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Furness D, Huynh NKT, Kaufmann L, Liu J, Nguyen TBN, Schaefer E, Tan L, Yau CD, Yu Q. Real-world insights on nutritional awareness and behaviors among preconception and pregnant women in three Asia Pacific countries. Front Glob Womens Health 2024; 5:1332555. [PMID: 38813069 PMCID: PMC11135049 DOI: 10.3389/fgwh.2024.1332555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/22/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction In many parts of Asia Pacific (APAC), insufficient intake of micronutrients that are important for conception and pregnancy remains a prevalent issue among women of reproductive age. It is crucial to gain insights into women's nutritional awareness and nutrition-related behaviors, as well as how these relate to their health literacy (HL). This understanding can help identify gaps and guide the development of appropriate intervention strategies. However, there appears to be limited relevant data available for the APAC region. We therefore examined nutritional awareness and behaviors among preconception and pregnant women in three APAC countries, and explored how these were related to women's HL. Methods Cross-sectional online surveys were conducted among preconception (i.e., planning to conceive within the next 12 months or currently trying to conceive) and pregnant women in Australia (N = 624), China (N = 600), and Vietnam (N = 300). The survey questionnaire included a validated tool for HL (Newest Vital Sign) and questions to examine awareness and behaviors relating to healthy eating and prenatal supplementation during preconception and pregnancy. Results Despite recommendations for a quality diet complemented by appropriate supplementation during preconception and pregnancy, many respondents in each country were not aware of the specific impact of adequate nutrition during these stages. While many respondents reported changes in their diet to eat more healthily during preconception and pregnancy, a substantial proportion were not taking prenatal supplements. Higher HL was related to greater nutritional awareness and higher use of prenatal supplements. Discussion Our findings suggest that there are gaps in nutritional awareness and practices of many preconception or pregnant women in the three countries. Interventions to improve HL would be valuable to complement conventional knowledge-centric nutrition education, and enhance understanding and empower women to adopt appropriate nutritional practices throughout their preconception/pregnancy journey.
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Affiliation(s)
- Denise Furness
- Nutritionist and Molecular Geneticist, Your Genes and Nutrition, Doonan, QLD, Australia
| | - Nguyen Khanh Trang Huynh
- Department of Obstetrics and Gynaecology, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Ligaya Kaufmann
- Department of Regulatory, Medical, Safety, Quality & Compliance (RMSQC), Bayer Consumer Care AG, Basel, Switzerland
| | - Jue Liu
- Department of Regulatory, Medical, Safety, Quality & Compliance (RMSQC), Bayer Healthcare Company Limited, Shanghai, China
| | - Thi Bich Ngoc Nguyen
- Department of Regulatory, Medical, Safety, Quality & Compliance (RMSQC), Bayer Vietnam Limited, Bien Hoa, Dong Nai, Vietnam
| | - Ella Schaefer
- Department of Regulatory, Medical, Safety, Quality & Compliance (RMSQC), Bayer Consumer Care AG, Basel, Switzerland
| | - Lucy Tan
- Department of Regulatory, Medical, Safety, Quality & Compliance (RMSQC), Bayer Australia Limited, Pymble, NSW, Australia
| | - Ching Danica Yau
- Department of Regulatory, Medical, Safety, Quality & Compliance (RMSQC), Bayer Healthcare Limited, Consumer Health, Hong Kong, Hong Kong SAR, China
| | - Qi Yu
- Gynecological Endocrinology and Reproductive Medicine Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
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Efthymiou A, Kalaitzaki A, Kondilis B, Rovithis M. Health literacy continuing education courses and tools for healthcare professionals: A scoping review. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:212-247. [PMID: 36545846 DOI: 10.1080/02701960.2022.2156865] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Strengthening the health literacy (HL) skills of the healthcare users is a multicomponent process involving the users, the healthcare professionals, the stakeholders, and the environment. Health organizations, universities, private initiatives, and funded projects focused on developing and implementing continuing education courses target at increasing healthcare professionals' HL. This scoping review aimed at reporting the HL continuing education courses for healthcare professionals to enhance their knowledge and skills in identifying and supporting healthcare users with limited HL, and particularly, older people. This review followed the five stages by Arksey and O'Malley framework and the guidelines by Joanna Briggs Institute for scoping reviews. Peer-reviewed papers and gray literature published between years 2000 to 2020 were included in this bibliometric search utilizing four electronic databases (PUBMED, MEDLINE, CINAHL, PSYCHINFO, and Opengrey). Twenty-seven (27) papers met the criteria, including twenty-one (21) full-texts and six (6) other records (website contents, eLearning, and funded projects). There is a lack of HL tools that address the training needs of healthcare professionals working with older adults. Tailored HL tools could benefit healthcare professionals' clinical work by improving their communication with older adults.
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Affiliation(s)
- Areti Efthymiou
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University (HMU), Heraklion, Crete, Greece
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
| | - Argyroula Kalaitzaki
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University (HMU), Heraklion, Crete, Greece
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
- University Centre of Research and Innovation 'Institute of AgriFood and Life Sciences, HMU
| | - Barbara Kondilis
- Department of Art & Sciences, Hellenic American University, Nashua, Greece
| | - Michael Rovithis
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
- Department of Business Administration and Tourism, Hellenic Mediterranean University, Heraklion, Crete
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Tsai HY, Lee SYD, Coleman C, Sørensen K, Tsai TI. Health literacy competency requirements for health professionals: a Delphi consensus study in Taiwan. BMC MEDICAL EDUCATION 2024; 24:209. [PMID: 38429669 PMCID: PMC10907998 DOI: 10.1186/s12909-024-05198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Cumulative evidence supports the importance of health literacy in determining the quality of healthcare delivery and outcomes. To enhance health literacy competencies among professionals and alleviate healthcare barriers owing to patients' inadequate health literacy, evidence-based health literacy competency guidelines are needed for the development of health professionals' training curricula. The aim of this study was to validate and refine a set of health literacy competencies, including knowledge, attitude, and skills of health professionals, and to prioritize the importance of health literacy practices among healthcare professionals. METHODS We employed a consensus-building approach that utilized a modified three-round Delphi process conducted in 2017. An online Delphi panel was assembled, comprising 20 Taiwanese health literacy experts from diverse fields such as medicine, nursing, public health, language, and communication. A set of health literacy competencies previously identified and validated by an international panel of health literacy experts was cross-culturally translated. RESULTS After three rounds of ratings and modifications, a consensus agreement was reached on 42 of 62 health literacy competencies, including 12 of 24 knowledge items, 9 of 11 attitude items, and 21 of 27 skill items. Of the 32 health literacy practices, "avoidance using medical jargon," "speaking slowly and clearly with patients," and "using analogies and examples" were deemed most important by the panelists. CONCLUSIONS The Delphi panel's consensus helped to identify a set of core health literacy competencies that could serve as measurable learning objectives to guide the development of a health literacy curriculum for health professionals. The prioritized health literacy practices can be employed as indicators of health literacy competencies that health professionals should learn and routinely use in clinical settings.
