Health Literacy Status and Its Relationship with Quality of Life among Nurses in Teaching Hospitals of Shiraz University of Medical Sciences

Factors Related to Health Literacy Among the Iranian Population: A Scoping Review

Background

The identification of the determinants of health literacy is an essential prerequisite for developing health literacy promotion programs. While these factors have been reported in previous studies, there is a lack of a comprehensive review specifically focused on the Iranian population. Therefore, this review aimed to identify the factors related to health literacy in Iran.

Methods

This scoping review used the Arksey and O'Malley methodological framework and the Joanna Briggs Institute framework. A search was performed in English-language databases-Web of Science, Scopus, and PubMed-using the MeSH keyword of "health literacy," and in Persian-language databases-Magirean and SID-using the related keywords. A narrative synthesis was conducted to describe all included studies' characteristics and explore factors associated with health literacy.

Results

A total of 76 studies were included. Based on the results of the study, related factors included personal factors-including sex, age, education level, field of study, parents' education level, marital status, occupation, work experience, employment status, ethnicity, income, socioeconomic status, medical history, duration of disease, addiction, number of children, media literacy, information literacy, computer literacy, and self-efficacy-situational factors-including use of the internet, use of social networks, social support, source of information, and participation in health education classes-and societal and environmental factors-including place of residence and type of insurance.

Conclusion

Modifiable factors identified in this study were self-efficacy, social support, information sources, media literacy, information literacy, computer literacy, internet or social networks, and participation in health education classes. Planners can consider these factors when developing interventions to promote health literacy.

eHealth literacy among hospital health care providers: a systematic review

BACKGROUND

eHealth literacy is a key concept in the implementation of eHealth resources. However, most eHealth literacy definitions and frameworks are designed from the perceptive of the individual receiving eHealth care, which do not include health care providers' eHealth literacy or acceptance of delivering eHealth resources.

AIMS

To identify existing research on eHealth literacy domains and measurements and identify eHealth literacy scores and associated factors among hospital health care providers.

METHODS

This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. A systematic literature search was conducted in MEDLINE, Cinahl, Embase, Scopus, PEDro, AMED and Web of Science. Quantitative studies assessing eHealth literacy with original research, targeting hospital health care providers were included. Three eHealth literacy domains based on the eHealth literacy framework were defined a priori; (1) Individual eHealth literacy, (2) Interaction with the eHealth system, and (3) Access to the system. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data.

RESULTS

Fourteen publications, of which twelve publications were conducted in non-Western countries, were included. In total, 3,666 health care providers within eleven different professions were included, with nurses being the largest group. Nine of the included studies used the eHealth literacy scale (eHEALS) to measure eHealth literacy, representing the domain of individual eHealth literacy. A minority of the studies covered domains such as interaction with the eHealth system and access to the system. The mean eHEALS score in the studies ranged from 27.8 to 31.7 (8-40), indicating a higher eHealth literacy. One study reported desirable eHealth literacy based on the Digital Health Literacy Instrument. Another study reported a relatively high score on the Staff eHealth literacy questionnaire. eHealth literacy was associated with socio-demographic factors, experience of technology, health behaviour and work-related factors.

CONCLUSIONS

Health care providers have good individual eHealth literacy. However, more research is needed on the eHealth literacy domains dependent on interaction with the eHealth system and access to the system. Furthermore, most studies were conducted in Eastern and Central-Africa, and more research is thus needed in a Western context.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews (CRD42022363039).

The roles of nurses in supporting health literacy: a scoping review

Introduction

The importance of health literacy in achieving optimum health is highly significant, particularly in the nursing profession where it is an integral part of the roles and functions of nurses. Therefore, this scoping review aims to describe the roles of nurses in promoting patient health literacy and identify the determinant factors of health literacy in nursing practices.

Methods

An integrative search was conducted through four databases, namely, ScienceDirect, ProQuest, SAGE Journal, and PubMed, using various keyword combinations such as "health literacy," "health information," "patient health literacy," "patient literacy," and "nurses." Furthermore, the inclusion criteria employed were peer-reviewed articles focused on the nursing profession, explicitly discussing health literacy related to nursing, and including original studies, such as cross-sectional, quasi-experimental, and qualitative studies. The selected review articles were all published between 2017 and 2022.

Results

In total, 13 articles met the criteria and were applied in this scoping review. Most of these discuss health literacy related to nursing practice in clinical and community settings, as well as educational institutions. Health literacy is an essential aspect of professional nursing practice. Consequently, the supportive roles of nurses include acting as caregivers, facilitators, and educators to help patients overcome their literacy limitations and attain improved wellbeing.

Conclusion

Nurses can improve the health literacy skills of patients by making health information related to their illnesses easier to access, understand, evaluate, and use. They must also recognize various factors influencing health literacy and use the factors as opportunities to optimize health literacy improvement. A health literacy approach can be applied by nurses to solve health problems and improve the quality of care for patients.

