1
|
Stewart CC, Yu L, Byrne M, Glover CM, Bennett DA, Boyle PA. Health and Financial Literacy and the Acquisition of COVID-19 Knowledge in Older Adults. J Appl Gerontol 2024:7334648241260223. [PMID: 38884370 DOI: 10.1177/07334648241260223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
Knowledge about COVID-19 enters into many aspects of decision making, especially for older people who are at increased risk of severe disease or death. Yet little is known about the resources that supported older people's uptake of COVID-19 knowledge. Here, we hypothesized that higher pre-pandemic health and financial literacy was associated with higher COVID-19 knowledge. Participants were 434 community-based older people without dementia. COVID-19 knowledge was assessed via a 5-item measure, and health and financial literacy was assessed via a 32-item measure. In an ordinal regression model adjusted for age, gender, and education, higher literacy was associated with higher COVID-19 knowledge (p < .0001), and this association persisted after further adjusting for robust measures of global cognition or one of five specific cognitive domains (all p's ≤ .0001). These findings suggest that literacy plays a key role in supporting older people's acquisition of impactful knowledge in the real world.
Collapse
Affiliation(s)
- Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Maeve Byrne
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
2
|
da Silva Serejo Cardoso R, Santana RF, Delphino TM, Gomes Brandão MA, de Souza PA, Lopes CT. Concept analysis of "Insufficient health literacy" in older adults and refinement of a diagnosis proposal. Int J Nurs Knowl 2024. [PMID: 38783544 DOI: 10.1111/2047-3095.12469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic. METHODS A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework. FINDINGS A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults. CONCLUSIONS The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults. IMPLICATIONS FOR NURSING PRACTICE The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings.
Collapse
Affiliation(s)
| | - Rosimere Ferreira Santana
- Departamento de Fundamentos de Enfermagem, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Tallita Mello Delphino
- Departamento de Enfermagem Médico Cirúrgico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Priscilla Alfradique de Souza
- Departamento de Enfermagem Médico Cirúrgico, Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Takáo Lopes
- Departamento Médico Cirúrgico, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Amin R, Vaishali K, Maiya GA, Mohapatra AK, Sinha MK, Bhat A, Bommasamudram T, Acharya V, Gore S. Patient education for individuals with Interstitial Lung Disease: A scoping review. F1000Res 2024; 13:405. [PMID: 38895701 PMCID: PMC11184280 DOI: 10.12688/f1000research.147340.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives Interstitial Lung Disease (ILD) is a severe and rapidly progressing disease with a high fatality rate. Patient education (PE) has been demonstrated to promote long-term adherence to exercise and lifestyle improvements by assisting patients in developing self-management techniques. Our scoping review's goal was to chart out the prevailing level of research about the content, processes, and effectiveness of PE for patients with ILD. Methods The relevant databases were searched using the rules provided by Arksey and O'Malley in 2005 and the Joanna Briggs Institute reviewers' manual 2015: an approach for JBI scoping reviews. Individuals with ILD, published in English between the years of inception and 2020, and describing PE administered by various healthcare practitioners were among the 355 studies found and reviewed. Thirteen studies met these criteria. Results PE delivery process, delivery techniques, quality of life assessments, common PE themes, and healthcare professional participation were all recognized and cataloged. Conclusion Despite the fact that healthcare professionals (physicians, nurses, and physiotherapists) provide PE to patients with ILD regularly, the PE provided varies greatly (contents of PE, process of delivery and delivery techniques). During the scoping review, a significant variation in the themes was addressed. They could not provide any evidence-based specific recommendations for all healthcare practitioners due to the studies' heterogeneity and lack of effectiveness measures.
Collapse
Affiliation(s)
- Revati Amin
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - K. Vaishali
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - G. Arun Maiya
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Aswini Kumar Mohapatra
- Respiratory Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Mukesh Kumar Sinha
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Anup Bhat
- Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Tulasiram Bommasamudram
- Exercise and Sports Science, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vishak Acharya
- Pulmonary Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, 575001, India
| | - Shweta Gore
- MGH Institute of Health Professions, Boston, Massachusetts, 02129, USA
| |
Collapse
|
4
|
Dineen-Griffin S, Benrimoj SI. The landscape of self-care in Australia: A pharmacy perspective. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100396. [PMID: 38174289 PMCID: PMC10762451 DOI: 10.1016/j.rcsop.2023.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
The evolving landscape of self-care in Australia underscores the imperative of recognizing and integrating the crucial role of pharmacists in promoting greater levels of self-care. Although the social and economic justifications for self-care are acknowledged internationally and in the literature, there is very little policy recognition in relation to self-care specifically in Australian health policy. Additionally, the distinct contributions of pharmacies to self-care, i.e., their experiences and accessibility in primary health care, are not consistently highlighted. Community pharmacies in Australia are currently navigating a transformative shift, expanding their scope of practice to deliver highly individualized care, with a special emphasis on the implementation of professional services crucial for the sector's enduring viability. Although pharmacists already play a substantial role in supporting self-care, there exists a compelling demand for a systematic and structured approach. Despite the limited availability of theoretical frameworks or models for pharmacists in self-care support within the existing literature, tangible practical evidence attests to the success of interventions. In an era where patients increasingly assume responsibility for self-managing conditions, the pharmacist's role in facilitating self-care and judicious self-medication is pivotal, promising not only tangible benefits for individuals but also contributing significantly to the long-term sustainability of the healthcare system in Australia. This necessitates a strategic and comprehensive framework that positions pharmacists as essential catalysts in the broader landscape of healthcare, ensuring their contributions are optimally leveraged to enhance patient outcomes and system efficiency.
Collapse
Affiliation(s)
- Sarah Dineen-Griffin
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, New South Wales, Australia
| | - Shalom I. Benrimoj
- Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Spain
| |
Collapse
|
5
|
Lima ACP, Maximiano-Barreto MA, Martins TCR, Luchesi BM. Factors associated with poor health literacy in older adults: A systematic review. Geriatr Nurs 2024; 55:242-254. [PMID: 38070263 DOI: 10.1016/j.gerinurse.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVES To identify factors associated with poor health literacy in older adults. METHODS A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy". PROSPERO - CRD 42022350140. RESULTS Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others). CONCLUSIONS The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies.
Collapse
Affiliation(s)
- Ana Caroline Pinto Lima
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | | | - Tatiana Carvalho Reis Martins
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Bruna Moretti Luchesi
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil.
| |
Collapse
|
6
|
Seangpraw K, Ong-Artborirak P, Boonyathee S, Bootsikeaw S, Kantow S, Panta P, Winaiprasert P. Effect of Health Literacy Intervention on Glycemic Control and Renal Function Among Thai Older Adults at Risk of Type 2 Diabetes Mellitus. Clin Interv Aging 2023; 18:1465-1476. [PMID: 37700781 PMCID: PMC10494859 DOI: 10.2147/cia.s413456] [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: 03/21/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose Diabetes patients with low health literacy often have poor health and clinical outcomes. The study aimed to assess the effectiveness of a health literacy intervention on glycemic control and renal function among Thai older adults at risk of type 2 diabetes mellitus (T2DM). Methods A quasi-experimental study was carried out in rural areas of Phayao Province in northern Thailand. The participants were older adults with T2DM who recorded blood glucose levels ranging from 140 to 180 mg/dL and who were not receiving prescribed medication. The intervention lasted 12 weeks, and data were collected at three points: baseline, post-intervention, and at 3 months' follow-up. The study outcomes included the measurement of fasting blood sugar (FBS), hemoglobin A1C (HbA1c), and glomerular filtration rate (eGFR) levels after the intervention. A linear mixed model and generalized estimating equations model were used to assess the intervention effect for continuous and binary outcomes, respectively. Results From baseline to post-intervention, FBS and HbA1c decreased more in the intervention group than in the control group by 8.2 mg/dL (p < 0.001) and 0.1% (p = 0.029), respectively, whereas eGFR increased by 8.0 mL/min/1.73m2 (p < 0.001). The absolute effect of the intervention at follow-up was -9.8 units for FBS, -0.4 units for HbA1c, and 14.0 units for eGFR. Abnormal HbA1c level (≥6.5%) of the intervention group was reported as 70.3% at baseline, 31.3% at post-intervention, and 9.4% at follow-up. Compared to baseline levels, the T2DM patients who received the intervention were 0.31 times less likely to have abnormal HbA1c levels than the control subjects at follow-up (p = 0.003) who received no intervention. Conclusion Our findings suggest that this intervention may potentially improve diabetes self-management and prevention behaviors, thereby reducing the diabetes burden in rural communities in northern Thailand.
Collapse
Affiliation(s)
| | | | | | | | - Supakan Kantow
- School of Public Health, University of Phayao, Phayao, 56000, Thailand
| | - Pitakpong Panta
- School of Nursing, University of Phayao, Phayao, 56000, Thailand
| | | |
Collapse
|
7
|
Stewart CC, Yu L, Glover C, Mottola G, Valdes O, Wilson RS, Bennett DA, Boyle PA. Well-Being and Aging-Related Decline in Financial and Health Literacy in Advanced Age. J Gerontol B Psychol Sci Soc Sci 2023; 78:1526-1532. [PMID: 37068007 PMCID: PMC10461526 DOI: 10.1093/geronb/gbad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Indexed: 04/18/2023] Open
Abstract
OBJECTIVES Emerging evidence suggests that financial and health literacy deteriorates in advanced age. By contrast, well-being promotes health in aging. This study tested the hypothesis that well-being is associated with slower aging-related literacy decline. METHODS Participants were 1,099 community-based older adults without dementia at baseline. Financial and health literacy was assessed at baseline and annually thereafter via a 32-item measure. Well-being was assessed at baseline via the 18-item version of Ryff's Scales of Psychological Well-Being. RESULTS During up to 12 years of annual follow-up, literacy declined about 1 percentage point per year on average (β = -0.91, standard error [SE] = 0.08, p < .001); however, there was considerable variation in change in literacy between participants (random slopes variance = 1.24, SE = 0.15, p < .001). In a linear mixed-effects model adjusted for age, sex, and education, higher well-being was associated with higher starting level of literacy (β = 2.31, SE = 0.67, p = .001) and, critically, slower literacy decline (β = 0.29, SE = 0.11, p = .01). The association of higher well-being with slower literacy decline persisted in models that additionally adjusted for income, medical conditions, depressive symptoms, and a robust measure of global cognition. DISCUSSION This study suggests that well-being helps stave off aging-related literacy decline.