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Affiliation(s)
- Han-Yi Tsai
- Department of Nursing, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, ROC
| | - Shoou-Yih D Lee
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, 900 E. Leigh St. 8Th Floor, Box 980203, Richmond, VA, 23298, USA
| | - Cliff Coleman
- Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Kristine Sørensen
- Global Health Literacy Academy, Borresøvej 26, 8240, Risskov, Denmark
| | - Tzu-I Tsai
- College of Nursing, National Yang Ming Chiao Tung University, Yang Ming Campus, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei, 112304, Taiwan.
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Simkins J, Breakwell R, Kumar K. Physiotherapists' views and experiences of health literacy in clinical practice. Musculoskeletal Care 2023; 21:1204-1212. [PMID: 37548540 DOI: 10.1002/msc.1800] [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: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Using a qualitative design, this study aimed to explore the experience of physiotherapists' supporting patient health literacy in clinical practice, gain an understanding of their conceptualisation of health literacy, and make recommendations for improving health literacy support in clinical practice. METHODS Convenience sampling via social media was used to recruit eight participants who were all physiotherapists practicing in the United Kingdom. Semi-structured interviews took place on Zoom during the second Covid-19 lockdown. Interviews were audio-recorded, transcribed, coded, and thematically analysed to uncover physiotherapists' views on health literacy, experiences of supporting patients with health literacy and opinions and recommendations for practice. RESULTS Of the eight participants, five were female and the mean years of clinical experience as a qualified physiotherapist was 5.8. Four main themes were identified: physiotherapists' conceptualisation of health literacy, identification of health literacy and skills required to support patients, training and barriers to providing health literacy-sensitive care and recommendations for improvement. CONCLUSION The findings highlighted that physiotherapists identified a patient's health literacy abilities by picking up tacit clues throughout their consultations and they pre-dominantly viewed health literacy as the ability to read, write and communicate effectively. They reported having a limited exposure to health literacy training and recommended raising awareness and education as key to improve practice.
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Affiliation(s)
- Joanna Simkins
- College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Richard Breakwell
- School of Nursing and Midwifery, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Kanta Kumar
- School of Nursing and Midwifery, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Connell L, Finn Y, Sixsmith J. Health literacy education programmes developed for qualified health professionals: a scoping review. BMJ Open 2023; 13:e070734. [PMID: 36997248 PMCID: PMC10069593 DOI: 10.1136/bmjopen-2022-070734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES Both literature and policy have identified the need for health literacy education for qualified health professionals. This study aimed to identify and map health literacy competencies and health literacy related communication skills educational interventions for qualified health professionals. The research questions included: Of the qualified health professional education interventions identified, which are focused on diabetes care? What health literacy competencies and health literacy related communication skills are integrated into each programme? What are the characteristics of each education programme? What were the barriers and facilitators to implementation? What methods are used to evaluate intervention effectiveness, if any? DESIGN Scoping review, informed by the Joanna Briggs Institute guidelines. DATA SOURCES The following databases: OVID; CINAHL; Cochrane; EMBASE; ERIC: PsycInfo; RIAN; Pro-Quest; UpToDate were searched. ELIGIBILITY CRITERIA Articles were included if the education programme focused on qualified health professionals, in all clinical settings, treating adult patient populations, of all study types. DATA EXTRACTION AND SYNTHESIS Two authors independently screened titles, abstracts and full text articles that met the inclusion criteria. The third author mediated any discrepancies. The data were extracted and charted in table format. RESULTS In total, 53 articles were identified. One article referred to diabetes care. Twenty-six addressed health literacy education, and 27 addressed health literacy related communication. Thirty-five reported using didactic and experiential methods. The majority of studies did not report barriers (N=45) or facilitators (N=52) to implementation of knowledge and skills into practice. Forty-nine studies evaluated the reported education programmes using outcome measures. CONCLUSIONS This review mapped existing education programmes regarding health literacy and health literacy related communication skills, where programme characteristics were identified to inform future intervention development. An evident gap was identified regarding qualified health professional education in health literacy, specifically in diabetes care.
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Affiliation(s)
- Lauren Connell
- Health Promotion Research Centre (HPRC), University of Galway, Galway, Ireland
- Alliance for Research and Innvoation in Wounds (ARIW), University of Galway, Galway, Ireland
- CDA Diabetic Foot Disease: from PRevention to Improved Patient Outcomes (CDA DFD PRIMO) programme, University of Galway, Galway, Ireland
| | - Yvonne Finn
- CDA Diabetic Foot Disease: from PRevention to Improved Patient Outcomes (CDA DFD PRIMO) programme, University of Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Jane Sixsmith
- Health Promotion Research Centre (HPRC), University of Galway, Galway, Ireland
- CDA Diabetic Foot Disease: from PRevention to Improved Patient Outcomes (CDA DFD PRIMO) programme, University of Galway, Galway, Ireland
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Kärnä E, Aavikko L, Rohner R, Gallistl V, Pihlainen K, Müller C, Ehlers A, Bevilacqua R, Strano S, Maranesi E, Cerna K, Hengl L, Kolland F, Waldenberger F, Naegele G, Park S, Hess M, Reuter V, Frewer-Graumann S, Korjonen-Kuusipuro K. A Multilevel Model of Older Adults' Appropriation of ICT and Acquisition of Digital Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15714. [PMID: 36497789 PMCID: PMC9737632 DOI: 10.3390/ijerph192315714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/14/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Digital literacy refers to a set of competencies related to the skilled use of computers and information technology. Low digital skills can be a barrier for older adults' full participation in a digital society, and COVID-19 has increased this risk of social exclusion. Older adults' digital inclusion is a complex process that consists of the interplay of structural and individual factors. The ACCESS project unwrapped the complexity of the process and developed an innovative, multilevel model that illustrates how societal, institutional, material and pedagogical aspects shape adults' appropriation of digital literacy. A holistic model describes factors contributing to older adults' digital literacy, acknowledging sociocultural contexts, environments, learning settings and instruction practices for learning digital literacy. Instead of seeing older adults' reasons for learning digital skills purely as individual choice, this model recognizes the interpersonal, institutional and societal aspects that implicitly or explicitly influence older adults' acquisition of digital literacy. The results offer a tool for stakeholders, the research community, companies, designers and other relevant stakeholders to consider digital skills and the given support. It demands diverse communication between different stakeholders about the things that should be discussed when organizing digital support in digitalized societies.