Examining the relationship between health literacy and quality of life: evidence from older people admitted to the hospital

INTRODUCTION

Literacy has become an increasingly serious problem, especially as it relates to health care. In this regard, health literacy (HL), as a cognitive skill, has proven to be an influential factor to improve of the quality of life (QOL). This study aimed to examine the level of HL and its relationship with the QOL of older people at the time of discharge from the hospital in the south of Iran.

METHODS

This descriptive-analytical cross-sectional study included 300 older people admitted and treated in 10 teaching-therapeutic hospitals affiliated with the Shiraz University of Medical Sciences in 2021. The standard Health Literacy for Iranian Adults (HELIA) questionnaire and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were used to collect the required data. Data were analyzed with SPSS software version 23 software using descriptive and inferential statistics, Pearson's correlation coefficient, T-test, ANOVA, and multiple linear regression at p = 0.05.

RESULTS

The mean scores of Hl and QOL for older people were 48.22 ± 9.63 (out of 100) and 61.59 ± 12.43 (out of 120), respectively. Moreover, there was a significant direct correlation between the participants' HL and their QOL (r=0.388, p<0.001). All dimensions of HL, including comprehension (β=0.461, p<0.001), decision-making and behavior (β=0.434, p<0.001), access (β=0.397, p<0.001), reading skill (β=0.362, p=0.002), and assessment (β=0.278, p=0.004), were significant relationship with QOL. A statistically significant difference was revealed between the mean scores of HL regarding the participants' gender (p=0.04) and level of education (p=0.001). Furthermore, the mean scores of QOL were significantly different with regard to older people's gender (p=0.02), marital status (p=0.03), level of education (p=0.002), and income (p=0.01).

CONCLUSION

The findings revealed the participants' inadequate HL and average QOL. Considering the relationship of HL with QOL, it is recommended to develop comprehensive programs and effective interventions to develop HL skills and subsequently improve QOL among older people.

Analysis the Effect of Job Strain on Nurses' Quality of Work-Life: A Mediating and Moderating Model

BACKGROUND

One of the most important issues in all organizations is to improve performance of human resources to achieve goals. Therefore, it is necessary plans and solutions to reduce Job Strain (JS) and then increase Organizational Citizenship Behaviors (OCB), and Quality of Work-Life (QWL). The purpose of this study is to investigate the effect of JS on QWL with mediating role of OCB and moderator of employment status.

MATERIALS AND METHODS

This cross-sectional study was conducted on 300 nurses who were non-randomly voluntary selected among nurses working in seven educational hospitals in Ahvaz, Iran. Data were collected using demographic and occupational characteristics questionnaire and JS questionnaire with 12 items, OCB with 16 items & QWL with 26 items in the 5-point Likert scale. Data analysis was performed in SPSS22 using descriptive and inferential statistics, and structural equation modeling with SmartPLS3.

RESULTS

The results indicated the mean (SD) score of 49.56 (6.68) for JS (more than normal) and 58.84 (5.94) and 49.88 (7.69) for QWL and OCB, respectively. Spearman correlation coefficients show that JS has a negative relationship with QWL (r = -0.69, p < 0.001) and OCB (r = -0.54, p = 0.008). Also, nurses' employment status (Formal and Contractual) moderates the relationship between JS, QWL, and OCB.

CONCLUSIONS

According to the results, job stress in nurses of Ahvaz hospitals was high and QWL was moderate (or less). Therefore, increased job stress leads to reduced QWL and OCBs of nurses. Also the employment Status and job security that it provides can modify this impact.

Promoting Health Literacy and Perceived Self-Efficacy in People with Chronic Obstructive Pulmonary Disease

Background

Chronic Obstructive Pulmonary Disease (COPD) is an irreversible condition and it is of great importance for the patients to practice self-care. Given the impact of inadequate health literacy on people's self-efficacy in a self-care program, the aim of this study was to improve health literacy and self-efficacy in people with COPD.

Materials and Methods

The present quasi-experimental study was conducted on 70 patients with COPD admitted to Shahrekord educational hospitals in 2019. Using random allocation software, the samples were randomly divided into intervention and control groups. Data collection tools included three questionnaires including demographic, health literacy, and perceived self-efficacy questionnaires. A training program, with three weekly sessions of theoretical and practical trainings, was conducted for the intervention group in classes in the hospital. The time of each session was 40 min. Data were collected three times i.e., before, immediately after, and three months after the trainings. Data were analyzed by means of SPSS 21 statistical software using descriptive and inferential statistics.

Results

Before the intervention, the mean scores of perceived self-efficacy and health literacy did not differ significantly between the two groups, but after the intervention, the scores of the members in the intervention group increased significantly (f = 62.15, p < 0.05).

Conclusions

The results of the study indicated an increase in the scores of perceived self-efficacy and health literacy in people with COPD. The use of targeted educational interventions can have a positive effect on the treatment and control of the disease.

Health literacy and health promoting behaviors among inpatient women during COVID-19 pandemic

BACKGROUND

One of the leading health indicators during the COVID-19 crisis is health literacy and health-promoting behaviors. The present study aimed to investigate health literacy and health-promoting behaviors among women hospitalized during the COVID-19 pandemic in the southern part of Iran in 2020.

