Information seeking behavior and perceived health literacy of family caregivers of persons living with a chronic condition. The case of spinal cord injury in Switzerland

Pregnancy, Childbirth and Puerperium in Women with Spinal Cord Injury: Guideline of the DGGG and DMGP (S2k-Level, AWMF Registry No. 179/002, August 2024

This guideline on pregnancy, childbirth and puerperium for women with spinal cord injury (SCI) presents general issues relating to the wish to have children and pregnancy in the context of SCI. The guideline was developed by the German-speaking Medical Society for Paraplegia ( Deutschsprachige Medizinische Gesellschaft für Paraplegiologie , DMGP) and the German Society for Gynecology and Obstetrics ( Deutsche Gesellschaft für Gynäkologie und Geburtshilfe , DGGG). As there were no generally available evidence-based guidelines about this complex set of problems, this new guideline aims to standardize procedures using a structured consensus-of-experts approach. The aim is to establish general interdisciplinary standards and provide practical assistance for the care and counseling of women with SCI who wish to have children/are pregnant and thereby close the identified gaps in medical care, information, interdisciplinary cooperation and research.

A cross-sectional study based on the Comprehensive Model of Information seeking: which factors influence health information-seeking behavior in patients with periodontitis

BACKGROUND

To investigate the current status of health information-seeking behavior (HISB) of periodontitis patients, and to identity its main influencing factors using the Comprehensive Model of Information Seeking (CMIS).

METHODS

In total, 274 periodontitis patients were recruited from a specialized dental hospital in Hangzhou by purposive sampling method for a cross-sectional study. Demographics, direct experience, salience, beliefs, characteristics and utility were 6 variables of CMIS. Data were collected from the patients by using the general information questionnaire, the Health Information Seeking Behavior Scale, the Self-Efficacy Scale for Self-care (SESS) for measuring belief, the Short Form of Health Literacy Dental Scale (HeLD⁃14) for measuring direct experience, and the Brief Illness Perception Questionnaire (BIPQ) for measuring salience. Univariate analysis and regression analysis were utilized to determine the factors influencing the HISB.

RESULTS

The HISB score of periodontitis patients in this study was 3.68 ± 0.40. The low level of HISB was negatively associated with multiple factors, including age of 40 ~ 59 (odds ratio [OR] 0.041, 95% confidence interval [CI] 0.006-0.299), age of 18 ~ 39 (OR 0.053, 95%CI 0.008-0.364), low level of understandability of information (characteristic) [OR 0.317, 95%CI 0.119-0.840] and low level of satisfaction of information (utility) [OR 0.027, 95%CI 0.008-0.089]. However, low level of HISB was positively correlated with medium self-efficacy level [OR 3.112, 95% CI 1.463-6.747] and low self-efficacy level [OR 8.061, 95% CI 1.981-32.807].

CONCLUSIONS

According to the CMIS model, we identified several factors influencing health-seeking behaviors (HISB). Lower levels of HISB are closely associated with older age and lower level of understandability and satisfaction of information. Conversely, higher self-efficacy may encourage patients to seek health information more actively. Therefore, it is essential to focus on elderly patients and assess their information expectations and needs in a timely manner, while also working to enhance their self-efficacy to promote more effective access to health information.

Patients' Perspective in Hereditary Ataxia

Hereditary ataxia represents a heterogeneous group of rare disorders with the chronic progression of motor symptoms that often become debilitating. Many forms include additional neurological, cognitive, or other symptoms. Most of these disorders lack specific treatment. We aimed to investigate aspects of patients' quality of life, experiences, and expectations. Patients with a diagnosis of hereditary ataxia were identified from our center's diagnostic register, direct referrals, and from a patient organization. We designed a questionnaire with 32 multiple-choice or open-ended questions on disability and impairment of daily life activities, the perceived effect of symptomatic and supportive therapies, coping strategies, and how they used and experienced various sources of information about their neurological disease. We also included the EQ-5D-3L quality-of-life instrument. Results were analyzed statistically for gender, age, and groups with and without a genetic diagnosis, and were compared to published data from the general population. Seventy-five patients returned the questionnaire. Patients reported considerable disease-related disability and impairment and had significantly lower quality-of-life scores than the general population. Physiotherapy and support from family or friends were important for patients' overall well-being. Patients with a genetic diagnosis had a lower average age at onset and felt more well-informed about their disease than patients without a genetic diagnosis. Patients used internet sources but relied primarily on their doctors to obtain information about their disease. Our study provides insights into hereditary ataxia patients' experiences that can lead to improvements in medical and nursing care for these patients.