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Affiliation(s)
- Eija Kärnä
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101 Joensuu, Finland
| | - Lotta Aavikko
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101 Joensuu, Finland
| | - Rebekka Rohner
- Division of Gerontology and Health Research, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Vera Gallistl
- Division of Gerontology and Health Research, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Kaisa Pihlainen
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101 Joensuu, Finland
| | - Claudia Müller
- Information Systems, esp. IT for the Ageing Society, University of Siegen, 57072 Siegen, Germany
| | - Anja Ehlers
- Research Association for Gerontology (FfG)/Institute for Gerontology, Technical University Dortmund, 44339 Dortmund, Germany
| | | | | | | | - Katerina Cerna
- Department of Applied IT, MDI Division, Gothenburg University, 413 14 Gothenburg, Sweden
| | - Lisa Hengl
- Division of Gerontology and Health Research, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Franz Kolland
- Division of Gerontology and Health Research, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | | | - Gerd Naegele
- Research Association for Gerontology (FfG)/Institute for Gerontology, Technical University Dortmund, 44339 Dortmund, Germany
| | - Sieun Park
- German Institute for Japanese Studies, Tokyo 102-0094, Japan
| | - Moritz Hess
- Hochschule Niederrhein, University of Applied Sciences, 47805 Krefeld, Germany
| | - Verena Reuter
- Research Association for Gerontology (FfG)/Institute for Gerontology, Technical University Dortmund, 44339 Dortmund, Germany
| | - Susanne Frewer-Graumann
- Division of Health and Social Affairs, FOM University of Applied Sciences, 48155 Münster, Germany
| | - Kristiina Korjonen-Kuusipuro
- Juvenia-Youth Research and Development Centre, South-Eastern Finland University of Applied Sciences, 50101 Mikkeli, Finland
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Low Health Literacy Is Associated with Poorer Physical and Mental Health-Related Quality of Life in Dialysed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13265. [PMID: 36293839 PMCID: PMC9602746 DOI: 10.3390/ijerph192013265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Health-related quality of life (HRQoL) is an important health indicator in chronic diseases like kidney diseases. Health literacy (HL) may strongly affect HRQoL, but evidence is scarce. Therefore, we assessed the associations of HL with HRQoL in dialysed patients. We performed a cross-sectional study in 20 dialysis clinics across Slovakia (n = 542 patients, mean age = 63.6 years, males = 60.7%). We assessed the association of categorised HL (low, moderate, high) with the SF36 physical component score (PCS) and mental component score (MCS) using generalised linear models adjusted for age, gender, education, and comorbidity (Charlson Comorbidity Index, CCI). We found significant associations of HL with PCS and MCS in dialysed patients, adjusted for age, gender, education, and CCI. Low-HL patients had a lower PCS (B = -3.27, 95%-confidence interval, CI: -5.76/-0.79) and MCS (B = -6.05, 95%-CI: -8.82/-3.29) than high-HL patients. Moderate-HL patients had a lower MCS (B = -4.26, 95%-CI: -6.83/-1.69) than high-HL patients. HL is associated with physical and mental HRQoL; this indicates that dialysed patients with lower HL deserve specific attention and tailored care to have their HRQoL increased.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University Bratislava, Mlynské luhy 4, 821 05 Bratislava, Slovakia
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
- II. Internal Clinic Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia
| | - Andrea F. de Winter
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Bánfai-Csonka H, Bánfai B, Jeges S, Betlehem J. Understanding Health Literacy among University Health Science Students of Different Nationalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11758. [PMID: 36142030 PMCID: PMC9517253 DOI: 10.3390/ijerph191811758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
An adequate level of health literacy is essential for clear communication between patients and health care workers. The internationalization of universities is increasing in the field of health care. The aims of our research were to measure (1) the level of health literacy and its correlation among university students and (2) the relationship between the different instruments measuring health literacy. A cross-sectional study was conducted in the 2020/2021 academic year. The questionnaire included questions on sociodemographic status, study data, health status, and health literacy level. According to the HLS-EU-Q16 health literacy questionnaire, more than half of the students had a limited HL level in disease prevention (52.4%) and health promotion (58.4%) subindexes. Nationality was found to be an influencing factor (p < 0.001). According to the NVS, 80.1% of the students had an adequate HL level. A significant correlation was found between the results and nationality (p = 0.005). None of the Chew questions demonstrated a correlation with nationality (q1 p = 0.269, q2 p = 0.368, q3 p = 0.528). Nationality is a key factor in the level of subjective and functional health literacy. We need to measure both types of levels to see the real results.
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Affiliation(s)
- Henrietta Bánfai-Csonka
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
- Institute of Emergency Care and Pedagogy of Health, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
- Emergency Department, Clinical Center, University of Pécs, 7624 Pécs, Hungary
| | - Bálint Bánfai
- Institute of Emergency Care and Pedagogy of Health, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - Sára Jeges
- Institute of Emergency Care and Pedagogy of Health, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - József Betlehem
- Institute of Emergency Care and Pedagogy of Health, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
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Boonstra MD, Abma FI, Wilming L, Ståhl C, Karlsson E, Brouwer S. Social Insurance Literacy of Dutch Workers Receiving Disability Benefits and its Associations with Socio-Economic Characteristics. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:494-504. [PMID: 34985681 PMCID: PMC9576638 DOI: 10.1007/s10926-021-10018-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Purpose This study explores the concept social insurance literacy (SIL) and corresponding questionnaire (SILQ) among workers receiving disability benefits and the comprehensibility of the social security institute (SSI), and examines associations with socio-economic characteristics. Methods 1753 panel members of the Dutch SSI were approached to complete the SILQ-NL37. This measure was based on the original SILQ. The SILQ-NL37 contains domains for obtaining, understanding and acting upon information for both individual SIL and system comprehensibility. A higher score means better SIL or comprehensibility. Data on age, gender, education, living situation, Dutch skills and time receiving disability benefits were also collected. With k-means clustering, groups with adequate and limited SIL were created. Associations with socio-economic characteristics were examined with independent t-tests and linear regression analyses for both the total scores and within domain scores. Cronbach α and Spearman rho's indicated measurement properties were good to acceptable for the SILQ-NL37. Results Thirty-five percent of the 567 participants were in the group with limited SIL. Higher individual SILQ-NL37 scores were associated with having a partner (p = 0.018) and northeastern living region (p = 0.031). Higher scores for obtaining (p = 0.041) and understanding (p = 0.049) information were associated with female sex, and for acting on information with younger age (p = 0.020). People with limited Dutch skills (p = 0.063) and a partner (p = 0.085) rated system comprehensibility higher. Conclusions According to the SILQ-NL37 scores, about 35% of the panel members have limited ability to obtain, understand and act upon social insurance systems information. Limited SIL is associated with several socio-economic factors. Future researches should study the concept in a more representative sample, and in different countries and social insurance contexts.
