Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review

From Novel Facial Measurements to Facial Implantology: A Systematic Review

Background

Facial implants have emerged as pivotal tools for both reconstructive and aesthetic skull bone augmentation. Contemporary manufacturing techniques, such as computer-aided design and manufacturing (CAD-CAM) systems, have revolutionized facial implants production, providing the advantages of high-level individualization. However, the absence of standardized facial measurements complicates the ability to accurately compare outcomes across various techniques. This systematic review investigates the strengths and limitations of various facial measurements employed in facial implants, with a particular focus on their impact on aesthetic outcomes and potential complications.

Methods

We identified 13 studies in our comprehensive search across PubMed/MEDLINE, Web of Science, EMBASE, and CENTRAL databases.

Results

In total, 620 patients were included. The majority of the chosen studies focused on aesthetic purposes (69%). Primarily, mandibular (46%) or nasal regions (23%) were investigated, with porous polyethylene (31%), silicone (23%), and polyetheretherketone (23%) being the most utilized materials. Despite considerable heterogeneity in measurement approaches, including variations in reference points and angles, complications such as surgical site infections and nerve-related injuries were reported in the included studies.

Conclusion

Our review highlights the importance of standardized facial analysis for optimal implant planning. Future research should prioritize the development of uniform measurement concepts tailored to diverse implant applications to enhance outcomes and patient satisfaction in facial implantation.

[Measuring health literacy: methods and tools for assessing general health literacy in adults]

The measurement of health literacy (HL) began in the 1990s with instruments that focused on a functional understanding of HL. Since then, the understanding of HL and the measurement of HL have evolved. This article reviews two particularly well-validated instruments for measuring comprehensive general health literacy: The Health Literacy Questionnaire (HLQ) and the HLS19-Q12 questionnaire.The HLQ consists of nine scales with a total of 44 items covering different HL aspects of coping with illness. The HLQ has been validated in numerous studies and translated into 47 languages. It has high content and criterion validity and is used, for example, in the WHO European Action Network on Health Literacy for Prevention and Control of Noncommunicable Diseases and in the European Joint Action on Cardiovascular Diseases and Diabetes (JACARDI). The nine scales can be used to create HL profiles of strengths and challenges.The HLS19-Q12 is a short questionnaire to measure general HL and is based on the HLS19-Q47. It consists of 12 items, has been validated in more than 20 countries, and has been translated into more than 30 languages. The HLS19-Q12 also has high content and criterion validity and is used in the Health Literacy Surveys of the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) and the European Joint Action Prevent Non-Communicable Diseases. Based on the 12 items, a total score is calculated that can be categorized into four levels of HL.In order to create a comparable database in the long run, it is recommended that these two instruments be used in studies, evaluations, and monitoring of HL.

Health literacy enhancement through food guide and hygiene education: a study among Taiwanese students

The World Health Organization defined health as 'a condition of full physical, mental and social well-being'. Nutrition and food safety are intertwined and two of the most influential determinants of human health. This study primarily aimed to design and implement a specialized curriculum focused on food hygiene, and Taiwan's daily food guide to enhance health literacy among junior high students in Taiwan. A student-centered approach, based on active learning and constructivist principles, was used to engage students in interactive discussions and hands-on activities related to dietary guidelines and food hygiene. Four classrooms, with a total of 92 students, participated in this study. The students were randomized into a control group (n = 46) and an experimental group (n = 46). The average age ranged from 13 to 15 years. An illustrated questionnaire underwent pilot testing and expert review, followed by pre- and post-intervention assessments to measure knowledge improvements. The results showed a significant connection between the Taiwan daily food guide and health literacy. Although food hygiene education played a lesser role, the intervention improved students' health literacy, supporting positive health outcomes. In addition, recognizing the lack of suitable assessment tools in this field, we developed a reliable and valid illustrated questionnaire to measure the effectiveness of the intervention and track changes in students' knowledge. The questionnaire demonstrated high internal consistency (Cronbach's alpha of 0.883) and strong inter-rater reliability (intraclass correlation factor above 0.7), confirming its effectiveness as a tool for educational research.