Collapse
Affiliation(s)
- Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Crystal Glover
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Gary Mottola
- FINRA Investor Education Foundation, Washington, District of Columbia, USA
| | - Olivia Valdes
- FINRA Investor Education Foundation, Washington, District of Columbia, USA
| | - Robert S Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Patricia A Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
8
|
Rustami E, Toçi D, Poshi K, Peka E, Pano I, Pula A. Determinants of Inadequate Health Literacy Among Faculty of Medical Technical Sciences Students in Albania: Cross-Sectional Survey. JMIR Form Res 2023; 7:e46476. [PMID: 37463034 PMCID: PMC10394598 DOI: 10.2196/46476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Health literacy (HL) refers to people's ability to find, understand, and use health information in order to make appropriate health decisions. Health literacy among students is important so that tomorrow's health professionals can deliver high-quality health care and enhance patient education and communication. OBJECTIVE In this context, the aim of this study was to assess the HL level of Faculty of Medical Technical Sciences (FMTS) students in order to shed light on this underresearched topic in Albanian settings. METHODS A cross-sectional study involving 193 FMTS students of various study branches (nursing, midwifery, physiotherapy, and laboratory technician) was carried out during June 22-29, 2022, on the premises of the FMTS Faculty in Tirana, Albania. The international European Health Literacy Survey Questionnaire (HLS-EU-Q) standardized questionnaire, validated in Albanian, was used to collect information about FMTS students' general HL through a face-to-face interview. Basic sociodemographic information was collected as well. Binary logistic regression was used to assess the factors associated with inadequate, problematic, or limited HL. RESULTS The mean level of general HL was 37.2 (on a scale from 0 [minimum HL] to 50 [maximal HL]). About one-quarter of FMTS students had inadequate (9/193, 4.7%) or problematic (38/193, 19.7%) HL, 51.3% (99/193) had sufficient HL, and 24.4% (47/193) had excellent HL. The prevalence of limited HL (inadequate and problematic HL) was higher among male than female students (6/12, 50% vs 41/181, 22.6%, respectively) and those with lower social and economic status. Upon adjusting for confounding effects, the only factor significantly increasing the likelihood of limited HL was male gender (odds ratio 8.13, 95% CI 1.68-39.39). Findings suggested that low social and economic status also increased the likelihood of limited HL, but such associations did not reach statistical significance. CONCLUSIONS To our knowledge, this is the first study exploring the level of HL and its associated factors among FMTS students in Albania. The prevalence of limited HL was relatively high among FMTS students. There is a need for targeted interventions to increase the HL of nursing and midwifery students, such as the inclusion of HL subjects in the nursing curriculum.
Collapse
Affiliation(s)
- Etleva Rustami
- Department of Clinical Subject, University of Medicine Tirane, Tirane, Albania
| | - Dorina Toçi
- Institution of Public Health, University of Medicine in Tirane, Tirane, Albania
| | - Klodiana Poshi
- Department of Clinical Subject, University of Medicine Tirane, Tirane, Albania
| | - Elida Peka
- Department of Clinical Subject, University of Medicine Tirane, Tirane, Albania
| | - Irida Pano
- Department of Clinical Subject, University of Medicine Tirane, Tirane, Albania
| | - Alma Pula
- Department of Clinical Subject, University of Medicine Tirane, Tirane, Albania
| |
Collapse
|
9
|
Bobinac A. Access to Healthcare and Health Literacy in Croatia: Empirical Investigation. Healthcare (Basel) 2023; 11:1955. [PMID: 37444789 DOI: 10.3390/healthcare11131955] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
Health literacy is related to different health-related outcomes. However, the nature of the relationship between health literacy and health outcomes is not well understood. One pathway may lead from health literacy to health outcomes by means of access to healthcare. The goal of the current study is to explore the association between health literacy and the particular measure of access to healthcare-unmet medical need-for the first time in Croatia and, to the best of our knowledge, for the first time in the EU context. We use data obtained from face-to-face interviews in a large nationally representative sample of the Croatian population (n = 1000) to estimate the level of health literacy and self-reported access to care and investigate the association between health literacy and self-perceived barriers to access. Our study showed that limited and problematic health literacy is prevalent and associated with higher rates of unmet medical need. Unmet need is largely caused by long waiting lists. It is therefore essential to design health services fitting the needs of those who have limited and/or problematic health literacy as well as enhance health education with the potential of improving the access to care and health outcomes as well as design policies that reduce waiting times.
Collapse
Affiliation(s)
- Ana Bobinac
- Center for Health Economics and Pharmacoeconomics (CHEP), Faculty of Economics and Business, University of Rijeka, 51 000 Rijeka, Croatia
| |
Collapse
|
10
|
Murdock N, Missner A, Mehta V. Health Literacy in Oculofacial Plastic Surgery: A Literature Review. Cureus 2023; 15:e41518. [PMID: 37551223 PMCID: PMC10404445 DOI: 10.7759/cureus.41518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 08/09/2023] Open
Abstract
Patient satisfaction following oculofacial cosmetic procedures depends on preoperative expectations, which may be influenced by online material. Patients with poor health literacy are particularly vulnerable to misinformation and low-quality resources. However, few studies have evaluated the quality of online information on common oculofacial plastic surgeries and procedures. This study aimed to review the literature on the readability and quality of online material related to oculofacial plastic surgery. We conducted a systematic search of the PubMed/MEDLINE database and included 10 studies in our review. Among the readability scores reported in these studies, the lowest was 10, representing a tenth-grade reading level. Furthermore, the online materials were often rated as "poor" quality based on multiple grading scales. Our systematic review of the literature demonstrates that online materials covering common oculofacial plastic surgery procedures are consistently of poor quality and exceed the recommended readability level. Therefore, considering these online materials that influence patient expectations could enable oculofacial plastic surgeons to better tailor their preoperative counseling.
Collapse
Affiliation(s)
- Narmien Murdock
- Ophthalmology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Alexander Missner
- Ophthalmology, Georgetown University School of Medicine, Washington, DC, USA
| | - Viraj Mehta
- Ophthalmology, MedStar Georgetown University Hospital, Washington, DC, USA
| |
Collapse
|
11
|
Dong Z, Ji M, Shan Y, Xu X, Xing Z. Functional Health Literacy Among Chinese Populations and Associated Factors: Latent Class Analysis. JMIR Form Res 2023; 7:e43348. [PMID: 37115594 PMCID: PMC10182450 DOI: 10.2196/43348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 03/11/2023] [Accepted: 03/11/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Poor functional health literacy has been found to be independently associated with poor self-assessed health, poor understanding of one's health condition and its management, and higher use of health services. Given the importance of functional health literacy, it is necessary to assess the overall status of functional health literacy in the general public. However, the literature review shows that no studies of functional health literacy have been conducted among the Chinese population in China. OBJECTIVE This study aimed to classify Chinese populations into different functional health literacy clusters and ascertain significant factors closely associated with low functional health literacy to provide some implications for health education, medical research, and public health policy making. METHODS We hypothesized that the participants' functional health literacy levels were associated with various demographic characteristics. Therefore, we designed a four-section questionnaire including the following information: (1) age, gender, and education; (2) self-assessed disease knowledge; (3) 3 validated health literacy assessment tools (ie, the All Aspects of Health Literacy Scale, the eHealth Literacy Scale, and the 6-item General Health Numeracy Test); and (4) health beliefs and self-confidence measured by the Multidimensional Health Locus of Control Scales Form B. Using randomized sampling, we recruited survey participants from Qilu Hospital affiliated to Shandong University, China. The questionnaire was administered via wenjuanxing. A returned questionnaire was valid only when all question items included were answered, according to our predefined validation criterion. All valid data were coded according to the predefined coding schemes of Likert scales with different point (score) ranges. Finally, we used latent class analysis to classify Chinese populations into clusters of different functional health literacy and identify significant factors closely associated with low functional health literacy. RESULTS All data in the 800 returned questionnaires proved valid according to the predefined validation criterion. Applying latent class analysis, we classified Chinese populations into low (n=292, 36.5%), moderate-to-adequate (n=286, 35.7%), and low-to-moderate (n=222, 27.8%) functional health literacy groups and identified five factors associated with low communicative health literacy: (1) male gender (aged 40-49 years), (2) lower educational attainment (below diploma), (3) age between 38 and 68 years, (4) lower self-efficacy, and (5) belief that staying healthy was a matter of luck. CONCLUSIONS We classified Chinese populations into 3 functional health literacy groups and identified 5 factors associated with low functional health literacy. These associated factors can provide some implications for health education, medical research, and health policy making.
Collapse
Affiliation(s)
- Zhaogang Dong
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Ji'nan, China
| | - Meng Ji
- School of Languages and Cultures, The University of Sydney, Sydney, Australia
| | - Yi Shan
- School of Foreign Studies, Nantong University, Nantong, China
| | - Xiaofei Xu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Zhaoquan Xing
- Department of Urology, Qilu Hospital of Shandong University, Ji'nan, China
| |
Collapse
|
12
|
Assessment of the Factors Influencing the Patient's Comprehension of the Informed Consent to Interventional Pain Procedures. Pain Res Manag 2023; 2023:7054089. [PMID: 36819746 PMCID: PMC9931461 DOI: 10.1155/2023/7054089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Abstract
Background Informed consent is the first step of every medical procedure and is considered a standard of care for patients undergoing medical interventions. Our study seeks to evaluate patients' understanding of the procedure they consented to and the factors affecting the degree of understanding. Methods In this cross-sectional study, we used an anonymous postprocedural questionnaire to assess our patients' understanding of the procedure being performed and their level of satisfaction. It was conducted between June 2021 and January 2022 on every consenting patient who declined English interpreter services and was undergoing a first elective lumbar epidural steroid injection. Results The mean age of 201 subjects was 57.3 (23-90) years, with a race distribution of Black (44.3%), White (31.8%), and other races (23.9%). 15.9% of our subjects worked in the medical field. Older age and patients identified as Black and other races had a positive correlation with the propensity to predict a poor understanding of consent. This study failed to demonstrate any difference in understanding of informed consent content between the different subgroups when stratified by assigned sex at birth, level of education, and profession. Patients' expectation from the treatment was classified as desperate (will take any help they can) in 78 patients (38.8%), feeling hopeful (expecting partial improvement in their symptoms) in 52 patients (25.9%), and being optimistic (will obtain full recovery from this injection) in 71 patients (35.3%). 192 patients (95.5%) were very satisfied with the consent process. Seven patients (3.5%) stated that they wanted more information, and 2 patients (1.0%) did not understand the explanation. 180 patients (89.6%) were satisfied with the overall experience, while 21 patients (10.4%) were not. The Wilks test (likelihood-ratio test) resulted in a p value of 0.023 and was deemed statistically significant for a relationship between understanding of consent and the satisfaction of the patient from the procedure. Conclusions Although patients carry a variable expectation of procedures, most patients in our pain clinic have a high level of satisfaction despite having a poor understanding of the procedure provided via informed consent. Although our patients' level of objective comprehension is low, those with a better understanding of the procedure tend to have a more satisfactory experience.