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Affiliation(s)
- M D Boonstra
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, Groningen, The Netherlands.
| | - F I Abma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, Groningen, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
| | - L Wilming
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, Groningen, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
| | - C Ståhl
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- HELIX Competence Center, Linköping University, Linköping, Sweden
| | - E Karlsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - S Brouwer
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, Groningen, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
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Association between Health Literacy and Prevalence of Obesity, Arterial Hypertension, and Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159002. [PMID: 35897372 PMCID: PMC9331373 DOI: 10.3390/ijerph19159002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
Background: Health literacy (HL) is linked to many health outcomes, including self-management of chronic diseases. The aim of this study was to assess the association of health literacy with the prevalence of obesity, arterial hypertension (AH), and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional, single-center study included 500 patients (42.2% male and 57.8% females; median age, 63 years (interquartile range, 42−73)) hospitalized at General County Hospital in Požega, Croatia, between July and October 2020. The Short Assessment of Health Literacy for Croatian Adults (SAHLCA-50) questionnaire was used. Descriptive statistics (median with interquartile range (IQR), frequency, and percentages) and binary logistic regression were utilized. Results: Patients with AH had an inadequate level of health literacy as compared to those without AH (32 vs. 40 points; Mann−Whitney U test, p < 0.001). Patients with T2DM scored 31 points versus 39 points in patients without T2DM (Mann−Whitney U test, p < 0.001). Patients suffering from both AH and T2DM scored 31 points versus 33 points in those with either AH or T2DM and 41 points in patients without AH and T2DM (Kruskal−Wallis test, p < 0.001). There were no statistically significant differences in SAHLCA-50 scores according to the patient body mass index. Conclusions: An inadequate level of health literacy is significantly associated with AH and T2DM but not with obesity. Male gender, low level of education, rural place of residence, retirement, and older age are significant predictors of inadequate health literacy.
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Cesar FCR, Moraes KL, Brasil VV, Alves AG, Barbosa MA, Oliveira LMDAC. Professional Responsiveness to Health Literacy: A Scoping Review. Health Lit Res Pract 2022; 6:e96-e103. [PMID: 35522856 PMCID: PMC9126054 DOI: 10.3928/24748307-20220418-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Flaviane Cristina Rocha Cesar
- Address correspondence to Flaviane Cristina Rocha Cesar, MSc, PhD, Avenida Elizabeth Marques, 45 - St. Maysa, Trindade, Goiás, Brazil, 75380-307;
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Gibson C, Smith D, Morrison AK. Improving Health Literacy Knowledge, Behaviors, and Confidence with Interactive Training. Health Lit Res Pract 2022; 6:e113-e120. [PMID: 35522855 PMCID: PMC9126053 DOI: 10.3928/24748307-20220420-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/16/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Ensuring that health care professionals are knowledgeable about the influence limited health literacy has on health outcomes and how to apply health literate strategies is crucial to transform quality and safety in care settings. Although many organizational efforts to address health literacy have focused on hospital settings, few have focused on primary care. The designation of a patient-centered medical home requires the need to address integrating health literacy and the training needs of primary care settings. Brief description of activity: An interactive health literacy training intervention was developed, implemented, and evaluated for 25 primary care clinics. This included an online educational module, in-person application activities, and a sustainability plan to continue skill building, reinforce behaviors, and support practice. IMPLEMENTATION Using a descriptive pre- and post-training design, three survey measures were used to rate health literacy knowledge, behaviors, and confidence levels of more than 475 primary care staff. A pre-training survey was completed prior to completion of an interactive online health literacy module and attendance at an in-person training session which followed. A post-training survey was then completed. Sustainment activities, including lunch and learns, and reinforcement activities by clinic leaders, were initiated to promote use of the strategies in practice. A 1-year follow-up survey was then administered to measure sustainability. RESULTS The interactive training intervention improved primary care staff's knowledge, behaviors, and confidence in using health literacy strategies with patients and families. Common barriers and facilitators around the use of these strategies were also identified. LESSONS LEARNED Careful consideration should be taken when developing health literacy training to ensure it will be effective, efficient, and sustainable. Using elements that facilitate the transfer of training to practice will help improve success. Addressing barriers and promoting facilitators, as well as integrating and connecting health literacy strategies with existing organizational goals and initiatives offer additional ways to reinforce and sustain the practice change. [HLRP: Health Literacy Research and Practice. 2022;6(2):e113-e120.] Plain Language Summary: Clinic staff can improve how they provide information and education to children and families. Interactive training about health literacy led clinic staff to (1) know more about health literacy, (2) use health literacy strategies more, and (3) feel more confident using health literacy strategies. Training over time, supporting staff, and connecting to organizational goals are important for sustainment.
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Affiliation(s)
- Cori Gibson
- Address correspondence to Cori Gibson, MSN, RN, CNL, Children's Wisconsin Corporate Center, Suite 650, 999 N. 92nd Street, Milwaukee, WI 53226;
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Yang HF, Chang CC, Tseng PL, Lai HR, Tasi JS, Huang WH, Fan YH, Weng CX, Tung CY. Effectiveness of innovative instructional module for professional competence in health literacy in medical students. BMC MEDICAL EDUCATION 2022; 22:210. [PMID: 35351115 PMCID: PMC8960696 DOI: 10.1186/s12909-022-03252-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Physicians should be equipped with professional competence in health literacy to communicate more effectively with patients with limited health literacy. However, the health literacy curriculum has not yet been refined globally, and is scarce in Taiwan's medical education. We implemented an innovative instructional module to attain professional competence in health literacy among medical students and investigated its effects. METHODS We adopted a quasi-experimental design and recruited 204 fifth-year Taiwanese medical students between December 2019 and May 2020. Participants who worked as clerks at the Department of Family Medicine of three medical schools in northern Taiwan were assigned to the experimental group through convenience sampling. A total of 98 students received a three-hour innovative instruction, including medical simulation videos, role-playing, and board games. Both the experimental and control groups completed the online pre-test and mail-in post-test. A generalized estimating equation was applied to measure the effects of the intervention. RESULTS There was a significant difference between the experimental and control groups in terms of professional competence in health literacy in all three aspects. In terms of knowledge, the experimental group improved 12% more than the control group (𝛽=0.12, 95% CI: 0.05 ~ 0.19, p = 0.001). In terms of attitude, the experimental group improved by an average of 0.27 more points per question than the control group (𝛽=0.27, 95% CI: 0.08 ~ 0.46, p = 0.007). As for skill, the experimental group improved by an average of 0.35 more points per question than the control group (𝛽=0.35, 95% CI: 0.14 ~ 0.55, p = 0.001). CONCLUSION The proposed innovative instructional module significantly improved fifth-year medical students' professional competence in health literacy, which is expected to benefit their future medical practices.