Development and Preliminary Validation of a Screener for Digital Health Readiness

Importance

While telehealth use has grown, patient uptake is variable, which has the potential to increase health disparities. Identifying and understanding individuals' barriers to digital health readiness can help health systems efficiently deploy resources to provide personalized patient-centered support.

Objective

To develop and validate an instrument to evaluate digital health readiness to identify and quantify barriers to digital readiness.

Design, Setting, and Participants

In this qualitative mixed-methods study conducted from April 26, 2022, to June 8, 2023, the instrument was created in 4 phases. Patients and health care professionals were interviewed to explore barriers to telehealth use, scale items were developed for the screener, cognitive interviews were conducted to refine scale items, and psychometric properties of the screener were evaluated. The study was conducted in an urban, multisite academic health system and the surrounding community. Participants were older than 18 years, English-speaking, and able to provide informed consent. Professionals worked within the Jefferson Health system and were involved in telehealth services.

Exposure

Participants completed a semistructured interview (duration: 6-19 minutes), a cognitive interview (duration: 13-137 minutes), or the draft screener survey (duration: 5-10 minutes).

Main Outcomes and Measures

Development and validation of a screener for digital health readiness.

Results

Of 519 patients approached, 19 were ineligible, 122 declined, and 11 were excluded from analysis, resulting in inclusion of 367 participants (32 patient interviews, 16 professional interviews, 15 cognitive interviews, 304 psychometric survey testing). All 16 professionals who were approached participated. Most patient participants were Black (46.7%) or White (37.9%), male (56.4%), and had a high school degree or some college (49.6%); mean (SD) age was 45 (23) years for participants in cognitive interviews, 53 (18) years for survey respondents, and 57 (14) years for patient interviews. The structured interviews uncovered 21 concepts, leading to 48 items that were refined through cognitive interviews. Psychometric analyses of the 29 items that emerged from the cognitive interviews resulted in a final screener with 24 items across 2 factors: technical readiness (18 items; factor loading range, 0.488-0.968) and quality-of-care concerns (6 items; factor loading range, 0.619-0.942).

Conclusions and Relevance

In this qualitative study of digital health readiness, the findings suggest that the screener items may be valid to assess the complexity of factors influencing digital health uptake and highlight several areas for potential intervention.

Accuracy of Healthcare Professionals' Estimations of Health Literacy and Numeracy of Patients Visiting Metabolic Bariatric Surgery Clinic

INTRODUCTION

To effectively support patients through their weight loss journey, it is vital that healthcare professionals (HCPs) understand the health literacy skills of their patients and communicate in a way that meets these needs. This is the first study looking at the accuracy of HCPs' estimations of their patients' health literacy and numeracy attending a metabolic bariatric surgery (MBS) clinic.

METHOD

A cross-sectional study was completed at a tertiary-level MBS clinic in London. Patients completed a demographic questionnaire and a validated measure of health literacy and numeracy, the Medical Term Recognition Test (METER) and General Health Numeracy Test-Short Form (GHNT-6), respectively. HCPs provided estimations of their patient's health literacy and numeracy based on each questionnaire's scoring categories.

RESULTS

Data was collected for 31 patients. A 80.6% of patients had functional health literacy based on METER. HCPs estimated patients' health literacy correctly 61.1% of the time; inter-rater agreement was poor (ICC = 0.14; 95% CI =  - 0.19, 0.443; p = 0.202). A total of 22.6% of patients scored 0 out of 6 on GHNT-6. HCPs estimated health numeracy correctly 13.9% of the time and were more likely to overestimate than underestimate health numeracy. Inter-rater agreement for health numeracy was poor (ICC =  - 0.2; 95% CI =  - 0.49, 0.14; p = 0.878).

CONCLUSION

There is poor agreement between HCPs' perception of their patients' health literacy and numeracy and their assessed ability. HCPs' understanding of their patient's health literacy and numeracy skills is vital in ensuring HCPs can support patients through the challenging bariatric surgical pathway, consenting process and post-operative course.

