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Zhao X, Liu Q, Guo X, Hu X, Cheng L. Serial mediation roles of empowerment and self-care activities connecting health literacy, quality of life, and glycemic control in people with type 2 diabetes. Worldviews Evid Based Nurs 2024; 21:330-337. [PMID: 37855192 DOI: 10.1111/wvn.12684] [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: 02/01/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Health literacy, empowerment, and self-care activities are likely the crucial concepts affecting the quality of life and glycemic control in people with type 2 diabetes (T2D). However, evidence demonstrating the mechanisms underlying these concepts is scarce. AIMS The aim of this study was to test the serial mediation roles of empowerment and self-care activities on the relationships between health literacy and quality of life and between health literacy and hemoglobin A1c (HbA1c) in people with T2D. METHODS A cross-sectional study was conducted among 319 people with T2D in Guangzhou, China, from July 2019 to January 2020. Data were collected using the Health Literacy Scale, the Diabetes Empowerment Scale-Short Form, the Summary of Diabetes Self-Care Activities Measure, and the Adjusted Diabetes-Specific Quality of Life Scale. RStudio 4.2.1 was used for serial mediation analysis. RESULTS The dimension of communicative health literacy accounted for the most total variance (β = 0.810, p < .001) in the construct of health literacy. The serial multiple mediation of empowerment and self-care activities in the associations between health literacy and quality of life (β = -.046, p = .019) and between health literacy and HbA1c (β = -.045, p = .005) were statistically significant. LINKING EVIDENCE TO ACTION This study emphasized the vital role of communicative health literacy when improving health literacy in people with T2D. Diabetes care and education specialists could implement empowerment approaches and flexible self-care strategies to improve the quality of life and glycemic control in people with T2D. Enhancing health literacy was suggested as a favorable strategy for promoting empowerment and self-care activities in people with T2D.
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Affiliation(s)
- Xiaoyan Zhao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Qiao Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xiaodi Guo
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiling Hu
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Fenta ET, Kidie AA, Tiruneh MG, Anagaw TF, Bogale EK, Dessie AA, Worku NK, Amera MG, Tesfa H, Limenh LW, Delie AM, Ayal BG. Exploring barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public hospitals; Northeast, Ethiopia, 2023: application of socio-ecological model. BMC Public Health 2024; 24:971. [PMID: 38581006 PMCID: PMC10998356 DOI: 10.1186/s12889-024-18524-8] [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: 11/04/2023] [Accepted: 04/04/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Health literacy is the important for the prevention of non-communicable disease to make informed health decisions, and practice healthy and protective behaviours. Therefore, application of socioecological model to this study aimed to identify multilevel factors on health literacy among patients and develop scientific health communication interventional strategies to improve health literacy on non-communicable disease prevention and care. OBJECTIVE To explore barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public Hospitals, Northeast Ethiopia, 2023. METHOD In this study phenomenological study design was conducted from February 5 to 30/2023.We have used purposive sampling technique to select study participants from chronic follow up clinics. Data were collected using in-depth interview and focused group discussion in which audio was recorded, transcribed verbatim and translated to English. Thematic analysis was performed with atlas ti. 7 software. RESULT In this study four main themes with seven subthemes were developed. The main themes were factors at the organizational, community, interpersonal, and intra-personal factors. The poor knowledge, lack of enough money for transportation and medication at the hospital were identified as barrier to get early diagnosis and treatment. Some participants explored that they have no any support from family or others. The cultural norms like weeding and funeral ceremonies enforce patients to consume prohibited substances like alcohol and salty foods. CONCLUSION In this study different barriers of health literacy were explored. Lack of knowledge, economic problems, lack of social support, poor communication with health care providers, cultural influences, lack of regular health education, lack of access to health care services and poor infrastructure were main barriers of health literacy in patients with NCD. Therefore, we recommended all concerned bodies to work on social and behavioral change communication intervention focusing on awareness creation, supply of drugs and create supportive environment to get accessible and affordable health care service to decrease the impact of non-communicable disease at personal, community and national level.