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Affiliation(s)
- Hui-Fang Yang
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Chen Chang
- Department of Senior Citizen Service Business, College of Human Ecology and Design, St. John's University, New Taipei, Taiwan
| | - Pei-Ling Tseng
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan
| | - Hsiang-Ru Lai
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan
| | - Jaw-Shiun Tasi
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Hsin Huang
- Community Health Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Hao Fan
- Department of General Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ci-Xiang Weng
- Department of General Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chen-Yin Tung
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan.
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Voigt-Barbarowicz M, Dietz G, Renken N, Schmöger R, Brütt AL. Patients' Health Literacy in Rehabilitation: Comparison between the Estimation of Patients and Health Care Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3522. [PMID: 35329219 PMCID: PMC8953381 DOI: 10.3390/ijerph19063522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 02/06/2023]
Abstract
The term health literacy (HL) comprises the handling of health information and disease-specific and generic self-management skills, especially relevant for patients with chronic conditions. Health care professionals (HCPs) should correctly identify patients' communication needs and their HL levels. Therefore, the aims of the study were (1) to determine inpatient medical rehabilitation patients' HL based on self-assessment, (2) to evaluate changes from admission to discharge, (3) to identify HCPs estimation of patients' HL, and (4) to compare the estimated patient HL by patients and HCPs. A combined cross-sectional and longitudinal study was conducted in an orthopedic rehabilitation center in Germany. The multidimensional Health Literacy Questionnaire (HLQ) was filled in by patients (admission, discharge). An adapted version was administered to HCPs (n = 32) in order to assess HL of individual patients. Data from 287 patients were used for the longitudinal analysis, and comparison was based on n = 278 cases with at least two HL estimations. The results showed a significant increase in HL in five of nine scales with small effect sizes. Moreover, HCPs mostly provided higher scores than patients, and agreement was poor to fair. Differences between the HL estimation might lead to communication problems, and communication training could be useful.
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Affiliation(s)
- Mona Voigt-Barbarowicz
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (R.S.); (A.L.B.)
| | - Günter Dietz
- Clinic for Orthopedic and Rheumatological Rehabilitation, Rehabilitation Centre Bad Zwischenahn, 26160 Bad Zwischenahn, Germany; (G.D.); (N.R.)
| | - Nicole Renken
- Clinic for Orthopedic and Rheumatological Rehabilitation, Rehabilitation Centre Bad Zwischenahn, 26160 Bad Zwischenahn, Germany; (G.D.); (N.R.)
| | - Ruben Schmöger
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (R.S.); (A.L.B.)
| | - Anna Levke Brütt
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (R.S.); (A.L.B.)
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Urstad KH, Andersen MH, Larsen MH, Borge CR, Helseth S, Wahl AK. Definitions and measurement of health literacy in health and medicine research: a systematic review. BMJ Open 2022; 12:e056294. [PMID: 35165112 PMCID: PMC8845180 DOI: 10.1136/bmjopen-2021-056294] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The way health literacy is understood (conceptualised) should be closely linked to how it is measured (operationalised). This study aimed to gain insights into how health literacy is defined and measured in current health literacy research and to examine the relationship between health literacy definitions and instruments. DESIGN Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES The MEDLINE, PsycINFO, ERIC and CINAHL databases were searched for articles published during two randomly selected months (March and October) in 2019. ELIGIBILITY CRITERIA We included articles with a quantitative design that measured health literacy, were peer-reviewed and original, were published in the English language and included a study population older than 16 years. DATA EXTRACTION AND SYNTHESIS Six researchers screened the articles for eligibility and extracted the data independently. All health literacy definitions and instruments were considered in relation to category 1 (describing basic reading and writing skills, disease-specific knowledge and practical skills) and category 2 (social health literacy competence and the ability to interpret and critically assess health information). The categories were inspired by Nutbeam's descriptions of the different health literacy levels. RESULTS 120 articles were included in the review: 60 within public health and 60 within clinical health. The majority of the articles (n=77) used instruments from category 1. In total, 79 of the studies provided a health literacy definition; of these, 71 were in category 2 and 8 were in category 1. In almost half of the studies (n=38), health literacy was defined in a broad perspective (category 2) but measured with a more narrow focus (category 1). CONCLUSION Due to the high degree of inconsistency between health literacy definitions and instruments in current health literacy research, there is a risk of missing important information about health literacy considered be important to the initial understanding of the concept recognised in the studies. PROSPERO REGISTRATION NUMBER CRD42020179699.