METHODS

This descriptive-analytical study encompassed 465 women hospitalized and treated in none teaching hospitals affiliated with the Shiraz University of Medical Sciences. Data collection tools were the Health Literacy for Iranian Adults (HELIA) and Health Promoting Lifestyle Profile II (HPLP-II). The collected data were analyzed using descriptive and inferential statistical methods.

RESULTS

The mean scores of the participants' "health literacy" and "health-promoting behaviors" were 64.41 ± 11.31 and 112.23 ± 16.09, respectively, indicating the poor level of health literacy and the average level of health-promoting behaviors. Moreover, there was a significant direct correlation between health literacy and health-promoting behaviors (P < 0.001, r = 0.471). Furthermore, all health literacy dimensions of comprehension (P < 0.001), accessibility (P < 0.001), reading skills (P < 0.001), evaluation (P = 0.002), and decision making and behavior (P = 0.003) were detected as the predictors of health-promoting behaviors. Further, statistically significant relationships were noticed between the mean score of health literacy with age (r =  - 0.327, P = 0.007), level of education (F = 3.119, P = 0.002), and place of residence (t = 2.416, P = 0.004) and between health-promoting behaviors with level of education (F = 3.341, P = 0.001) and marital status (F = 2.868, P = 0.02).

CONCLUSION

According to the findings, health policymakers should adopt national measures for educational planning to promote health literacy and support health-promoting behaviors to encourage women to adopt a healthy lifestyle.

Exploring the relationship between health literacy and fast food consumption: a population-based study from southern Iran

Background

Health literacy (HL) may affect the consumption of fast food. We aimed to evaluate the effect of HL on fast food consumption among adult populations in Iran.

Methods

We evaluated HL and fast food consumption in 421 adult participants with age range of 18–65 years old in Fasa, Fars Province, southern Iran. Two-step cluster and systematic sampling was performed to recruit the study sample. Data were collected using a fast food consumption checklist, and the Health Literacy Instrument for Adults (HELIA) by face-to-face interviews. Population data across groups with and without fast food intake were compared.

Results

Most participants used fast food every few months (49.9%). People with low or unstable income consumed more fast food than others (P < 0.05). Sandwich and hotdog were the most consumed fast food (60.8%) followed by pizza (34.9%). Sausage and soda were the most seasoning food (66.7%). Most participants used fast food as dinner (67.9%) and with family (72.2%), suggesting the institutionalized consumption of this type of food in the family. Fun was the most frequent reason for the use of fast food (66.5%). Most participants completely knew about the raw materials for fast food and their adverse effects. Finally, we found that overall health literacy was lower among those who used fast food than those who did not. Consumed fast food (68.16 ± 23.85 vs. 73.15 ± 20.15; p = 0.021). This difference was also observed for some components of health literacy including reading skills, and decision-making subscales.

Conclusions

The findings suggest there is a negative relationship between general health literacy and fast food consumption indicating that who possess lower level of health literacy is likely to consume more fast food. Specifically, the findings suggest that reading skills, and decision-making (behavioral intention) are more associated with decreased or increased fast food intake.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10763-3.

Forty years review of upstream documents of the Islamic Republic of Iran's health sector on strategic purchasing of advanced-expensive medical equipment

Purpose

According to the importance of strategic purchasing as an effective tool for resource allocation and service procurement, this study examines national laws, regulations and other related documents related to the strategic purchasing of health services related to the advanced medical equipment in Iran.

Design/methodolgy/approach

It was a national qualitative document analysis conducted in 2019 applying content analysis approach. The four-step Scott method was used to include the documents in terms of authenticity, credibility, representation and meaningfulness. After retrieving the related documents, they were coded with the implicit and explicit approach. MAXQDA10 was used for content analysis.

Findings

The findings show that according to the framework of effective factors on the strategic purchasing of health services, seven main factors are determined as the main essential factors in purchasing advanced medical equipment. These factors consist of health care providers, health service buyers, purchaser and service provider contracts, payment mechanisms, organization and management evaluation of health technology including expensive medical equipment and technology-related.

Research limitation/implication

The study had some limitations as follows: the proposed method should be tested and its feasibility has to be investigated through appropriate tools for Iranian insurance companies and those with the similar settings.

Practical implication

The results of this study can shed more light for policy makers affiliated in Ministry of Health as the main service provider, Ministry of Welfare and the insurance agencies as the main purchasers of health services on paying attention to these seven main themes extracted from the upstream documents and laws and regulations of the Islamic Republic of Iran.

Social implication

The strategic purchasing of expensive high technology-based medical equipment is a necessity for Iranian public health insurance organizations that is emphasized in national documents in the way of implementing this necessity.

Originality/value

This study examines all the laws and regulations and all related documents in the strategic purchasing of health services related to advanced medical equipment, giving an analysis of the most important challenges and requirements of implementing strategic purchasing in the health services provision sector with expensive medical equipment.