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Affiliation(s)
- Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Atitegeb Abera Kidie
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Misganaw Guadie Tiruneh
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Fentabel Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amanuel Addisu Dessie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Nigus Kassie Worku
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mastewal Giza Amera
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Hiwot Tesfa
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | | | - Amare Mebrate Delie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Birtukan Gizachew Ayal
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
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Magi CE, Bambi S, Rasero L, Longobucco Y, El Aoufy K, Amato C, Vellone E, Bonaccorsi G, Lorini C, Iovino P. Health Literacy and Self-Care in Patients with Chronic Illness: A Systematic Review and Meta-Analysis Protocol. Healthcare (Basel) 2024; 12:762. [PMID: 38610184 PMCID: PMC11011384 DOI: 10.3390/healthcare12070762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Self-care plays a critical role in symptom recognition, management, and risk factor modification for patients with chronic illnesses. Despite its significance, self-care levels in this population are generally poor. Health literacy (HL) is pivotal for promoting effective self-care, yet the association across specific chronic illnesses remains fragmented and conflicting. Therefore, a systematic review and meta-analysis will be conducted. Inclusion criteria encompass quantitative studies involving adult patients with at least one chronic illness reporting on the association between a measure of HL and one or more elements of self-care behaviors as outcomes. Databases to be searched include PubMed, CINAHL, APA PsycINFO, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The studies will undergo risk of bias and certainty of evidence assessment using ROBINS-E and GRADE. Extracted data will include authors, publication date, aim(s), study location, design, sample characteristics, chronic illness type, study length, HL, and self-care measures. Understanding the link between HL and self-care can aid healthcare providers in implementing strategies to enhance health-promoting behaviors, contributing valuable insights to the scientific community and fostering nuanced discussions. This protocol ensures methodological transparency, stimulates discourse, and paves the way for informed interventions to improve overall health outcomes.
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Affiliation(s)
- Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Carla Amato
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Ercole Vellone
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
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Li J, Wang Q, Zhou X. Health literacy, worry about unmet needs for medical care, and psychological well-being among older Chinese adults. Geriatr Gerontol Int 2024; 24 Suppl 1:202-207. [PMID: 38050461 DOI: 10.1111/ggi.14754] [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: 09/03/2023] [Revised: 10/24/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
AIM This study aims to examine the relationship between older adults' health literacy and their psychological well-being and the role of worry about future unmet needs for medical care in mediating this relationship. METHODS We adopted a sample of 965 older Chinese people aged 60+ (49.74% female) from the 2021 Chinese General Social Survey. A series of structural equation models (SEMs) were performed. Health literacy was measured by three items regarding older people's ability to understand medical professionals, ask them questions, and read medical instructions. A single-item question was adopted to measure participants' worry about unmet needs for future medical care. Psychological well-being was measured by three items regarding emotional problems and depressed or anxious mood in the past 4 weeks. RESULTS Worry about future unmet needs for medical care mediates the relationship between lack of health literacy and Chinese older people's psychological well-being. The indirect effect accounts for 22.3% of the total effect. The SEM model has a satisfactory model fit (goodness of fit index = 1.000, comparative fit index = 0.999, Tucker-Lewis index = 0.997, root mean square error of approximation = 0.009, standardized root mean square residual = 0.023, chi-square test = 50.96, P = 0.321). CONCLUSIONS The findings of this study underscore the importance of improving communication quality between healthcare providers and older adults. Clinical interventions that promote health literacy and address worries about unmet needs for medical services may benefit older adults. Geriatr Gerontol Int 2024; 24: 202-207.