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Affiliation(s)
- Kristin Hjorthaug Urstad
- Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences, VID Specialized University, Oslo, Akershus, Norway
| | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Marie Hamilton Larsen
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diaconal University College, Oslo, Akershus, Norway
| | - Christine Råheim Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Scienes, Oslo Metropolitan University, Oslo, Norway
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Health Literacy and Change in Health-Related Quality of Life in Dialysed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020620. [PMID: 35055440 PMCID: PMC8776225 DOI: 10.3390/ijerph19020620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 12/10/2022]
Abstract
Health-related quality of life (HRQoL) is likely to deteriorate with the progression of chronic kidney disease (CKD). This change may be worsened by low health literacy (HL). We performed a longitudinal study at over 20 dialysis clinics in Slovakia (n = 413; mean age = 64.8 years; males = 58.4%). We assessed the association of three HL groups with a change in HRQoL over two years using binary logistic regression adjusted for type of vascular access, dialysis effectiveness, comorbidity, age and gender. We found that patients with low HL had poorer HRQoL at baseline in comparison to high-HL patients. We did not find significant associations of lower HL with the deterioration of mental or physical HRQoL after two years. In the adjusted model, patients with lower HL were not more likely to have deteriorated physical (low-HL patients: odds ratio/95% confidence interval: 0.99/0.53–1.84; moderate-HL patients: 0.97/0.55–1.73) or mental HRQoL (low-HL patients: 1.00/0.53–1.87; moderate-HL patients: 0.95/0.53–1.70) in comparison to high-HL patients. The HRQoL of lower-HL patients is worse at baseline but develops similarly to that of high-HL patients during dialysis treatment. Their relative HRQoL, thus, does not worsen further, but it does not improve either. Tailoring care to their needs may help to decrease the burden of low HL in dialysed patients.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Correspondence: ; Tel.: +421-055-234-3390
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 11 Kosice, Slovakia;
- II. Internal Clinic, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 11 Kosice, Slovakia;
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenná 5, 040 01 Kosice, Slovakia;
| | - Andrea F. de Winter
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
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Boonstra MD, Reijneveld SA, Navis G, Westerhuis R, de Winter AF. Co-Creation of a Multi-Component Health Literacy Intervention Targeting Both Patients with Mild to Severe Chronic Kidney Disease and Health Care Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413354. [PMID: 34948960 PMCID: PMC8704507 DOI: 10.3390/ijerph182413354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
Limited health literacy (LHL) is common in chronic kidney disease (CKD) patients and frequently associated with worse self-management. Multi-component interventions targeted at patients and healthcare professionals (HCPs) are recommended, but evidence is limited. Therefore, this study aims to determine the objectives and strategies of such an intervention, and to develop, produce and evaluate it. For this purpose, we included CKD patients with LHL (n = 19), HCPs (n = 15), educators (n = 3) and students (n = 4) from general practices, nephrology clinics and universities in an Intervention Mapping (IM) process. The determined intervention objectives especially address the patients’ competences in maintaining self-management in the long term, and communication competences of patients and HCPs. Patients preferred visual strategies and strategies supporting discussion of needs and barriers during consultations to written and digital strategies. Moreover, they preferred an individual approach to group meetings. We produced a four-component intervention, consisting of a visually attractive website and topic-based brochures, consultation cards for patients, and training on LHL for HCPs. Evaluation revealed that the intervention was useful, comprehensible and fitting for patients’ needs. Healthcare organizations need to use visual strategies more in patient education, be careful with digitalization and group meetings, and train HCPs to improve care for patients with LHL. Large-scale research on the effectiveness of similar HL interventions is needed.
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Affiliation(s)
- Marco D. Boonstra
- Department of Health Sciences, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
- Correspondence: ; Tel.: +31653243985
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
| | - Gerjan Navis
- Department of Nephrology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (G.N.); (R.W.)
| | - Ralf Westerhuis
- Department of Nephrology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (G.N.); (R.W.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
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eHealth Literacy: From Theory to Clinical Application for Digital Health Improvement. Results from the ACCESS Training Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211800. [PMID: 34831555 PMCID: PMC8618977 DOI: 10.3390/ijerph182211800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022]
Abstract
Skills, knowledge, and awareness of digital and technological tools are essential to improve the state of well-being and health of older adults and also to mitigate the condition of social isolation in the aging process. For this reason, it is necessary to implement a social learning of electronic/digital tools for health of older people to support the achievement of eHealth and digital competences. The paper reports the results of an Italian innovative eHealth training for the European project ACCESS. The training has been based on blended didactical and interactive educational techniques, aimed at collecting as many points of view as possible from older adults. A total of 58 older adults were recruited to attend a four-week training program, which included five modules. The results showed a statistical significant difference between the eHealth Literacy Scale (eHEALS) mean value before and after the course. A significant negative correlation was found between eHEALS and positive/total Survey of Technology Use (SOTU), suggesting an inverse relationship between positive/total SOTU and eHEALS. There is a strong positive and statistically significant relationship between satisfaction with the training and eHEALS. The results indicate that the intervention increased the digital competences of participants connected to health.
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Stock S, Altin S, Nawabi F, Civello D, Shukri A, Redaèlli M, Alayli A. A cross-sectional analysis of health literacy: patient- versus family doctor-reported and associations with self-efficacy and chronic disease. BMC FAMILY PRACTICE 2021; 22:187. [PMID: 34525978 PMCID: PMC8442421 DOI: 10.1186/s12875-021-01527-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 08/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adequate health literacy (HL) levels contribute to good health outcomes and successful disease self-management in patients with chronic disease. Hence, it is essential that family doctors recognize patients with inadequate HL in need of additional support. This study had two aims: (1) to assess and compare patient self-reported versus family doctor-rated HL estimates, and (2) to explore associations between patient-reported HL, self-efficacy and chronic diseases. METHODS Participants in this cross-sectional survey were recruited through general practices in North Rhine-Westphalia, Germany. Patient self-reported HL was measured using the European Health Literacy Survey-16. Family doctor-rated HL was measured with an adapted version of this instrument. Using crosstabulations patient-reported and family doctor-rated HL estimates were compared for 346 patient-family doctor pairs. Associations between HL, self-efficacy and chronic disease were investigated using regression analyses. RESULTS Patient-reported and family doctor-rated HL estimates were concordant in 38% of all cases. On average family doctors rated their patients' HL lower than patients rated their own HL. The lower average family doctor ratings were more pronounced when patients were older, male and had more than one chronic disease. Female family doctors rated HL of male patients lower than their male colleagues. Patient reported HL had a significant positive association with self-efficacy. Mediation analysis provided support that self-efficacy acts as mediator between HL and the number of chronic diseases. CONCLUSIONS Our study findings indicate a significant discrepancy between patients' self-reported HL and externally rated HL by family doctors. A more systematic utilization of HL screeners might help reduce this discrepancy. At the same time, consideration should be given to enhancing communication training for family doctors and addressing critical HL skills in patient education.
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Affiliation(s)
- Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | | | - Farah Nawabi
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Daniele Civello
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Arim Shukri
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Marcus Redaèlli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Adrienne Alayli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany.
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Lubasch JS, Voigt-Barbarowicz M, Lippke S, De Wilde RL, Griesinger F, Lazovic D, Ocampo Villegas PC, Roeper J, Salzmann D, Seeber GH, Torres-de-la-Roche LA, Weyhe D, Ansmann L, Brütt AL. Improving professional health literacy in hospitals: study protocol of a participatory codesign and implementation study. BMJ Open 2021; 11:e045835. [PMID: 34400444 PMCID: PMC8370497 DOI: 10.1136/bmjopen-2020-045835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION In connection with a hospital stay, patients have to make important health-related decisions. They need to find, understand, assess and apply health-related information, and therefore, require health literacy. Adequately responding to the needs of patients requires promoting the communication skills of healthcare professionals within healthcare organisations. Health-literate healthcare organisations can provide an environment strengthening professionals' and patients' health literacy. When developing health-literate healthcare organisations, it has to be considered that implementing organisational change is typically challenging. In this study, a communication concept based on previously evaluated communication training is codesigned, implemented and evaluated in four clinical departments of a university hospital. METHOD AND ANALYSIS In a codesign phase, focus group interviews among employees and patients as well as a workshop series with employees and hospital management are used to tailor the communication concept to the clinical departments and to patients' needs. Also, representatives responsible for the topic of health literacy are established among employees. The communication concept is implemented over a 12-month period; outcomes studied are health literacy on the organisational and patient levels. Longitudinal survey data acquired from a control cohort prior to the implementation phase are compared with data of an intervention cohort after the implementation phase. Moreover, survey data from healthcare professionals before and after the implementation are compared. For formative evaluation, healthcare professionals are interviewed in focus groups. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the Medical Faculty of the University of Oldenburg and is in accordance with the Declaration of Helsinki. Study participants are asked to provide written informed consent. The results are disseminated via direct communication within the hospital, publications and conference presentations. If the intervention turns out to be successful, the intervention and implementation strategies will be made available to other hospitals. TRIAL REGISTRATION NUMBER DRKS00019830.