Collapse
|
13
|
Cardoso RSS, Tosin MHS, de Oliveira BGRB, Moraes KL, Santana RF. The Multidimensionality of Low Health Literacy in Older Adults: A Scoping Review of International Studies. Clin Nurs Res 2023; 32:270-277. [PMID: 36625242 DOI: 10.1177/10547738221146461] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This scoping review aims to map the dimensions encompassing the low health literacy (HL) of older adults, describing their respective causes and consequences. A three-step search strategy was conducted using 16 databases from nine portals and reference lists. Of the 4,259 identified studies, 2,845 were screened and 29 (1%) were included. Studies were published between 1999 and 2021, most of them in English (86.2%), from the American continent (48.3%) and with observational design (86.2%). Four dimensions encompassing the low HL of older adults were mapped: (1) patient dimension, (2) healthcare system dimension, (3) social/economic dimension, and (4) health condition dimension. This review highlights specific dimensions encompassing the low literacy in older adults with evidence about its causes and consequences. These results can guide future research and evidence-based practice involving HL of older adults.
Collapse
Affiliation(s)
| | - Michelle H S Tosin
- Fluminense Federal University, Niterói, RJ, Brazil.,Rush University Medical Center, Chicago, IL, USA
| | | | | | | |
Collapse
|
14
|
Xu D, Arling G. Are Frail Older People from Racial/Ethnic Minorities at Double Jeopardy of Putting off Healthcare during the Pandemic? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1034. [PMID: 36673788 PMCID: PMC9859101 DOI: 10.3390/ijerph20021034] [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: 08/17/2022] [Revised: 12/06/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Given the differential impacts of COVID-19 on racial and ethnic groups, it is unclear how racial/ethnic status and frailty combine to influence pandemic-related healthcare disruptions. This study aimed to test the double jeopardy hypothesis: racial/ethnic minority older adults suffer a double disadvantage in access to health care during the pandemic due to the interactive effects of frailty and race. This study uses the linked National Health and Aging Trends Study (NHATS) and COVID-19 public use data files. A multivariate logistic regression model was performed. Overall, approximately two out of five (41%) older adults reported postponing care due to the pandemic. The likelihood of putting off care increased slightly by frailty status. We found no significant difference between Whites and non-Whites in putting off care. However, the simple comparison masked significant variation across frailty status. Robust non-White older people were less likely to put off care than robust Whites (robust non-Whites: 29% vs. robust Whites: 39%); in contrast, frail non-White older people were more likely to put off care (frail non-Whites: 55% vs. frail Whites: 42%). Being frail and non-White creates double jeopardy, which has a negative impact on access to healthcare. Timely access to care is essential for frail older people, particularly non-Whites, because of their complex health conditions accentuated by health and social disparities.
Collapse
Affiliation(s)
- Dongjuan Xu
- School of Nursing, Purdue University, West Lafayette, IN 47907, USA
| | | |
Collapse
|
15
|
Exploring Health Literacy Categories in Patients With Heart Failure: A Latent Class Analysis. J Cardiovasc Nurs 2023; 38:13-22. [PMID: 36508237 DOI: 10.1097/jcn.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although a growing number of studies have demonstrated that patients' health literacy is associated with health outcomes, the exact relationship between them is not clear. AIMS AND OBJECTIVES The aim of this study was to explore latent classes of health literacy in patients with heart failure and analyze the differences among different groups. DESIGN AND METHODS This is a cross-sectional survey. Patients diagnosed with heart failure were selected from 3 tertiary hospitals in Tianjin, China, from March 2019 to November 2019. We measured patients' health literacy using the Health Literacy Scale for Chronic Patients. Latent class analysis was carried out based on the patients' Health Literacy Scale for Chronic Patients scores. Multinomial logistic regression was used to identify the predictive indicators of the latent classes. RESULTS The health literacy of patients with heart failure was divided into 3 different latent classes, named "high health literacy group," "low literacy high dependence group," and "moderate literacy high willingness group." There were statistically significant differences in gender, age, smoking history, marital status, education level, household income level, and quality of life among different health literacy classes. Low education level and household income level predicted poor health literacy. CONCLUSION There were 3 latent classes for the health literacy of patients with heart failure. Different health literacy classes exhibited their own distinctive characteristics. Patients in the "moderate literacy high willingness group" had the worst quality of life. Understanding the specific types of health literacy in patients with heart failure facilitates targeted nursing interventions to improve their quality of life.
Collapse
|
16
|
Cohen SA, Fisher AC, Pershing S. Analysis of the Readability and Accountability of Online Patient Education Materials Related to Glaucoma Diagnosis and Treatment. Clin Ophthalmol 2023; 17:779-788. [PMID: 36923248 PMCID: PMC10008728 DOI: 10.2147/opth.s401492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/15/2023] [Indexed: 03/10/2023] Open
Abstract
Purpose To assess the readability and accountability of online patient education materials related to glaucoma diagnosis and treatment. Methods We conducted a Google search for 10 search terms related to glaucoma diagnosis and 10 search terms related to glaucoma treatment. For each search term, the first 10 patient education websites populated after Google search were assessed for readability and accountability. Readability was assessed using five validated measures: Flesch Reading Ease (FRE), Gunning Fog Index (GFI), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and New Dale-Chall (NDC). Accountability was assessed using the Journal of the American Medical Association (JAMA) benchmarks. The source of information for each article analyzed was recorded. Results Of the 200 total websites analyzed, only 11% were written at or below the recommended 6th grade reading level. The average FRE and grade level for 100 glaucoma diagnosis-related articles were 42.02 ± 1.08 and 10.53 ± 1.30, respectively. The average FRE and grade level for 100 glaucoma treatment-related articles were 43.86 ± 1.01 and 11.29 ± 1.54, respectively. Crowdsourced articles were written at the highest average grade level (12.32 ± 0.78), followed by articles written by private practice/independent users (11.22 ± 1.74), national organizations (10.92 ± 1.24), and educational institutions (10.33 ± 1.35). Websites averaged 1.12 ± 1.15 of 4 JAMA accountability metrics. Conclusion Despite wide variation in the readability and accountability of online patient education materials related to glaucoma diagnosis and treatment, patient education materials are consistently written at levels above the recommended reading level and often lack accountability. Articles from educational institutions and national organizations were often written at lower reading levels but are less frequently encountered after Google search. There is a need for accurate and understandable online information that glaucoma patients can use to inform decisions about their eye health.
Collapse
Affiliation(s)
- Samuel A Cohen
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Byers Eye Institute at Stanford, Stanford, CA, USA
| | - Ann Caroline Fisher
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Byers Eye Institute at Stanford, Stanford, CA, USA
| | - Suzann Pershing
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Byers Eye Institute at Stanford, Stanford, CA, USA.,VA Palo Alto Health Care System, Palo Alto, CA, USA
| |
Collapse
|
17
|
Roble S, Wångdahl J, Warner G. COVID-19 Information in Sweden: Opinions of Immigrants with Limited Proficiency in Swedish. HEALTH COMMUNICATION 2022; 37:1510-1519. [PMID: 35287507 DOI: 10.1080/10410236.2022.2050005] [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] [Indexed: 06/14/2023]
Abstract
COVID-19 has highlighted the importance of health information for prevention of communicable disease. Knowledge about groups that have high risk is important to prevent disease transmission. In Sweden, immigrants have been identified as one such group. Yet, little is known about where they have sourced information about COVID-19 and their opinions toward it. The aim of this study was to describe the COVID-19 information sources used by immigrants with limited proficiency in Swedish as well as their opinions on how comprehensive the information has been, the importance of the recommendations and their possibility to follow them. A cross-sectional survey was conducted via introductory Swedish language classes in Region Uppsala (n = 855). The results showed the immigrants were using different information sources, with the majority using school, media and social media. The immigrants' opinions about COVID-19 information differed. Most reported they knew where to find information; however, over two-fifths reported the recommendations from the authorities should be more extensive. The majority reported it is important to follow the recommendations, whereas the possibility to follow the recommendations was more mixed. Age differences in opinions toward COVID-19 information were detected. Although the results were largely positive, there still appears to be a need for improvement in how immigrant groups with limited ability in the host country´s language are reached. Effective health communication that engages the whole nation is an important factor authorities should commit to as we face the current pandemic. This research suggests that an approach tailored by age could be helpful.
Collapse
Affiliation(s)
- Sagal Roble
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University
| | - Josefin Wångdahl
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University
| |
Collapse
|
18
|
Abstract
OBJECTIVE To evaluate the baseline level and demographic predictors of statistical literacy in orthopaedic patients who sustained traumatic injuries. DESIGN Prospective observational. SETTING Level 1 trauma center. PATIENTS One hundred ninety-eight patients presenting to the orthopaedic trauma clinic. INTERVENTION Berlin Numeracy Test (BNT) and General Health Numeracy Test-6 (GHNT-6). RESULTS When assessed using the BNT, 67% of patients had results that placed them into the lowest quartile of objective numeracy skills. Only 3.5% of patients had results that scored in the top quartile. Our multivariate ordinal regression model demonstrated lower education level ( P = 0.01), and older age ( P = 0.03) were significant predictors of poor performance on the BNT. The mean score on the GHNT-6 was 36% (SD 30%). CONCLUSIONS In a cohort of traumatically injured patients, poor statistical literacy was common, occurring in more than two-thirds of patient surveyed. Older age and lower levels of education were predictive of poor BNT performance and should be considered when discussing surgical options, associated risks, and likelihood of potential complications.
Collapse
|
19
|
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.
Collapse
|
20
|
Systematic review of effectiveness and quality assessment of patient education materials and decision aids for breathlessness. BMC Pulm Med 2022; 22:237. [PMID: 35725454 PMCID: PMC9208236 DOI: 10.1186/s12890-022-02032-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Around 10% of adults suffer from clinically significant breathlessness. High quality and actionable patient education materials (PEMs) and patient decision aids (PDAs) have an important role for shared decision making and patient self-management. OBJECTIVE To systematically assess the effectiveness of patient education materials (PEMs) and patient decision aids (PDAs) on clinical outcomes. Secondly, to assess the quality of PEMs and PDAs for breathlessness that are accessible online. METHODS A systematic review of PEM or PDA intervention for breathlessness published between 1 January 2010 and November 2020 was conducted. An environmental scan and quality assessment of publicly available PEMs and PDAs was also conducted. RESULTS Out of 2985 records, five studies were eligible for inclusion in this systematic review. Results of two randomised controlled trials suggest potential effectiveness of PEMs to improve patient reported outcomes and reduce healthcare utilization. In the environmental scan, 88 materials were included. Minimum reading age for most was high (Grade 10) and PEMs scored an average of 87% for understandability and 67% for actionability. Based on the DISCERN tool only 10 were classified as high quality. CONCLUSION There is a paucity of evidence on the effectiveness of PEMs and PDAs for improvement in breathlessness. There is a need to develop higher quality PEMs for breathlessness.