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Affiliation(s)
- Jia Li
- Department of Social Work, Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong, HKSAR, China
| | - Qi Wang
- School of Graduate Studies and Institute of Policy Studies, Lingnan University, Hong Kong, HKSAR, China
| | - Xiaochen Zhou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, HKSAR, China
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Panagiotidis P, Kalokairinou A, Tzavara C, Michailidou A, Velonaki VS. Health Literacy, Self-Efficacy and Glycemic Control in Patients With Diabetes Type 2 in a Greek Population. Cureus 2024; 16:e55691. [PMID: 38586620 PMCID: PMC10997967 DOI: 10.7759/cureus.55691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Aim To investigate the relationship between health literacy (HL), self-efficacy (SE), and achievement of treatment goals in patients with type 2 diabetes mellitus (T2DM). Method The cross-sectional study was conducted with a random sample of patients with T2DM attending the diabetology clinic and the Home Care department of the General Hospital of Drama, Greece. They completed two questionnaires: the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) to measure HL and the Diabetes Management Self-Efficacy Scale (DMSES) for people with T2DM to measure SE. Medical history, demographic characteristics, and values related to glycemic control were also recorded. Linear regression analysis was used to search for the dependence of glycosylated hemoglobin (A1C) values with HL and SE and the dependence between them. Result About 120 patients with T2DM (response rate of 92.3%) were enrolled in the study. The mean age of the participants was 62.5 years [standard deviation (SD) = 10.6 years] and most of them were female (53.3%). A1C was found to be significantly negatively associated with diet, physical activity, and SE score. Also, a statistically significant positive correlation was found between HL and SE. HL was correlated with age, gender, education level, and A1C, with women and older people having lower HL, while conversely higher education level was significantly associated with higher HL. Higher A1C was significantly associated with lower HL. Also, SE partially mediates the relationship between HL and A1C, in a significant way. Conclusion The results of the study confirm the important role of HL and SE in the successful management of T2DM. Multi-level educational interventions for diabetic patients could improve HL and SE and promote diabetes self-management.
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Affiliation(s)
- Panagiotis Panagiotidis
- Nursing, National and Kapodistrian University of Athens, Athens, GRC
- Outpatient Diabetes Clinic, General Hospital of Drama, Drama, GRC
| | | | - Chara Tzavara
- Biostatistician, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
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Othman AA, Alassaf MS, Hasubah SM, Aljuhani M, Kabli AM, Alsulaimani M. Is Arabic online patient-centered information about dental extraction trustworthy? An infodemiological study. Digit Health 2024; 10:20552076241264390. [PMID: 39055782 PMCID: PMC11271091 DOI: 10.1177/20552076241264390] [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: 02/26/2024] [Accepted: 05/29/2024] [Indexed: 07/27/2024] Open
Abstract
Background Assessment of the Arabic online patient-centered information is understudied. The study aims to assess the quality and readability of the Arabic web-based knowledge about dental extraction. Methods The first 100 Arabic websites focusing on dental extraction were gathered using popular terms from Google, Bing, and Yahoo searches. These sites were organized and their quality was assessed using three key standards: the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN instrument, and the inclusion of the Health on the Net Foundation Code of Conduct (HON code) seal. Additionally, the ease of reading of these websites was evaluated through various online readability indexes. Results Out of 300 initially reviewed websites on dental extraction in Arabic, 80 met the eligibility criteria. Nonprofit organizations were most common (41.3%), followed by university/medical centers (36.3%), and commercial entities (21.3%). Government organizations were minimally represented (1.3%). All websites were medically oriented, with 60% offering Q&A sections. Quality assessment showed moderate scores on the DISCERN instrument, with no site reaching the highest score. JAMA benchmarks were poorly met, and none had the HON code seal. Readability was generally high, with most sites scoring favorably on readability scales. Conclusions The rapidly evolving online information about dental extraction lacks readability and quality and can spread misinformation. Creators should focus on clear, unbiased content using simple language for better public understanding.