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Affiliation(s)
- Johanna Sophie Lubasch
- Division for Organizational Health Services Research, Department of Health Services Research, University of Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Mona Voigt-Barbarowicz
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen gGmbH, Bremen, Germany
| | - Rudy Leon De Wilde
- University Hospital for Gynaecology, Pius-Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Frank Griesinger
- University Hospital for Haematology and Oncology, Pius-Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Djordje Lazovic
- University Hospital of Orthopedics and Trauma Surgery Pius-Hospital, Medical Campus University Oldenburg, Oldenburg, Lower Saxony, Germany
| | | | - Julia Roeper
- University Hospital for Haematology and Oncology, Pius-Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Daniela Salzmann
- University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Gesine H Seeber
- University Hospital of Orthopedics and Trauma Surgery Pius-Hospital, Medical Campus University Oldenburg, Oldenburg, Lower Saxony, Germany
| | | | - Dirk Weyhe
- University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Lena Ansmann
- Division for Organizational Health Services Research, Department of Health Services Research, University of Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Anna Levke Brütt
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, Oldenburg, Lower Saxony, Germany
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21
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Michels NRM, Maagaard R, Švab I, Scherpbier N. Teaching and Learning Core Values in General Practice/Family Medicine: A Narrative Review. Front Med (Lausanne) 2021; 8:647223. [PMID: 34046417 PMCID: PMC8145612 DOI: 10.3389/fmed.2021.647223] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
General Practice/Family Medicine (GP/FM) is a key discipline within primary health care and so by extension for the whole health care system. An essential condition for effective GP/FM care is a work force that is highly qualified. As society is changing rapidly, a revision of the GP/FM definition is ongoing, in addition to a recent movement of identifying related core values. In this paper, we want to give an overview on how these new paths and perspectives are currently reflected in GP/FM teaching and training. We selected four core values that fit in with possible future visions: person-centered care, continuity of care, cooperation in care, and community-oriented care. By a narrative review, we observed that GP/FM education toward core values is often built around overarching topics. Teaching and learning take place in specific contexts, most of all through placements within communities, primary care settings, or hospital wards. Mixed teaching- and training methods are used combining knowledge, skills, and attitude. Furthermore, collaboration with other health professionals and peers is stressed, in addition to the importance of role models, a holistic focus and the involvement of patients. Since these core values are important within GP/FM and rather few studies on the educational aspects and learning tools were found we advocate encouraging each other more to share good practices, certainly the innovative ones specifically related to GP/FM.
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Affiliation(s)
- Nele R M Michels
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Roar Maagaard
- Centre for Health Sciences Education, Aarhus University, Aarhus, Denmark
| | - Igor Švab
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nynke Scherpbier
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
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22
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Jansen CJM, Koops van ’t Jagt R, Reijneveld SA, van Leeuwen E, de Winter AF, Hoeks JCJ. Improving Health Literacy Responsiveness: A Randomized Study on the Uptake of Brochures on Doctor-Patient Communication in Primary Health Care Waiting Rooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095025. [PMID: 34068577 PMCID: PMC8126085 DOI: 10.3390/ijerph18095025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 11/30/2022]
Abstract
Presenting attractive and useful health education materials in waiting rooms can help improve an organization’s health literacy responsiveness. However, it is unclear to what extent patients may be interested in health education materials, such as brochures. We conducted a three-week field study in waiting rooms of three primary care centers in Groningen. Three versions of a brochure on doctor-patient communication were randomly distributed, 2250 in total. One version contained six short photo stories, another version was non-narrative but contained comparable photos, and the third version was a traditional brochure. Each day we counted how many brochures were taken. We also asked patients (N = 471) to participate in a brief interview. Patients who consented (N = 390) were asked if they had noticed the brochure. If yes (N = 135), they were asked why they had or had not browsed the brochure, and why they had or had not taken it. Interview responses were categorized by two authors. Only 2.9% of the brochures were taken; no significant association with brochure version was found. Analysis of the interview data showed that the version with the photo narrative was noticed significantly more often than the non-narrative version or the traditional version. These results suggest that designing attractive and comprehensible health materials is not enough. Healthcare organizations should also create effective strategies to reach their target population.
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Affiliation(s)
- Carel J. M. Jansen
- Department of Communication and Information Sciences, Faculty of Arts, University of Groningen, P.O. Box 7600, 9700 AS Groningen, The Netherlands; (R.K.v.J.); (E.v.L.); (J.C.J.H.)
- Language Centre, Stellenbosch University, 44 Banghoek Rd, Stellenbosch 7600, South Africa
- Correspondence: ; Tel.: +31-(06)-20248673
| | - Ruth Koops van ’t Jagt
- Department of Communication and Information Sciences, Faculty of Arts, University of Groningen, P.O. Box 7600, 9700 AS Groningen, The Netherlands; (R.K.v.J.); (E.v.L.); (J.C.J.H.)
- Aletta Jacobs School of Public Health, P.O. Box 7600, 9700 AS Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
| | - Ellen van Leeuwen
- Department of Communication and Information Sciences, Faculty of Arts, University of Groningen, P.O. Box 7600, 9700 AS Groningen, The Netherlands; (R.K.v.J.); (E.v.L.); (J.C.J.H.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (S.A.R.); (A.F.d.W.)
| | - John C. J. Hoeks
- Department of Communication and Information Sciences, Faculty of Arts, University of Groningen, P.O. Box 7600, 9700 AS Groningen, The Netherlands; (R.K.v.J.); (E.v.L.); (J.C.J.H.)