Collapse
|
21
|
Cheng BT, Kim AB, Tanna AP. Readability of Online Patient Education Materials for Glaucoma. J Glaucoma 2022; 31:438-442. [PMID: 35283441 DOI: 10.1097/ijg.0000000000002012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
PRCIS We assessed the readability of online glaucoma patient education materials using seven validated instruments. Overall, glaucoma materials were written at a 10th to 11th grade level, above the recommended seventh grade reading level. PURPOSE Online health information is increasingly used by patients, yet previous studies show online patient education materials are often difficult to understand. As such, the American Medical Association recommends that patient education materials are written at or below a seventh grade reading level. This study aimed to assess the readability of online glaucoma patient education materials. METHODS Glaucoma was entered into the Google search engine, and the first 30 search results were assessed for readability using seven validated readability instruments. Scientific articles, forums, and dictionary entries were excluded. Single sample t tests were used to assess whether online glaucoma materials were written above the recommended seventh grade level. RESULTS Overall, glaucoma materials were written at a mean grade level of 10.33 (SD: 2.02). Across 6 grade level readability instruments, these patient education materials were written above the recommended seventh grade reading level (P<0.0001 for all). Glaucoma education materials only on the first page of Google search results were of a similar reading level: mean 10.56 (SD: 2.13). The readability instruments used in this study showed strong consistency. CONCLUSIONS Glaucoma patient education materials are written above the recommended reading level to promote accessibility of education materials. This may contribute to lower patient engagement, worse clinical outcomes, and greater racial and ethnic disparities in glaucoma management. There is a need for reliable, simple glaucoma information to improve patient outcomes.
Collapse
Affiliation(s)
- Brian T Cheng
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine
| | - Anne B Kim
- Rush University Medical College, Chicago, IL
| | - Angelo P Tanna
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine
| |
Collapse
|
22
|
Wang Y, Inglehart MR, Yuan C. Impact of Parents' Oral Health Literacy on Their Own and Their Children's Oral Health in Chinese Population. Front Public Health 2022; 10:809568. [PMID: 35345505 PMCID: PMC8957213 DOI: 10.3389/fpubh.2022.809568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Oral health literacy (OHL) has been recognized as a component of oral health disparities; however, the precise relationship between literacy and oral health outcomes has not been established. To explore the role of parents' OHL for their own subjective oral health, related behavior, and for the proxy assessment of their child's oral health, oral health-related behavior. Methods Survey data were collected from 406 parents of 4- to 7-year-old children in Beijing, China. The background characteristics, oral health assessment, oral health-related behavior, knowledge and attitudes, and diet-related questions of parents and their children were surveyed by a questionnaire. OHL was assessed with the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREAL-30) Scale and a revised version that asked the respondents to indicate if they understood the words (HKREALD-30-Understand). Results The HKREALD-30 responses correlated with the HKREALD-30-Understand responses. The higher the parents' HKREALD-30-Understand scores, the better they described the health of their own teeth and gums, the greater their child's diet was influenced by the protein, sugar and calories of the food, and the more positive their oral health-related attitudes were. The higher the parent's HKREALD-30 scores, the healthier they described their child's teeth and gums. Conclusions Both the HKREALD-30 and HKREALD-30-Understand Scores correlate with parents' self and proxy oral health-related responses. Chinese parents could understand that the word would add predictive value to the prediction of how parents' oral health literacy affects their own oral health care, children's oral health and other related aspects.
Collapse
Affiliation(s)
- Yu Wang
- Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.,International Trained Dentist Program, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Chao Yuan
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| |
Collapse
|
23
|
Farrell TW, Towsley GL, Eaton J, Butler JM, Supiano KP, Stephens C, Witt C, Nelson NM, Edelman LS. The Development and Validation of a Communication Survey Instrument for Long-term Care Staff. J Contin Educ Nurs 2022; 53:123-130. [PMID: 35244460 DOI: 10.3928/00220124-20220210-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Information transfers in long-term care (LTC) settings between and among providers, staff, residents, and family caregivers are often fragmented. In order to identify training needs to improve communication, a survey instrument was developed and refined to assess the self-efficacy of LTC staff in communicating with staff, providers, residents, and caregivers. This 11-item survey instrument, based on a literature review, covered four key concepts (mutual respect, recognizing and responding to sensory deficits, limited health literacy, and changes in condition) relevant to communicating health information in LTC settings. Ten content experts evaluated each survey item using a 4-point scale. The content validity of the survey was established by using the content validity index to assess results at the item and scale levels. All items scored 0.90 or greater and were retained. Future work should entail broad-scale validation and testing of this survey across the United States. By assessing the self-efficacy of LTC staff in communicating with the interprofessional team, leadership teams can design personalized interprofessional continuing education activities aimed at improving communication skills. [J Contin Educ Nurs. 2022;53(3):123-130.].
Collapse
|
24
|
Sullivan-Baca E, Babicz MA, Choudhury TK, Miller BI. The Relationship between Health Literacy and Comfort with Teleneuropsychology in a Veteran Sample. Arch Clin Neuropsychol 2022; 37:292-301. [PMID: 34599332 PMCID: PMC8500040 DOI: 10.1093/arclin/acab079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Health literacy is a strong psychosocial determinant of health disparities and has been found to relate to various aspects of health-related technology use. With the increased implementation of neuropsychological services performed via telehealth during the coronavirus disease 2019 pandemic, the relationship between health literacy and comfort with teleneuropsychology warrants further investigation. METHOD The present study examined 77 Veterans participating in neuropsychological evaluations as a part of standard clinical care. The sample was diverse in terms of age ethnicity, and psychiatric and neurocognitive diagnoses. In addition to a fixed-flexible neuropsychological battery, the Brief Health Literacy Screening Tool (BRIEF) was administered to evaluate health literacy. Self-reported comfort with the teleneuropsychological evaluation was assessed using an informal 10-point scale, and qualitative comfort responses were also recorded. RESULTS Independent samples t-tests revealed older adults were more likely to participate in the evaluation via telephone than with VA Video Connect. Although health literacy was not related to telehealth modality, it was correlated with comfort with the teleneuropsychological evaluation (r = .34, p < .01), although it is notable that average comfort levels were high across modalities (M = 8.16, SD = 2.50). CONCLUSIONS Findings support the notion that teleneuropsychological services may feasibly be implemented with a diverse group of patients, although flexibility with modality may be necessary. Those performing these services should also be aware that patients with lower health literacy may feel less comfortable with teleneuropsychology as they seek to build rapport and optimize evaluation engagement.
Collapse
Affiliation(s)
- Erin Sullivan-Baca
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Michelle A Babicz
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Tabina K Choudhury
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Brian I Miller
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
25
|
Suksatan W, Prabsangob K, Choompunuch B. Association between Health Literacy, Self-care Behavior, and Blood Sugar Level among Older Patients with Type 2 Diabetes in Rural Thai Communities. Ann Geriatr Med Res 2021; 25:318-323. [PMID: 34958731 PMCID: PMC8749034 DOI: 10.4235/agmr.21.0117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/15/2021] [Indexed: 01/20/2023] Open
Abstract
Background Diabetes mellitus is a major problem worldwide. Moreover, older patients with significantly limited health literacy (HL) tend to have worse self-care behaviors and health outcomes. This study aimed to describe the associations of HL, self-care behavior, and blood sugar levels among older patients with type 2 diabetes in rural Thai communities. Methods This cross-sectional study included 415 patients with diabetes who were purposively selected from rural Thai communities. Data were collected using questionnaires and analyzed using descriptive statistics, Pearson correlation, Spearman rho, and stepwise multiple linear regression. Results The results revealed that most participants were women (66.50%). The respondents had moderate overall HL (2.68±0.64). On average, the respondents had fair overall self-care behavior (4.0±0.33). We discovered that HL was significantly positively correlated with self-care behavior (r=0.90) but not with blood sugar level. In addition, self-care behavior was significantly negatively correlated with blood sugar level (r=-0.50). Self-care behaviors and blood sugar levels were significant predictors of HL in patients with type 2 diabetes (total variance, 28.4%). Conclusion The results suggested increased HL in patients with diabetes would improve self-care behavior and, consequently, decrease their blood sugar level. Our findings indicate the need to involve nurses and multidisciplinary healthcare teams when developing health promotion programs to encourage blood sugar control.
Collapse
Affiliation(s)
- Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kantapong Prabsangob
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Samut Songkram, Thailand
| | | |
Collapse
|
26
|
Yu L, Mottola G, Bennett DA, Boyle PA. Adverse Impacts of Declining Financial and Health Literacy in Old Age. Am J Geriatr Psychiatry 2021; 29:1129-1139. [PMID: 33676832 PMCID: PMC8357843 DOI: 10.1016/j.jagp.2021.02.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Inadequate financial and health literacy presents a formidable public health and economic challenge in old age. This study investigated declining financial and health literacy in relation to decision making performance, scam susceptibility and psychological wellbeing. DESIGN Longitudinal study. SETTING A community-based cohort in Northeastern Illinois, USA. PARTICIPANTS One thousand fourty-six older adults who were free of dementia at baseline and underwent annual clinical and literacy assessments. MEASUREMENTS Financial and health literacy, decision making, scam susceptibility, and psychological wellbeing were assessed using validated instruments. Linear mixed effects models estimated person-specific rates of change in financial and health literacy, and multivariable regression analyses examined the associations of declining literacy with subsequent levels of decision making, scam susceptibility, and psychological wellbeing. RESULTS The mean age was 81 years and 76% were female. Over up to 10 years of annual follow-ups, the average financial and health literacy score dropped 1 percentage point a year. Substantial variability in decline was observed between participants. Faster decline in financial and health literacy was associated with poorer decision making, higher scam susceptibility, and lower psychological wellbeing. Notably, these associations were above and beyond the baseline literacy level and persisted even after controlling for cognition. CONCLUSIONS Most community-dwelling older adults experience decline in financial and health literacy over time, but decline is not inevitable. Declining literacy is related to poorer decision making, greater scam susceptibility and lower wellbeing. These findings suggest that efforts to mitigate declining financial and health literacy may promote independence and wellbeing in old age.
Collapse
Affiliation(s)
- Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center (LY, DAB, PAB), Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center (LY, DAB), Chicago, IL, USA.
| | - Gary Mottola
- FINRA Investor Education Foundation (GM), Washington DC, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center (LY, DAB, PAB), Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center (LY, DAB), Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center (LY, DAB, PAB), Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center (PAB), Chicago, IL, USA
| |
Collapse
|
27
|
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.
Collapse
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.
| |
Collapse
|
28
|
Valdez R, Spinler K, Kofahl C, Seedorf U, Heydecke G, Reissmann DR, Lieske B, Dingoyan D, Aarabi G. Oral Health Literacy in Migrant and Ethnic Minority Populations: A Systematic Review. J Immigr Minor Health 2021; 24:1061-1080. [PMID: 34448993 PMCID: PMC9256555 DOI: 10.1007/s10903-021-01266-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 11/24/2022]
Abstract
Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs.