Perceived eHealth literacy and health literacy among people with spinal cord injury: A cross-sectional study

OBJECTIVES

This purpose of this research was to (1) to evaluate eHealth and general health literacy levels among individuals with spinal cord injury (SCI) and (2) to identify relationships between eHealth literacy, general health literacy, and various sociodemographic factors.

DESIGN

Cross-sectional.

SETTING

The study was conducted in the community setting.

PARTICIPANTS

As part of a larger study, a total of 50 community-dwelling individuals with SCI were recruited.

INTERVENTIONS

n/a.

OUTCOME MEASURES

Quantitative online survey data were collected on participants' sociodemographic characteristics, eHealth literacy (using the eHealth Literacy Scale), general health literacy (using the Brief Health Literacy Screening Tool).

RESULTS

The average age of participants was 49 years old; 25 participants were male and 25 were female. A total of 39 participants experienced traumatic SCI and 11 participants experienced non-traumatic SCI. Participants demonstrated moderate levels of eHealth literacy (31.6 out of 40) and general health literacy (17.6 out of 20). A significant, positive correlation was found between eHealth literacy and general health literacy. Significant, positive correlations were found between general health literacy and sociodemographic factors, including income and education. A significant, negative correlation was found between general health literacy and time since injury.

CONCLUSION

No previous studies we are aware of have evaluated perceived eHealth literacy and general health literacy among people with SCI. This study demonstrated the diverse range of eHealth literacy levels in SCI populations and how this, and other factors, may impact an individual's ability to self-manage and adopt to eHealth technologies.

Health Information Sourcing and Health Knowledge Quality: Repeated Cross-sectional Survey

Background

People’s health-related knowledge influences health outcomes, as this knowledge may influence whether individuals follow advice from their doctors or public health agencies. Yet, little attention has been paid to where people obtain health information and how these information sources relate to the quality of knowledge.

Objective

We aim to discover what information sources people use to learn about health conditions, how these sources relate to the quality of their health knowledge, and how both the number of information sources and health knowledge change over time.

Methods

We surveyed 200 different individuals at 12 time points from March through September 2020. At each time point, we elicited participants’ knowledge about causes, risk factors, and preventative interventions for 8 viral (Ebola, common cold, COVID-19, Zika) and nonviral (food allergies, amyotrophic lateral sclerosis [ALS], strep throat, stroke) illnesses. Participants were further asked how they learned about each illness and to rate how much they trust various sources of health information.

Results

We found that participants used different information sources to obtain health information about common illnesses (food allergies, strep throat, stroke) compared to emerging illnesses (Ebola, common cold, COVID-19, Zika). Participants relied mainly on news media, government agencies, and social media for information about emerging illnesses, while learning about common illnesses from family, friends, and medical professionals. Participants relied on social media for information about COVID-19, with their knowledge accuracy of COVID-19 declining over the course of the pandemic. The number of information sources participants used was positively correlated with health knowledge quality, though there was no relationship with the specific source types consulted.

Conclusions

Building on prior work on health information seeking and factors affecting health knowledge, we now find that people systematically consult different types of information sources by illness type and that the number of information sources people use affects the quality of individuals’ health knowledge. Interventions to disseminate health information may need to be targeted to where individuals are likely to seek out information, and these information sources differ systematically by illness type.