The effect of emergency department history on health literacy level and role of digital literacy: An observational study

In this research, it was aimed to evaluate the effect of emergency department history on health literacy level and the role of digital literacy. A total of 454 participants were subjected to survey including health literacy scale, the digital literacy scale, and the demographic information form. Participants were divided into 2 groups as emergency medicine service (EMS) history (n = 269) and no EMS history (n = 185) groups. Health literacy, attitude, cognitive, and total digital literacy level of EMS history group were significantly higher than no EMS history group (P < .05). Social dimension of digital literacy scale was significantly higher in no EMS history group (P < .05). In no EMS history group, health literacy was significantly correlated with attitude (r = 0.298; P < .01), technical (r = 0.157; P < .01), cognitive (r = 0.369; P < .01), social (r = -0.302; P < .01) dimensions, and total score of digital literacy (r = 0.213; P < .01). In EMS history group, health literacy was significantly correlated with attitude (r = 0.553; P < .01), technical (r = 0.488; P < .01), cognitive (r = 0.555; P < .01) dimensions, and total score of digital literacy (r = 0.514; P < .01). Digital literacy had significant and positive effect on health literacy for all participants (OR = 0.126; P < .01), no EMS history (OR = 0.059; P < .01) and EMS history group (OR = 0.191; P < .01). People's health literacy skills are positively impacted if they have ever received medical attention from EMS units, regardless of the reason. Furthermore, among those who have used emergency medical services in the past, the impact of digital literacy on health literacy is statistically substantially larger.

Translation and Validation of Digital Competence Indicators in Greek for Health Professionals: A Cross-Sectional Study

BACKGROUND

it is widely accepted that living in the digital transformation era, the need to develop and update new professional skills and tools in health sectors is crucially important. Therefore, this study aimed to explore the reliability and validity of the Digital Competence Indicators tool in assessing the digital skills of Greek health professionals.

METHODS

in this cross-sectional study, 494 health professionals, including doctors (175) and registered nurses (319) working in four Greek hospitals were recruited and willingly participated using a convenience-sampling method. The original framework of Digital Competence Indicators was translated from English to Greek based on guidelines for cross-cultural adaptation of questionnaires. The validity of the tool was explored using confirmatory factor analysis (CFA) to verify the fit of the model using inductive techniques. The instrument reliability was confirmed using Cronbach's alpha (α) and McDonald's Omega coefficients.

RESULTS

the reliability was estimated at 0.826 (Cronbach's-α) and 0.850 (McDonald's Omega-ω). The indicators of CFA were all calculated within an ideal range of acceptance. Specifically, the CFA comparative fit index produced the following adjustment indices: x2/df = 1.152 (p = 0.037), CFI = 0.997, Lewis index (TLI) = 0.966, and root mean square error of approximation (RMSEA) = 0.018.

CONCLUSIONS

The present study demonstrated that the Digital Competence Indicator instrument has high reliability, internal consistency, and construct validity and, therefore, it is suitable for measuring digital skills of health professionals.

The effect of yoga on insomnia and quality of life among nursing professionals during COVID-19: A pre-post-test interventional study

Background

The coronavirus disease 2019 (COVID-19) pandemic has taken a toll on the well-being and quality of life (QoL) of healthcare professionals, especially nurses. Insomnia, a common consequence of the pandemic, adds to the physical and mental strain on healthcare workers.

Aim

This study aimed to assess the impact of workplace yoga intervention on insomnia severity and QoL among female nursing and healthcare professionals during the pandemic.

Methods

A pre-post-interventional study was conducted among 173 nursing professionals working in a hospital setting. Baseline assessments collected age, body mass index (BMI), insomnia severity using the Insomnia Severity Index (ISI), and QoL using the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF). A 6-week workplace yoga intervention was conducted by trained professionals, followed by posttest assessments.

Results

Among 173 participants, 57 had insomnia. Participants without significant insomnia had higher QoL scores (P < 0.001). Following the yoga intervention, both subthreshold and moderate clinical insomnia groups experienced reduced insomnia severity (P < 0.001). Quality-of-life scores in the physical, psychological, and environmental domains improved significantly (P < 0.05).

Conclusion

Workplace yoga intervention appears to be a promising approach to alleviate insomnia and enhance QoL among female nursing and healthcare professionals during the COVID-19 pandemic. Implementing tailored workplace yoga programs can play a crucial role in promoting the well-being and resilience of healthcare workers, contributing to a positive work environment and improved patient care outcomes.