Collapse
Affiliation(s)
- R Valdez
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Spinler
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Kofahl
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - U Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Lieske
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Dingoyan
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
29
|
Serbim A, Paskulin L, Nutbeam D. Improving health literacy among older people through primary health care units in Brazil: feasibility study. Health Promot Int 2021; 35:1256-1266. [PMID: 31821454 DOI: 10.1093/heapro/daz121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There are only a small number of reported intervention studies to improve health literacy among older populations. This paper reports on a study designed to investigate the feasibility and potential impact on health literacy and health practices of embedding an intervention programme to improve health literacy with older people through established primary health care units (PHCUs) in a disadvantaged urban community in Brazil. This investigation utilized a quasi-experimental design, with 42 participants recruited for the intervention group and comparison group. The Alfa-Health Program was offered by a nurse in a PHCU as part of the public universal health system over a period of 5 months, and was compared for its impact on a range of health literacy and self-reported health outcomes with routine health care available for older people. The intervention achieved relatively high levels of participation, and positive feedback from participants. Some improvements in vaccination rates, health literacy and reported health behaviours related to food choices and physical activity were observed. The intervention made good use of existing facilities; the content and methods were well received by the participants. However, there were some difficulties in recruitment and in retention of participants. The study has demonstrated the practical feasibility of delivering a comprehensive health education programme designed to improve health literacy in a PHCU in Brazil.
Collapse
Affiliation(s)
- Andreivna Serbim
- Nursing School, Federal University of Alagoas (UFAL), Arapiraca Campus, Brazil
| | - Lisiane Paskulin
- Nursing School, Nursing Graduate Program, Federal University of Rio Grande do Sul (UFRGS), Brazil
| | - Don Nutbeam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| |
Collapse
|
30
|
Busse PJ, McDonald VM, Wisnivesky JP, Gibson PG. Asthma Across the Ages: Adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:1828-1838. [PMID: 32499032 DOI: 10.1016/j.jaip.2020.03.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 02/06/2023]
Abstract
Asthma is a common disease affecting approximately 300 million people worldwide, across all age ranges. Despite advances in asthma outcomes of the last few decades, there remains room for improvement in asthma management and for patient outcomes, particularly in older patients. The heterogeneity of asthma is now well recognized, and is known to complicate response to treatment and patient behavior and impact health outcomes. Asthma and its heterogeneity change according to age. Asthma affects people differently across the life span. In adults, prevalence is highest among those in middle age; however, mortality is greater in the older age group. In this clinical commentary, we describe how age impacts asthma prevalence and incidence, outcomes, disease expression, and approach to management in adulthood and in older patients.
Collapse
Affiliation(s)
- Paula J Busse
- Division of Allergy and Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, NSW, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, NSW, Australia; Viruses, Immunology, Vaccines, Asthma (VIVA) Programme, Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter G Gibson
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, NSW, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, NSW, Australia; Viruses, Immunology, Vaccines, Asthma (VIVA) Programme, Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| |
Collapse
|
31
|
Crespo TS, Andrade JMO, Lelis DDF, Ferreira AC, Souza JGS, Martins AMEDBL, Santos SHS. Adherence to medication, physical activity and diet among older people living with diabetes mellitus: Correlation between cognitive function and health literacy. IBRO Rep 2020; 9:132-137. [PMID: 33336106 PMCID: PMC7733141 DOI: 10.1016/j.ibror.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Diabetes mellitus (DM) is a public health problem, which requires enhanced self-care in order to avoid complications. However, cognitive impairment can reduce these abilities and may affect health literacy (HL) of patients in terms to understand and apply information. Therefore, this study evaluated the correlation between cognitive condition and HL related to medication adherence, physical activity and nutritional status among people living with DM. Methods A cross-sectional study was carried out among elderly people (≥ 60 years old) with DM. The cognitive condition was evaluated using the Mini-Mental State Examination (MMSE) and the HL using the following questionnaires: Literacy Assessment for Diabetes (LAD-60), Nutritional Literacy among People with Diabetes (NLD), Health Literacy on the Practice of Physical Activities among Diabetics (HLPPA - D), and Health Literacy regarding Drug Adherence among Diabetics (HLDA-D). Sociodemographic and biochemical profile was also evaluated. Spearman correlation was used (p < 0.05). Results 187 individuals with DM were included. Regarding laboratory analyses, insulin dosage had a mean value of 12.3 microUI/mL (SD: ±15.7), mean blood glucose was 148.1 mg/dl (SD: ±59.7) and mean HbA1c was 7.54 % (SD: ±1.8). In the correlation analysis, higher age and lower income were weakly correlated with lower cognitive level. No correlation was identified for biochemical variables and cognitive condition. A positive and weak correlation between cognition and HL was observed in the studied population. Conclusions In older people living with DM the cognitive condition is correlated to specific topics of HL (nutritional status, physical activity and medication adherence).
Collapse
Affiliation(s)
- Thaísa Soares Crespo
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Physiopathology, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - João Marcus Oliveira Andrade
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Nursing, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - Deborah de Farias Lelis
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - Alice Crespo Ferreira
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | | | - Andréa Maria Eleutério de Barros Lima Martins
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Dentistry, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
| | - Sérgio Henrique Sousa Santos
- Laboratory of Health Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Department of Dentistry, Center of Health and Biological Sciences, Montes Claros State University, Montes Claros, Minas Gerais, Brazil.,Institute of Agricultural Sciences. Food Engineering College, Federal University of Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
| |
Collapse
|
32
|
Slesinger NC, Yost KJ, Choi SW, Hahn EA. Validation of a Short Form for Health Literacy Assessment Using Talking Touchscreen Technology. Health Lit Res Pract 2020; 4:e200-e207. [PMID: 33034662 PMCID: PMC7544526 DOI: 10.3928/24748307-20200909-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/04/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Health literacy is an area of growing research and clinical interest, necessitating short, accurate measures of this complex construct. Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT) measures prose, document, and quantitative literacy by self-administration on a touchscreen computer. OBJECTIVE The objective of this study was to assess the validity of a short form of Health LiTT and to identify a meaningful cutoff score for adequate health literacy. METHODS A subsample of 137 participants from the Literacy and Cognitive Function among Older Adults study completed a 10-item Health LiTT short form and three interviewer-administered health literacy measures: Test of Functional Health Literacy in Adults (TOFHLA), Rapid Estimate of Adult Literacy in Medicine (REALM), and Newest Vital Sign (NVS). Convergent validity was assessed by correlating scores for all measures, and known-groups validity was assessed by comparing mean Health LITT scores across TOFHLA levels (inadequate, marginal, adequate). Internal consistency reliability was estimated with Cronbach's alpha. A cutoff score for adequate health literacy was established using the TOFHLA cutoff for adequate versus inadequate/marginal health literacy. KEY RESULTS Spearman correlations between Health LiTT scores and total TOFHLA, REALM, and NVS scores were 0.65, 0.69, and 0.56, respectively (all p < .001). Mean Health LiTT scores were significantly and meaningfully different across inadequate (40.4), marginal (50.1), and adequate (57.1) TOFHLA categories (F = 60.6; p < .001). Cronbach's alpha for the Health LiTT short form was .73. A cutoff score of 55 on Health LiTT showed acceptable sensitivity and specificity to identify adequate health literacy. CONCLUSIONS This 10-item Health LiTT short form demonstrated excellent convergent and known-groups validity and acceptable internal consistency reliability in older adults. The established cutoff also showed excellent sensitivity and specificity. Validation of other custom Health LiTT short forms with varying items from the bank and computer adaptive test-generated Health LiTT scores is ongoing. [HLRP: Health Literacy Research and Practice. 2020;4(4):e200-e207.] PLAIN LANGUAGE SUMMARY: This article provides evidence of the need for and psychometric properties of a valid and reliable short form of the flexible, technologically advanced Health Literacy Assessment Using Talking Touchscreen Technology measure, as well as a cutoff score to note adequate versus marginal/inadequate health literacy.
Collapse
Affiliation(s)
- Noël C. Slesinger
- Address correspondence to Noël C. Slesinger, MS, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 2700, Chicago, IL 60611;
| | | | | | | |
Collapse
|
33
|
Rohringer M, Kellerer JD, Fink C, Schulc E. The role of health literacy in orthopaedic rehabilitation after total knee and hip arthroplasty: A scoping review. Int J Orthop Trauma Nurs 2020; 40:100793. [PMID: 32988777 DOI: 10.1016/j.ijotn.2020.100793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/06/2020] [Accepted: 06/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Health literacy (HL) is a key aspect in empowering patient education as part of orthopaedic rehabilitation after total knee or hip arthroplasty (TKA/THA). OBJECTIVES This scoping review aims to demonstrate the prevalence of patient-related outcome measures in studies on the effectiveness of orthopaedic rehabilitation of older people after TKA/THA. The review also focuses on the identification of outcome measures that assess patients' HL or HL-related aspects. METHODS A scoping literature search was conducted using the JBI methodology for scoping reviews. The databases MEDLINE (PubMed), CINAHL Complete, The Cochrane Library, Academic Search Elite, and ERIC were searched with keywords and phrases to find relevant literature. Identified outcome measures were conceptually analysed in a peer reviewed procedure. Those with suspected HL-related content were analysed at item level. Text analyses were performed using MAXQDA. RESULTS 117 papers were included in this review. 45 patient-related outcome measures could be found, 2 of which assess HL-related aspects. No paper could be found that assessed patients' HL in orthopaedic rehabilitation after TKA/THA. CONCLUSIONS HL has hitherto been of limited importance in orthopaedic rehabilitation. Health professionals are responsible for assessing patients' health literacy and developing appropriate strategies for patient education in the context of orthopaedic rehabilitation.
Collapse
Affiliation(s)
- Matthias Rohringer
- UMIT Private University for Health Sciences, Medical Informatics and Technology, Department of Nursing Science and Gerontology, Tyrol, Austria.
| | - Jan Daniel Kellerer
- UMIT Private University for Health Sciences, Medical Informatics and Technology, Department of Nursing Science and Gerontology, Tyrol, Austria
| | - Christian Fink
- UMIT Private University for Health Sciences, Medical Informatics and Technology, Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Tyrol, Austria
| | - Eva Schulc
- UMIT Private University for Health Sciences, Medical Informatics and Technology, Department of Nursing Science and Gerontology, Tyrol, Austria
| |
Collapse
|
34
|
Horvat N, Kos M. Development, validation and performance of a newly designed tool to evaluate functional medication literacy in Slovenia. Int J Clin Pharm 2020; 42:1490-1498. [PMID: 32885323 DOI: 10.1007/s11096-020-01138-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 08/25/2020] [Indexed: 11/30/2022]
Abstract
Background Medication literacy refers to the ability of individuals to safely and appropriately access, understand and act on basic medication information. It is vital for correctly and safely using medications. General health literacy measures do not adequately address specific skills for medication literacy, and there are no general, self-administered, performance-based instruments for assessing patients' medication literacy. Objective The aim was to develop and validate a self-administered performance-based questionnaire measuring functional medication literacy and to evaluate functional medication literacy among the Slovenian general population. Setting A random sample of adult Slovenian residents received the questionnaires at their home addresses. Method The initial content was derived from medication counselling literature. Thirteen patients and 14 healthcare professionals provided feedback about its comprehensibility, comprehensiveness, and difficulty thus supporting content and face validity. The developed questionnaire, comprising 30 items divided into 5 categories (dosage, adverse effects, interactions, precautions, and other information), was sent to a random sample of 1500 adult Slovenian residents. The overall validity of the questionnaire was assessed via reliability, criterion and discriminant validity using the Kuder-Richardson Formula 20, multiple linear regression and Mann-Whitney test. Descriptive statistics were used to evaluate medication literacy. Main outcome measure The psychometric properties of the questionnaire (reliability, content, face, criterion, and discriminant validity); level of functional medication literacy. Results A total of 402 residents returned eligible questionnaires (26.8% response rate). The Kuder-Richardson Formula 20 reliability coefficient for the whole questionnaire was 0.823. One item that did not demonstrate discriminant validity was deleted. Criterion validity was supported by a significant association between age and medication literacy (β = - 0.303). Income (β = 0.243) and current self-perceived health (β = 0.187) also were associated with medication literacy. The median of medication literacy score was 24 out of 29 points. Dosage-related items requiring understanding of long text instructions and the use of numeracy skills received the most incorrect answers. Conclusion A performance-based questionnaire measuring functional medication literacy among a general population with supported validity was developed. Slovenian residents encountered difficulties when dealing with items requiring prose literacy and numeracy skills, especially related to dosing. Special attention should be paid to low-income elderly with poor self-perceived health.