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Affiliation(s)
- Ahmad A. Othman
- Department of Oral and Maxillofacial Diagnostic Sciences, Tabiah University, Medina, Saudi Arabia
| | - Muath S. Alassaf
- Department of Oral and Maxillofacial Surgery, King Fahad Hospital, Medina, Saudi Arabia
| | - Saad M. Hasubah
- Department of Dental Education, Taibah University, Medina, Saudi Arabia
| | - Mohammad Aljuhani
- Department of Restorative Dentistry, Ohud Hospital, Medina, Saudi Arabia
| | - Ahmad M. Kabli
- Department of Preventive Dental Sciences, Taibah University, Medina, Saudi Arabia
| | - Mahmoud Alsulaimani
- Department of Preventive Dental Sciences, Taibah University, Medina, Saudi Arabia
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Du S, Tian L, Tian Y, Feng Z, Wang Y. The role of self-efficacy and self-care agency as mediating factors in the link between health literacy and health-promoting lifestyle among older adults post covid 19 era: A multiple mediator model. Geriatr Nurs 2023; 54:252-257. [PMID: 37897930 DOI: 10.1016/j.gerinurse.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/30/2023]
Abstract
Health-promoting lifestyle is poor in older adults during COVID-19 pandemic. Elucidate the underlying mechanisms between health literacy and health-promoting lifestyle is important. Therefore, we investigated the mediating effect of self-efficacy and self-care agency in relation between health literacy and health-promoting lifestyle among older adults post covid 19 era. A cross-sectional descriptive survey on 200 older adults with the mean age of 68.3 were recruited from Lecai urban community in China, through convenience sampling. Information was assessed using Health literacy Assessment Scale for Infectious Diseases of Chinese Residents, the General Self Efficacy Scale, Chinese version of the Elderly Self-care Ability Scale, and the Health-Promoting Lifestyle Profile-Chinese Elderly. A serial multiple mediation modeling was tested using the PROCESS macro for SPSS to validate the pathways. Results indicated that positive correlations were found between health literacy, self-efficacy, self-care agency and health-promoting lifestyle in older adults. Meanwhile, health literacy was linked to enhanced health-promoting lifestyle through two pathways: (1) self-efficacy; (2) chain combination of self-efficacy and self-care agency. Self-efficacy and self-care agency mediated the relationship between health literacy and health-promoting lifestyle in older adults. Therefore, attention to improving self-efficacy, self-care agency and health literacy should be considered crucial for improving health-promoting lifestyle.
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Affiliation(s)
- Shaoying Du
- School of nursing, Hebei University, Hebei, China
| | - Licong Tian
- School of nursing, Hebei University, Hebei, China
| | - Yimiao Tian
- School of nursing, Hebei University, Hebei, China
| | - Zhimin Feng
- School of clinical medicine, Hebei University, Hebei, China
| | - Yan Wang
- School of nursing, Hebei University, Hebei, China.
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Qadhi OA, Albothi GK, Fallatah R, Anazi M, Al-Rawi MBA, Syed W. Navigating Health Literacy and Practices: A Cross-Sectional Study on Nursing Undergraduates in Riyadh, Saudi Arabia. Med Sci Monit 2023; 29:e941632. [PMID: 37751420 PMCID: PMC10541790 DOI: 10.12659/msm.941632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND This study aimed to assess the health literacy (HL) and health practices (HP) among nursing undergraduates at King Saud University in Riyadh, Saudi Arabia. MATERIAL AND METHODS A cross-sectional survey-based study was conducted in 2023 to assess how nursing students perceive HL and HP. HL is the ability of individuals to acquire, interpret, assess, and act on information to promote and maintain good health, while HP involves the application of knowledge and skills. HL was assessed using a total of 16 items, subdivided into 4 domains (understanding, evaluating, accessing, and utilizing health information) while HP was assessed using 11 items on a 5-point Likert scale. RESULTS In this study, 53.9% of the students were found to have poor HP, while 40.9% (n=166) reported moderate HP, and 5.2% (n=21) reported good HP. With regards to HL, 38.9% (n=158) of students were found to have good HL while 52.2% (n=212) reported moderate HL, and 8.9% (n=36) reported poor HL. The findings indicated that there was a relationship between age and HP, indicating that age is a major predictor of HP (P=0.001). Other comparisons, including year of study, income source, marital status, and the prevalence of chronic conditions, were discovered to have a significant relationship (P=0.001) with HP levels. CONCLUSIONS According to these findings, most students reported poor HP, while one-third claimed good HL. Therefore, there is a need to address the factors related to poor HP while also recommending methods to support good HP among students.
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Affiliation(s)
- Omaimah A. Qadhi
- Department of Medical-Surgical, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Gada Khalid Albothi
- Department of Medical-Surgical, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Reem Fallatah
- Department of Medical-Surgical, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Maryam Anazi
- Department of Medical-Surgical, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Mahmood Basil A. Al-Rawi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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