The Impact of an Evidence-Informed Spinal Cord Injury Activities of Daily Living Education Manual (SADL-eM): Protocol for a Randomized Controlled Trial

BACKGROUND

Spinal cord injury (SCI) is a catastrophic injury associated with functional loss and life-threatening complications. Many people with SCI in the Gaza Strip of Palestine are discharged from inpatient rehabilitation to the community while still lacking many daily life skills. This randomized controlled trial (RCT) seeks to test the impact of the Spinal Cord Injury Activities of Daily Living Education Manual (SADL-eM)-an evidence-based occupational therapy patient educational intervention-on rehabilitation outcomes.

OBJECTIVE

The proposed trial aims to evaluate the SADL-eM intervention compared with standard treatment among people with SCI.

METHODS

This is a parallel RCT with two study arms: intervention and control. A total of 90 patients treated in inpatient rehabilitation settings will be randomly allocated to two study groups. Both groups will receive standard care. The intervention group will also use the SADL-eM with their treating occupational therapist during rehabilitation. The SADL-eM is a comprehensive activities of daily living (ADL) educational tool that was codeveloped with people with SCI and stakeholders across Gaza. The self-report version of the Spinal Cord Independence Measure will be used on admission (ie, baseline measure) and after 6 weeks as the primary outcome measure. Secondary outcomes include the third version of the Spinal Cord Independence Measure, the Private Religiousness Practices Scale, the Organizational Religiousness Short-Form, additional ADL domains covered by the education manual, and adherence to the intervention. The effect of the intervention will be determined using repeated-measures analysis of variance.

RESULTS

This study will be conducted from April 2021 through December 2022, with results expected to be available in January 2023.

CONCLUSIONS

If the SADL-eM is demonstrated as clinically effective, this will have significant implications for occupational therapy interventions in low- and middle-income countries.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04735887; https://clinicaltrials.gov/ct2/show/NCT04735887.

Collective caregivers: A novel examination of health literacy management approaches

OBJECTIVE

Health literacy and communication skills are necessary for family caregivers who often work in pairs, known as collective caregiving. Health literacy management is a relational process where communication between caregivers can be a barrier or pathway to improving or co-creating health literacy. The purpose of this study was to examine how collective caregivers manage health literacy.

METHODS

Semi-structured interviews were conducted separately for 42 caregiving pairs (n = 84). The interview guide was developed using a cancer caregiver health literacy framework. Caregiving pairs were placed into one of three collective caregiving communication patterns (absolute concordant, semi-concordant, absolute discordant). Interviews were audio-recorded, transcribed, and a thematic analysis was performed by independent coders.

RESULTS

The analysis revealed three different health literacy management approaches: a defined approach where caregiver roles were clearly designated (absolute concordant pairs); a contrasting approach where one caregiver was the health literacy expert (semi-concordant pairs); an independent approach characterized by individual information seeking, processing, and patient/provider engagement (absolute discordant pairs).

CONCLUSIONS

Health literacy support should address aspects of the family system such as caregiver-caregiver communication which influence variance in health literacy management. Practice implications Our study can inform provider communication and healthcare interventions aimed at supporting health literacy for caregivers.

The information trust formation process for informal caregivers of people with dementia: a qualitative study

Purpose

This paper provides new insights on trust formation during information-seeking processes of informal caregivers of people with dementia and identifies the sources of information deemed as trustworthy by caregivers.

Design/methodology/approach

The study adopts a phenomenological qualitative approach in the form of in-depth, semi-structured interviews with a sample of 20 informal caregivers.

Findings

Caregivers trust sources that are perceived as authoritative and particularly value the information and advice provided by other caregivers. Trust in information can be divided into subjective and objective, but both are important precursors to the actual use of the information. The information available to caregivers is sufficient in quantity but inadequate in terms of ease of use, clarity and usefulness. Often, some key information needs remain unsatisfied due to the lack of timeliness, relevance and personalisation of the information.

Practical implications

This paper provides recommendations for information and healthcare providers on how to improve communication and information relevance for informal caregivers of people with dementia.

Originality/value

This paper contributes to a more comprehensive perspective on caregivers’ information trust formation processes, which takes into account both the characteristics of the information and caregivers’ individual factors.