Collapse
Affiliation(s)
- Nejc Horvat
- Department of Social Pharmacy, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Mitja Kos
- Department of Social Pharmacy, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
| |
Collapse
|
35
|
Bogza LM, Patry-Lebeau C, Farmanova E, Witteman HO, Elliott J, Stolee P, Hudon C, Giguere AMC. User-Centered Design and Evaluation of a Web-Based Decision Aid for Older Adults Living With Mild Cognitive Impairment and Their Health Care Providers: Mixed Methods Study. J Med Internet Res 2020; 22:e17406. [PMID: 32442151 PMCID: PMC7468645 DOI: 10.2196/17406] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 02/06/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is often considered a transitional state between normal and pathologic (eg, dementia) cognitive aging. Although its prognosis varies largely, the diagnosis carries the risk of causing uncertainty and overtreatment of older adults with MCI who may never progress to dementia. Decision aids help people become better informed and more involved in decision making by providing evidence-based information about options and possible outcomes and by assisting them in clarifying their personal values in relation to the decision to be made. Objective This study aimed to incorporate features that best support values clarification and adjust the level of detail of a web-based decision aid for individuals with MCI. Methods We conducted a rapid review to identify options to maintain or improve cognitive functions in individuals with MCI. The evidence was structured into a novel web-based decision aid designed in collaboration with digital specialists and graphic designers. Qualitative and user-centered evaluations were used to draw on users’ knowledge, clarify values, and inform potential adoption in routine clinical practice. We invited clinicians, older adults with MCI, and their caregivers to evaluate the decision aid in 6 consecutive rounds, with new participants in each round. Quantitative data were collected using the Values Clarity and Informed subscales of the Decisional Conflict Scale, the System Usability Scale, the Ottawa Acceptability questionnaire, and a 5-point satisfaction rating scale. We verified their comprehension using a teach-back method and recorded usability issues. We recorded the audio and computer screen during the session. An inductive thematic qualitative analysis approach was used to identify and describe the issues that arose. After each round, an expert panel met to prioritize and find solutions to mitigate the issues. An integrated analysis was conducted to confirm our choices. Results A total of 7 clinicians (social workers, nurses, family physicians, psychologists) and 12 older (≥60 years) community-dwelling individuals with MCI, half of them women, with education levels going from none to university diploma, were recruited and completed testing. The thematic analysis revealed 3 major issues. First, the user should be guided through the decision-making process by tailoring the presentation of options to users’ priorities using the values clarification exercise. Second, its content should be simple, but not simplistic, notably by using information layering, plain language, and pictograms. Third, the interface should be intuitive and user friendly, utilize pop-up windows and information tips, avoid drop-down menus, and limit the need to scroll down. The quantitative assessments corroborated the qualitative findings. Conclusions This project resulted in a promising web-based decision aid that can support decision making for MCI intervention, based on the personal values and preferences of the users. Further ongoing research will allow its implementation to be tested in clinical settings.
Collapse
Affiliation(s)
- Laura-Mihaela Bogza
- Laval University Research Centre on Community-Based Primary Health Care, Quebec, QC, Canada.,Quebec Centre for Excellence on Aging, Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC, Canada
| | - Cassandra Patry-Lebeau
- Quebec Centre for Excellence on Aging, Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC, Canada
| | - Elina Farmanova
- Quebec Centre for Excellence on Aging, Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Holly O Witteman
- Laval University Research Centre on Community-Based Primary Health Care, Quebec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC, Canada
| | - Jacobi Elliott
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Paul Stolee
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Carol Hudon
- School of Psychology, Laval University, Québec, QC, Canada
| | - Anik M C Giguere
- Laval University Research Centre on Community-Based Primary Health Care, Quebec, QC, Canada.,Quebec Centre for Excellence on Aging, Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC, Canada
| |
Collapse
|
36
|
Shayakhmetov SS, Toguzbayeva KK, Ismailova AA, Tabibi R, Derbishalieva ZK, Dzhusupov KO. Health Literacy of Rural Population of Kazakhstan. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1269-1277. [PMID: 33083293 PMCID: PMC7548489 DOI: 10.18502/ijph.v49i7.3580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND To date, there is no data available of health literacy of the population in Kazakhstan. This study was aimed to assess the health literacy of the rural population for the development of the targeted health education programs. METHODS The adapted HLS-EU-Q47 survey was carried out among 1650 respondents aged 18-76 from rural settlements in Almaty region of Kazakhstan in 2013. The health literacy competences to assess, understand, appraise and apply health information on healthcare, disease prevention and health promotion were measured. The associations between the health literacy competencies and demographic and socio-economic characteristics were shown through a multiple linear regression analysis. RESULTS The overall health literacy rate of the rural population of Almaty region was problematic and inadequate. With regards to their age, sex, social and economic characteristics, the health literacy competencies differ according to health literacy domain. Respondents with low education level or perceived social status had respectively low health literacy scores, especially in appraising and applying information of disease prevention. CONCLUSION Low educated people and with lower income have lower health literacy in comparison to respondents with higher education level and higher income. Respondents with higher health literacy have higher rate of self-assessed health.
Collapse
Affiliation(s)
- Syrym S Shayakhmetov
- Department of Public Health, Semey State Medical University, Semey, Republic of Kazakhstan
| | - Karlygash K Toguzbayeva
- Department of Nutrition and Preventive Medicine, JSC National Medical University, Almaty, Republic of Kazakhstan
| | - Aigul A Ismailova
- Department of Ecology, Seyfullin Agrotechnical University, Nur-Sultan, Republic of Kazakhstan
| | - Ramin Tabibi
- School of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Kenesh O Dzhusupov
- Department of Public Health, International School of Medicine, Bishkek, Kyrgyzstan
| |
Collapse
|
37
|
Stewart CC, Yu L, Lamar M, Wilson RS, Bennett DA, Boyle PA. Associations of health and financial literacy with mortality in advanced age. Aging Clin Exp Res 2020; 32:951-957. [PMID: 31273677 DOI: 10.1007/s40520-019-01259-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/24/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Health and financial literacy are central to older adults' well-being and financial standing, but the relation of literacy with mortality in advanced age remains unclear. AIMS To determine whether lower literacy, as reflected in measures of total literacy and subscales of health and financial literacy, was associated with an increased risk of mortality. METHODS Participants were 931 community-based older adults from the Rush Memory and Aging Project [age: mean (SD) = 80.9 (7.6), range 58.8-100.8], an ongoing, prospective observational cohort study of aging. Participants were without dementia at the time literacy was assessed. Proportional hazards models were used to determine whether literacy measures were associated with mortality. RESULTS During up to 8 years of follow-up, 224 (24.1% of 931) participants died. In models that adjusted for age, sex, and education, lower total, health, and financial literacy were each associated with an increased risk of mortality (total literacy: HR = 1.020, 95% CI 1.010-1.031, p < 0.001; health literacy: HR = 1.015, 95% CI 1.008-1.023, p < 0.001; financial literacy: HR = 1.013, 95% CI 1.003-1.023, p = 0.014). These associations persisted after additionally adjusting for income and indices of health status; however, only the association of lower health literacy with mortality persisted after further adjusting for a robust measure of global cognition. DISCUSSION We suspect that the current associations of lower literacy with mortality reflect the detrimental effect of early pathologic brain aging on literacy. CONCLUSIONS Lower literacy, particularly lower health literacy, is associated with mortality in advanced age.
Collapse
Affiliation(s)
- Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine, 355 W. 16th St. (GH 4222), Indianapolis, IN, 46202, USA.
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
38
|
Stormacq C, Van den Broucke S, Wosinski J. Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review. Health Promot Int 2020; 34:e1-e17. [PMID: 30107564 DOI: 10.1093/heapro/day062] [Citation(s) in RCA: 339] [Impact Index Per Article: 84.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
While socioeconomic disparities are among the most fundamental causes of health disparities, socioeconomic status (SES) does not impact health directly. One of the potential mediating factors that link SES and health is health literacy (HL). Yet although HL can be considered a modifiable risk factor of socioeconomic disparities in health, the relationship between SES, HL and health disparities is not well understood. This study reviewed the evidence regarding the mediating role of HL in the relationship between socioeconomic and health disparities. Medline, Cinahl, Embase, PsychInfo, Eric, Web of Science, Google, Google Scholar, Mednar, Doaj and Worldcat were used to retrieve studies that specifically addressed socioeconomic and socio-demographic factors related to low HL levels, as well as the mediating role of HL in the relationship between SES and disparities in health outcomes. Selected studies were assessed for methodological quality. Sixteen published studies were retained for inclusion and content analyzed using the constant comparison method. The review indicates that disadvantaged social and socioeconomic conditions contribute to low HL levels, whereby low SES, and particularly educational attainment, is the most important determinant of HL, and that HL mediates the relationship between SES and health status, quality of life, specific health-related outcomes, health behaviors and use of preventive services. HL can be considered as a modifiable risk factor of socioeconomic disparities in health. Enhancing the level of HL in the population or making health services more accessible to people with low HL may be a means to reach a greater equity in health.