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Eronen J, Paakkari L, Portegijs E, Saajanaho M, Rantanen T. Health literacy supports active aging. Prev Med 2021; 143:106330. [PMID: 33220399 DOI: 10.1016/j.ypmed.2020.106330] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/14/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
From the individual viewpoint, active aging refers to the ability of older persons, depending on their goals, functional capacity and opportunities, to engage in desired activities. This study investigated the role of health literacy in active aging among persons differing in their number of chronic conditions. Data were collected from 948 individuals, 57% women, aged 75, 80 and 85 in 2017-2018 in the city of Jyväskylä in Central Finland. Health literacy was assessed with the 16-question version of the European Health Literacy Survey (HLS-EU-Q16), active aging with the University of Jyväskylä Active Aging Scale (UJACAS) and self-reported physician-diagnosed chronic conditions. Both health literacy (r = 0.40) and number of chronic conditions (r = -0.21) correlated with the active aging score. Linear regression models revealed that health literacy was a stronger predictor than chronic conditions of active aging (β 0.18, p < 0.001 vs. β -0.06, p = 0.030) and that its predictive value remained statistically significant after adjustment for cognitive capacity, number of depressive symptoms, physical performance and length of education. Higher health literacy can enable older persons, including those with multiple chronic conditions, to maintain higher levels of active aging. As more people are projected to live with chronic conditions to older ages, health literacy may help them to cope with illnesses and functional limitations and lead a fulfilling life. These cross-sectional findings lay a foundation for future prospective and experimental studies on health literacy and active aging.
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Affiliation(s)
- Johanna Eronen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
| | - Leena Paakkari
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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Walters R, Leslie SJ, Sixsmith J, Gorely T. Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228641. [PMID: 33233804 PMCID: PMC7699978 DOI: 10.3390/ijerph17228641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
Following a diagnosis of cardiovascular disease there is a need for patients to self-manage. Health literacy has been shown to be lower in patients with cardiovascular disease, yet research into health literacy in this population is limited. This study used the Health Literacy Questionnaire (HLQ) to examine the health literacy and associated health, health behaviours and psychological profiles of cardiac rehabilitation patients from a remote and rural regional programme in the Scottish Highlands. Consecutive patients referred to the service in a calendar year were sent a cross-sectional questionnaire by post. Hierarchical cluster analysis grouped respondents based on their health literacy profile, and nonparametric methods were used to analyse differences between clusters on the other measures. A total of 282 participants responded (45.7%). Respondents were older (median: 71 years) and more likely to be from more affluent areas. Five health literacy clusters emerged with different profiles of health, physical activity, self-efficacy, motivation and illness perceptions. There was no difference in relation to cardiac rehabilitation attendance by health literacy cluster, but those with lower health literacy were less likely to be aware of the referral. Patterns of health literacy are associated with health, health behaviours and some psychological constructs. Knowledge of distinct cluster characteristics may help services better target interventions.
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Affiliation(s)
- Ronie Walters
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
- Correspondence:
| | - Stephen J. Leslie
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
- Cardiac Department, Raigmore Hospital, Inverness IV2 3UJ, UK
| | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Trish Gorely
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
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25
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Voigt-Barbarowicz M, Brütt AL. The Agreement between Patients' and Healthcare Professionals' Assessment of Patients' Health Literacy-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072372. [PMID: 32244459 PMCID: PMC7177784 DOI: 10.3390/ijerph17072372] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 12/26/2022]
Abstract
Healthcare professionals (HCPs) can play a key role in promoting health literacy (HL) in patients to help them navigate the healthcare system effectively. This involves assisting patients to locate, comprehend and evaluate health information. HCPs should assess patients’ health literacy needs and check the patient´s understanding to communicate adequate health information. This review investigates the agreement between the patients’ and HCPs assessment of patients’ HL. A systematic literature search in PubMed, Scopus, PsycINFO, CINAHL and the Cochrane Library was performed in November 2019. The search yielded 6762 citations, seven studies met the inclusion criteria. The following HL measurement instruments were completed by the patients in the included studies: REALM (n = 2), REALM-R (n = 1), S-TOFHLA (n = 1), NVS (n = 1), SILS (n = 1), HLSI-SF (n = 1) and HLS-EU-Q16 (n = 1). The HCPs assessed patients’ HL by answering questions that reflect the content of standardized tools. Six studies reported that a high proportion of patients assigned to have HL needs based on their self-report were overestimated by their HCPs in terms of the HL level. The results demonstrated that HCPs had difficulty determining patients’ HL adequately. Differences between the HL estimation of HCPs and the actual HL skills of patients might lead to communication problems.
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26
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Kaper MS, Reijneveld SA, van Es FD, de Zeeuw J, Almansa J, Koot JA, de Winter AF. Effectiveness of a Comprehensive Health Literacy Consultation Skills Training for Undergraduate Medical Students: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010081. [PMID: 31861918 PMCID: PMC6982343 DOI: 10.3390/ijerph17010081] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022]
Abstract
Comprehensible communication by itself is not sufficient to overcome health literacy related problems. Future doctors need a larger scope of capacities in order to strengthen a patient’s autonomy, participation, and self-management abilities. To date, such comprehensive training-interventions are rarely embedded in curricula, nor systematically evaluated. We assessed whether comprehensive training increased these health literacy competencies, in a randomized controlled trial (RCT), with a waiting list condition. Participants were international undergraduate medical students of a Dutch medical faculty (intervention: 39; control: 40). The 11-h-training-intervention encompassed a health literacy lecture and five interactive small-group sessions to practise gathering information and providing comprehensible information, shared decision-making, and enabling of self-management using role-play and videotaped conversations. We assessed self-reported competencies (knowledge and awareness of health literacy, attitude, self-efficacy, and ability to use patient-centred communication techniques) at baseline, after a five and ten-week follow-up. We compared students’ competencies using multi-level analysis, adjusted for baseline. As validation, we evaluated demonstrated skills in videotaped consultations for a subsample. The group of students who received the training intervention reported significantly greater health literacy competencies, which persisted up to five weeks afterwards. Increase was greatest for providing comprehensible information (B: 1.50; 95% confidence interval, CI 1.15 to 1.84), shared decision-making (B: 1.08; 95% CI 0.60 to 1.55), and self-management (B: 1.21; 95% CI 0.61 to 1.80). Effects regarding demonstrated skills confirmed self-rated competency improvement. This training enhanced a larger scope of health literacy competences and was well received by medical students. Implementation and further evaluation of this training in education and clinical practice can support sustainable health literacy capacity building of future doctors and contribute to better patient empowerment and outcomes of consultations.
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Affiliation(s)
- Marise S. Kaper
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
- Correspondence:
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Frank D. van Es
- Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (F.D.v.E.); (J.d.Z.)
| | - Janine de Zeeuw
- Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (F.D.v.E.); (J.d.Z.)
| | - Josué Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Jaap A.R. Koot
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
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