierarchical multiple regressions were employed to examine and explore the relationships among all the variables. Results Almost half the 802 study participants were male (416, 51.9%), and the average age of the participants was 32.65 years. Most of the 802 participants had high education levels (624, 77.7%), had high income >¥5000 (US $736.29) (525, 65.3%), were married (496, 61.8%), and were in good health (486, 60.6%). The average time of social media use was approximately 2 to 3 hours per day (mean 2.34 hours, SD 1.11), and the most frequently used media types were public social media (mean score 4.49/5, SD 0.78) and aggregated social media (mean score 4.07/5, SD 1.07). Social media use frequency (β=.20, P<.001) rather than time significantly predicted preventive behaviors for COVID-19. Respondents were also equipped with high levels of disease knowledge (mean score 8.15/10, SD 1.43) and eHealth literacy (mean score 3.79/5, SD 0.59). Disease knowledge (β=.11, P=.001) and eHealth literacy (β=.27, P<.001) were also significant predictors of preventive behaviors. Furthermore, eHealth literacy (P=.038) and disease knowledge (P=.03) positively moderated the relationship between social media use frequency and preventive behaviors, while eHealth literacy (β=.07) affected this relationship positively and disease knowledge (β=–.07) affected it negatively. Different social media types differed in predicting an individual’s preventive behaviors for COVID-19. Aggregated social media (β=.22, P<.001) was the best predictor, followed by public social media (β=.14, P<.001) and professional social media (β=.11, P=.002). However, official social media (β=.02, P=.597) was an insignificant predictor. Conclusions Social media is an effective tool to promote behaviors to prevent COVID-19 among the public. Health literacy is essential for promotion of individual health and influences the extent to which the public engages in preventive behaviors during a pandemic. Our results not only enrich the theoretical paradigm of public health management and health communication but also have practical implications in pandemic control for China and other countries.
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Affiliation(s)
- Xiaojing Li
- Center for Health and Medical Communication, School of Media & Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Qinliang Liu
- Center for Health and Medical Communication, School of Media & Communication, Shanghai Jiao Tong University, Shanghai, China
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Hahn EA, Boileau NR, Hanks RA, Sander AM, Miner JA, Carlozzi NE. Health literacy, health outcomes, and the caregiver role in traumatic brain injury. Rehabil Psychol 2020; 65:2020-37274-001. [PMID: 32463261 PMCID: PMC7704789 DOI: 10.1037/rep0000330] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose/Objective: The purpose of this study is to estimate the occurrence of low health literacy among caregivers of people with traumatic brain injury (TBI), and to evaluate associations of health literacy with caregiver health-related quality of life (HRQOL) and perceptions of the caregiving role. Research Method/Design: The TBI-CareQOL measurement system assesses important self-reported outcomes for caregivers of civilians or service members/veterans (SMVs) with TBI. The validation phase included the Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT) measure. Multivariable regression evaluated the impact of low health literacy on generic and TBI-specific HRQOL and appraisals of the caregiving role, adjusted for caregiver gender, race/ethnicity and education, and the functional status of the TBI care recipient. Results: Among 131 caregivers, 28 (21%) had low health literacy. Compared with the high health literacy group, the group with low health literacy had fewer women, more racial/ethnic minorities, and lower education (all p < .05). The low health literacy group reported more subjective caregiving burden, less satisfaction with their relationship with the TBI recipient, less caregiving mastery, and poorer physical health (all p < .05). There were no differences between health literacy groups in caregiving ideology, caregiver-specific HRQOL or general mental health. Conclusions/Implications: A better understanding of the links between health literacy and caregiver HRQOL and the caregiving role can help identify strategies to meet the needs of this underserved population. Tailored interventions for caregivers with low health literacy could improve outcomes for both the caregiver and the care recipient. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Elizabeth A Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Nicholas R Boileau
- Center for Clinical Outcomes Development and Application (CODA), Department of Physical Medicine and Rehabilitation, University of Michigan
| | - Robin A Hanks
- Department of Physical Medicine and Rehabilitation, School of Medicine, Wayne State University
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine
| | - Jennifer A Miner
- Center for Clinical Outcomes Development and Application (CODA), Department of Physical Medicine and Rehabilitation, University of Michigan
| | - Noelle E Carlozzi
- Center for Clinical Outcomes Development and Application (CODA), Department of Physical Medicine and Rehabilitation, University of Michigan
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McKee MM, Hauser PC, Champlin S, Paasche-Orlow M, Wyse K, Cuculick J, Buis LR, Plegue M, Sen A, Fetters MD. Deaf Adults' Health Literacy and Access to Health Information: Protocol for a Multicenter Mixed Methods Study. JMIR Res Protoc 2019; 8:e14889. [PMID: 31599730 PMCID: PMC6812478 DOI: 10.2196/14889] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 01/26/2023] Open
Abstract
Background Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population. Objective This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions. Methods This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants’ ownership and use of computer and mobile devices and their level of Web-based information use, including health information. Results Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals. Conclusions The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills. International Registered Report Identifier (IRRID) PRR1-10.2196/14889
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Affiliation(s)
- Michael M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Peter C Hauser
- Department of American Sign Language and Interpreter Education, Rochester Institute of Technology, Rochester, NY, United States
| | - Sara Champlin
- Mayborn School of Journalism, University of North Texas, Denton, TX, United States
| | | | - Kelley Wyse
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jessica Cuculick
- Center on Cognition and Language, National Technical Institute for Deaf, Rochester Institute of Technology, Rochester, NY, United States
| | - Lorraine R Buis
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Melissa Plegue
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Ananda Sen
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
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