Collapse
Affiliation(s)
- Coraline Stormacq
- Faculty of Public Health, Catholic University of Louvain, Clos Chapelle-aux-Champs 30, B-1200 Bruxelles, Belgium.,Institut et Haute Ecole de Santé La Source, HES-SO, University of Applied Sciences and Arts Western Switzerland, Avenue Vinet 30, CH-1004 Lausanne, Switzerland
| | - Stephan Van den Broucke
- Faculty of Psychology and Educational Sciences, Psychological Sciences Research Institute (IPSY), Catholic University of Louvain, Place du Cardinal Mercier 10, B-1348 Louvain-la-Neuve, Belgium
| | - Jacqueline Wosinski
- Institut et Haute Ecole de Santé La Source, HES-SO, University of Applied Sciences and Arts Western Switzerland, Avenue Vinet 30, CH-1004 Lausanne, Switzerland
| |
Collapse
|
39
|
Saremi M, Shekaripour ZS, Khodakarim S. Guessability of U.S. pharmaceutical pictograms in Iranian prospective users. Pharm Pract (Granada) 2020; 18:1705. [PMID: 32256894 PMCID: PMC7104798 DOI: 10.18549/pharmpract.2020.1.1705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/08/2020] [Indexed: 02/03/2023] Open
Abstract
Objective: This study examined the gueassability of US pharmaceutical pictograms as well
as associated demographic factors and cognitive design features among
Iranian adults. Methods: A total of 400 participants requested to guess the meaning of 53 US
pharmaceutical pictograms using the open-ended method. Moreover, the
participants were asked to rate the cognitive design features of each
pictorial in terms of familiarity, concreteness, simplicity, meaningfulness
and semantic closeness on a scale of 0-100. Results: The average guessability score (standard deviation) was 66.30 (SD=24.59).
Fifty-five percent of pharmaceutical pictograms understudy met the
correctness criteria of 67% specified by ISO3864, while only
30% reached the criterion level of 85% set by ANSIz535.3. Low
literate participants with only primary school education had substantial
difficulty in the interpretation of pharmaceutical pictograms compared to
those completed higher education levels. Younger adults of <30 years
significantly performed better in the interpretation of pharmaceutical
pictograms as compared to >31 years old participants. ‘Home
patient care’ and ‘daily medication use’ had no effect
on guessability performance. Concerning cognitive design features,
meaningfulness better predict geussability score compared to the others. Conclusions: Several USP pictograms fail to be correctly interpreted by Iranian users and
need to be redesigned respecting cognitive design features. Interface
designers are recommended to incorporate more familiar and concrete elements
into their graphics in order to create more meaningful pictorial symbols and
to avoid any misinterpretation by the user. Much effective medication use is
expected to be achieved by means of this approach, through the improvement
of the communication property of pharmaceutical pictograms.
Collapse
Affiliation(s)
- Mahnaz Saremi
- PhD. Associate Professor. Workplace Health Promotion Research Center and School of Public Health and Safety, Shahid Beheshti University of Medical Sciences. Tehran (Iran).
| | - Zeinab S Shekaripour
- MSc. School of Public Health and Safety, Shahid Beheshti University of Medical Sciences. Tehran (Iran).
| | - Soheila Khodakarim
- PhD. Associate Professor. School of Public Health and Safety, Shahid Beheshti University of Medical Sciences. Tehran (Iran).
| |
Collapse
|
40
|
Factors Associated with Health Literacy among the Elderly People in Vietnam. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3490635. [PMID: 32309429 PMCID: PMC7139882 DOI: 10.1155/2020/3490635] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/08/2019] [Accepted: 03/13/2020] [Indexed: 11/17/2022]
Abstract
Background There is a lack of information regarding health literacy (HL) in elderly people in Vietnam. Objective The aim of this study was to evaluate the health literacy and the associated factors in elderly people in Vietnam. Methods A cross-sectional study was conducted on a sample of 300 elderly people aged 55 years and above. Data were obtained from study participants using face-to-face interviews using designed questionnaires on sociodemographics, behaviors, and health literacy. Multiple linear regression models were performed to identify potential determinants of health literacy. Results HL scores were 29.70 ± 8.20 for the general HL dimension, 32.00 ± 9.60 for the healthcare dimension, 21.97 ± 10.06 for the disease prevention dimension, and 35.15 ± 9.43 for the health promotion dimension. In the final model, age was negatively associated with HL (B - coefficient = -0.09, 95% confidence interval (95% CI) (-0.17 to -0.008), P = 0.030). Occupation (B = 4.77, 95% CI (3.18 to 6.36), P < 0.001), taking care of children (B = 1.68, 95% CI (0.21 to 3.15), P = 0.025), social activity (B = 4.61, 95% CI (2.86 to 6.37), P < 0.001), doing exercises (B = 2.52, 95% CI (1.07 to 3.96), P = 0.001), television watching (B = 2.10, 95% CI (0.75 to 3.45), P = 0.002), using the Internet (B = 2.93, 95% CI (1.29 to 4.57), P = 0.001), and social connection (B = 3.50, 95% CI (1.23 to 5.78), P = 0.003) were positively associated with HL, respectively. Conclusion Age, occupation, and a number of behaviors were significantly associated with HL in elder people. Health education campaigns should take into account the above factors as facilitating access to the Internet and providing opportunities for social networks for the elderly.
Collapse
|
41
|
Merchant RC, Marks SJ, Clark MA, Carey MP, Liu T. Limited Ability of Three Health Literacy Screening Items to Identify Adult English- and Spanish-Speaking Emergency Department Patients With Lower Health Literacy. Ann Emerg Med 2020; 75:691-703. [PMID: 32200999 DOI: 10.1016/j.annemergmed.2020.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 01/11/2020] [Accepted: 01/15/2020] [Indexed: 10/24/2022]
Abstract
STUDY OBJECTIVE Brief, easily administered, and valid health literacy assessment tools are needed to optimize health care delivery in the emergency medicine setting. Three health literacy screening items have been proposed to assess health literacy in outpatient settings. We investigated their ability to identify English- and Spanish-speaking adult emergency department (ED) patients with lower health literacy. METHODS Participants were Spanish- or English-speaking adult patients randomly selected from 4 geographically spread, US, urban, safety-net EDs. Participants completed the 3 health literacy screening items, as well as the Short Assessment of Health Literacy-Spanish and English (SAHL-S&E). Test performance characteristics, including receiver operating characteristics area under the curve, of the 3 health literacy screening items were estimated, as compared with the SAHL-S&E. RESULTS According to the SAHL-S&E, 36% of the 1,165 English speakers and 35% of the 1,605 Spanish speakers had lower health literacy. Areas under the curve for each health literacy screening item individually were: needing others to help read materials (English 0.59, 95% confidence interval [CI] 0.56 to 0.62; Spanish 0.58, 95% CI 0.56 to 0.61), problems learning because of difficulty reading (English 0.63, 95% CI 0.60 to 0.66; Spanish 0.59, 95% CI 0.56 to 0.62), and confidence with completing forms (English 0.62, 95% CI 0.59 to 0.65; Spanish 0.60, 95% CI 0.57 to 0.63). Areas under the curve for the 3 screening items combined were: English 0.66 (95% CI 0.63 to 0.70) and Spanish 0.62 (95% CI 0.59 to 0.64). CONCLUSION The 3 health literacy screening items performed poorly in identifying adult ED patients with lower health literacy. Higher-validity screening measures are needed to better serve the health care needs of this vulnerable population in the ED setting.
Collapse
Affiliation(s)
- Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Sarah J Marks
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Melissa A Clark
- Department of Health Services Policy and Practice, School of Public Health, Brown University, Providence, RI; Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
| | - Tao Liu
- Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI
| |
Collapse
|
42
|
Kobayashi R, Ishizaki M. Relationship Between Health Literacy and Social Support and the Quality of Life in Patients With Cancer: Questionnaire Study. J Particip Med 2020; 12:e17163. [PMID: 33064103 PMCID: PMC7434077 DOI: 10.2196/17163] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/29/2020] [Accepted: 02/23/2020] [Indexed: 01/09/2023] Open
Abstract
Background Low health literacy is associated with factors such as not taking medication as prescribed as well as poor health status and increased hospitalization and mortality risk, and has been identified as a risk factor for decreased physical function in older individuals. Health literacy is becoming an increasingly important issue because of the increased number of people affected by cancer who must make complicated treatment decisions. Health literacy has been shown to be positively associated with quality of life (QOL), and social support has been identified as important for addressing health-related problems and reducing the relative risk of mortality in patients with cancer. However, few studies have examined the relationship between health literacy, social support, age, and QOL. Objective The aim of this study is to examine the effects of health literacy, social support, and age on the QOL of patients with cancer. Methods An anonymous, self-administered online questionnaire was conducted from March 28 to 30, 2017, in Japan on patients with lung, stomach, or colon cancer that were voluntarily registered with an internet survey company. The survey covered basic attributes, health literacy, social support, and QOL. The European Health Literacy Survey Questionnaire, a comprehensive measure of health literacy instrument, was used to measure health literacy; the Japanese version of the Social Support Scale was used to measure social support; and the Japanese version of the Functional Assessment of Cancer Therapy-General (7-item version) assessment tool was used to measure QOL. Results A total of 735 survey invitations were randomly sent to patients with lung, stomach, or colorectal cancer, and responses were obtained from 619 (82.2% response rate). Significant effects on the QOL in patients with lung, stomach, or colon cancer were observed for health literacy, social
support, and age, and for the interactions of health literacy and social support and of social support and age. Health literacy, social support, and the interaction between these variables also showed a significant effect on the QOL in patients 50 years or older, but not on those younger than 50 years. Conclusions The results of this study revealed that higher health literacy, social support, and age were associated with the QOL in patients with cancer. In addition, the relationship with QOL was stronger for social support than for health literacy. These findings suggest the importance of health literacy and social support and indicate that social support has a greater effect on QOL than does health literacy, while the QOL in patients with cancer aged younger than 50 years was lower than that of those 50 years or older. Therefore, elucidating the needs of these patients and strengthening social support based on those needs may improve their QOL.
Collapse
Affiliation(s)
- Rei Kobayashi
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Masato Ishizaki
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
43
|
Rudd RE. Health Literacy Considerations for a New Cancer Prevention Initiative. THE GERONTOLOGIST 2020; 59:S7-S16. [PMID: 31100142 PMCID: PMC6524755 DOI: 10.1093/geront/gnz032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Indexed: 11/17/2022] Open
Abstract
Cancer prevention efforts are newly focused on the older adult population. Adult literacy and health literacy findings and suggestions can help shape more efficacious health communication strategies and thereby increase the “accessibility” of important health information and the potential for healthful action. National and international surveys of adult literacy skills have consistently offered problematic findings that older adults have more limited proficiencies than do younger working adults and face difficulties using commonly available materials to accomplish everyday tasks. Clinical as well as population-based studies of health literacy similarly find limited health literacy among a majority of U.S. adults and even poorer health literacy among older adults. This is of concern because health literacy studies have established clear links between limited literacy and poor health outcomes as well as diminished participation in activities related to disease prevention. Literacy experts note difficulties associated with abstract concepts and with sophisticated numeracy tasks, both associated with disease prevention. Health literacy findings and insights are important considerations in the development of health messages and materials to promote cancer prevention among older adults.
Collapse
Affiliation(s)
- Rima E Rudd
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
44
|
Cheng C, Rodner CM. Associations Between Insurance Type and the Presentation of Cubital Tunnel Syndrome. J Hand Surg Am 2020; 45:26-32. [PMID: 31610906 DOI: 10.1016/j.jhsa.2019.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 05/17/2019] [Accepted: 07/23/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE In the setting of cubital tunnel syndrome (CuTS), delays in diagnosis can have permanent effects including sensory loss, muscle weakness, and atrophy of intrinsic hand muscles. This study sought to evaluate the association of insurance type on the severity of CuTS. We hypothesized that publicly insured patients will have delayed presentation to the orthopedics office and more significant condition severity. METHODS A retrospective chart review was conducted for all patients evaluated for CuTS between December 2013 and January 2018 by a fellowship-trained orthopedic hand and upper extremity surgeon at our tertiary referral center. Insurance type, demographics, and measures of CuTS severity were compared. RESULTS Patients presenting with CuTS of severity greater than or equal to McGowan stage 2A had 4.4-fold greater odds of being publicly insured than privately. Motor and sensory velocities across the elbow were diminished at 42.2 ± 13.9m/s and 33.0 ± 20.8m/s in publicly insured patients compared with 47.5 ± 11.3 m/s and 47.0 ± 16.4m/s for privately insured patients. The same trend was present for motor and sensory amplitudes at 6.6 ± 3.8 μV and 16.9 ± 17.8 μV in publicly insured patients compared with 8.5 ± 3.2 μV and 26.0 ± 18.9 μV in privately insured patients. Patients with public insurance were symptomatic for longer prior to their initial visit, on average 82.8 ± 86.5 weeks, compared with 42.4 ± 58.9 weeks for patients with private insurance. CONCLUSIONS Publicly insured patients were significantly delayed in seeing an orthopedic surgeon for evaluation and treatment of CuTS and presented with more severe clinical and electrodiagnostic findings compared with privately insured patients. These findings suggest that insurance type, among other socioeconomic factors, may be a barrier to CuTS care. TYPE OF STUDY/LEVEL OF EVIDENCE Prevalence IV.
Collapse
Affiliation(s)
- Christopher Cheng
- Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT
| | - Craig M Rodner
- Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT.
| |
Collapse
|
45
|
Affiliation(s)
- Matteo Farinella
- Presidential Scholar in Society and Neuroscience, Columbia University, New York, New York, USA
| | | |
Collapse
|
46
|
Scotté F, Bossi P, Carola E, Cudennec T, Dielenseger P, Gomes F, Knox S, Strasser F. Addressing the quality of life needs of older patients with cancer: a SIOG consensus paper and practical guide. Ann Oncol 2019; 29:1718-1726. [PMID: 30010772 DOI: 10.1093/annonc/mdy228] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Around 60% of people living with cancer are aged 65 years or older. Older cancer patients face a unique set of age-associated changes, comorbidities and circumstances that impact on their quality of life (QoL) in ways that are different from those affecting younger patients. A Task Force of the International Society of Geriatric Oncology recommends and encourages all healthcare professionals involved in cancer care to place greater focus on the QoL of older people living with cancer. This paper summarizes current thinking on the key issues of importance to addressing QoL needs of older cancer patients and makes a series of recommendations, together with practical guidance.
Collapse
Affiliation(s)
- F Scotté
- Department of Medical Oncology and Supportive Care, Foch Hospital, Suresnes, France.
| | - P Bossi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Carola
- Groupe Hospitalier Public Sud de L'Oise, Creil, France
| | - T Cudennec
- Service de Médecine Gériatrique, HU-PIFO site Ambroise Paré, AP-HP, Boulogne Billancourt, France
| | - P Dielenseger
- Département des Innovations Thérapeutiques et Essais Précoces, Gustave Roussy Cancer Campus, French Oncology Nursing Society, Paris, France
| | - F Gomes
- Medical Oncology Department, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - S Knox
- EUROPA DONNA - The European Breast Cancer Coalition, Milan, Italy
| | - F Strasser
- Oncological Palliative Medicine, Clinic Medical Oncology and Hematology, Department of Internal Medicine, Cantonal Hospital St Gallen, St Gallen, Switzerland
| |
Collapse
|
47
|
Tilburt JC, O Byrne T, Branda ME, Phelan S. Higher BMI associated with shorter visits in male oncology patients: An exploratory analysis. PATIENT EDUCATION AND COUNSELING 2019; 102:2353-2357. [PMID: 31331706 PMCID: PMC6851463 DOI: 10.1016/j.pec.2019.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/28/2019] [Accepted: 07/09/2019] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To determine the potential relationship between measures of patient-provider communication and patient body mass index (BMI) and gender in cancer care. METHODS We audio-recorded cancer patients' communication with their clinicians in an academic medical oncology practice from 2012-2014. We coded audio-recordings with the Roter Interaction Analysis System. We then examined whether BMI was associated with patient centeredness, time with doctor, global affect, and patient self-reported communication quality. Univariate associations with BMI were assessed with Chi-square and Kruskal-Wallis tests. A cumulative logit model adjusted for patient and visit characteristics in a multivariable model. RESULTS We recorded 327 patient interactions with 37 clinicians. After adjusting for patient sex, and visit characteristics, visit length, patient-centeredness, global affect (patient or clinician) and satisfaction did not differ. However, higher BMI was associated with shorter visit length, and lower Negative Global Affect (p = 0.03 and p = 0.03, respectively) in men only. CONCLUSION In this exploratory analysis, communication characteristics did not vary by patient BMI overall. However, in men, higher BMI was associated with shorter visit length and more negative affect. Those differences did not persist after adjusting for multiple comparisons. PRACTICE IMPLICATIONS Patient body size may contribute to clinical communication in cancer care, particularly for obese men.
Collapse
Affiliation(s)
- Jon C Tilburt
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Healthcare Policy and Research, Mayo Clinic, Rochester, MN, USA; Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA.
| | - Thomas O Byrne
- Division of Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Megan E Branda
- Department of Biostatistics and Informatics, Colorado School of Public Health, Denver, CO, USA
| | - Sean Phelan
- Division of Healthcare Policy and Research, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
48
|
Baker-Goering MM, Howard DH, Will JC, Beeler Asay GR, Roy K. Association Between Self-Reported Hypertension and Antihypertensive Medication Use and Cardiovascular Disease-Related Events and Expenditures Among Patients Diagnosed With Hypertension. Public Health Rep 2019; 134:493-501. [PMID: 31404507 DOI: 10.1177/0033354919864363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Research suggests that persons who are aware of the risk factors for cardiovascular disease (CVD) are more likely to engage in healthy behaviors than persons who are not aware of the risk factors. We examined whether patients whose insurance claims included an International Classification of Diseases, Ninth Revision (ICD-9) code associated with hypertension who self-reported high blood pressure were more likely to fill antihypertensive medication prescriptions and less likely to have CVD-related emergency department visits and hospitalizations (hereinafter, CVD-related events) and related medical expenditures than patients with these codes who did not self-report high blood pressure. METHODS We used a large convenience sample from the MarketScan Commercial Database linked with the MarketScan Health Risk Assessment (HRA) Database to identify patients aged 18-64 in the United States whose insurance claims included an ICD-9 code associated with hypertension and who completed an HRA from 2008 through 2012 (n = 111 655). We used multivariate logistic regression analysis to examine the association between self-reported high blood pressure and (1) filling prescriptions for antihypertensive medications and (2) CVD-related events. Because most patients with hypertension will not have a CVD-related event, we used a 2-part model to analyze medical expenditures. The first part estimated the likelihood of a CVD-related event, and the second part estimated expenditures. RESULTS Patients with an ICD-9 code of hypertension who self-reported high blood pressure had a significantly higher predicted probability of filling antihypertensive medication prescriptions (26.5%; 95% confidence interval, 25.7-27.3; P < .001), had a significantly lower predicted probability of a CVD-related event (0.6%, P < .001), and on average spent significantly less on CVD-related events ($251, P = .01) than patients who did not self-report high blood pressure. CONCLUSION This study affirms that self-knowledge of high blood pressure, even among patients who are diagnosed and treated for hypertension, can be improved. Interventions that improve patients' awareness of their hypertension may improve antihypertensive medication use and reduce adverse CVD-related events.
Collapse
Affiliation(s)
- Madeleine M Baker-Goering
- 1 Policy Research Analysis and Development Office, Office of the Associate Director for Policy, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David H Howard
- 2 Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie C Will
- 3 Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Garrett R Beeler Asay
- 1 Policy Research Analysis and Development Office, Office of the Associate Director for Policy, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kakoli Roy
- 1 Policy Research Analysis and Development Office, Office of the Associate Director for Policy, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
49
|
Abstract
Visual representation methods have long been used as tools to communicate information in health education settings, and their effect on improving health literacy has been investigated. The question arises: How should an illustration function in relation to the textual information it illustrates? Medical illustrations are likely to be featured in media such as brochures and textbooks. If the textual information in such materials is so complex, what function should illustrations play? We reviewed the sociological literature on illustrations to obtain findings potentially applicable to health education and the improvement of health literacy. We then evaluated these tools to determine the types of illustrations that are suitable for the information. Of the three topics for which we developed the materials-cancer, food allergies and HEV light-only for the HEV light topic were earlier findings replicated. One key factor behind this result was that the illustrations for the HEV topic underwent a more thorough deliberative process than those for the other two topics. The results of our study also highlight the importance of third-party opinion in the illustration design process.
Collapse
Affiliation(s)
- Makiko Haragi
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate Student Care Path Support Centre, Institute for General Education, Ritsumeikan University, Kyoto, Japan
| | - Hirono Ishikawa
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Social and Behavioural Sciences/Health Communication, Graduate school of Public Health, The Teikyo University, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
50
|
Hochhauser M, Brusovansky M, Sirotin M, Bronfman K. Health literacy in an Israeli elderly population. Isr J Health Policy Res 2019; 8:61. [PMID: 31291986 PMCID: PMC6621944 DOI: 10.1186/s13584-019-0328-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 06/13/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Health literacy is important for patients' comprehension of the health and medical messages conveyed to them and their meaning for them so that they can better manage their health. The aim of the study was to examine the level of health literacy within the elderly population. The hypothesis was that health literacy would be inadequate, and related to demographic variables. METHOD Sixty men and women over the age of 65 who volunteered to participate in the study completed a 13-item health literacy questionnaire. RESULTS Overall, the level of health literacy among the participants was mostly inadequate. They reported difficulty in reading medical material in Hebrew and understanding the doctor, thus requiring assistance (20%); difficulty in reading medical documents, completing medical forms and understanding medical terms; difficulty in reading the leaflet attached to medications (33%), test results (40%) and medical information written in English (66%) and difficulty searching the internet for information (53.3%). The level of health literacy was associated with education while the best profile for adequate health literacy was for those who spoke Hebrew and completed secondary education. CONCLUSIONS Medical teams have an obligation to be alert and attentive to the level of health literacy of elderly patients and to modify communication and information to an accommodating degree, so that elderly patients can better manage their health.
Collapse
Affiliation(s)
- Michal Hochhauser
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ramat Hagolan 65, 4070000 Ariel, Israel
| | | | | | - Katerina Bronfman
- Loewenstein Hospital, Rehabilitation center in Ra’anana, Ra’anana, Israel
| |
Collapse
|