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Moore C, Gallagher P, Dunne S. Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers. Front Psychol 2024; 15:1283227. [PMID: 38434952 PMCID: PMC10904647 DOI: 10.3389/fpsyg.2024.1283227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.
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Affiliation(s)
- Chloe Moore
- School of Psychology, Dublin City University, Dublin, Ireland
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Sadeghian R, Hamedani MA, Salehipour S, Sarabandi A, Kiani F, Babamohamadi H. The health literacy level and its related factors in Iranian women with breast cancer undergoing chemotherapy. Front Public Health 2023; 11:1150148. [PMID: 37841736 PMCID: PMC10568019 DOI: 10.3389/fpubh.2023.1150148] [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: 01/23/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Background Breast Cancer (BC) is the most common cause of female mortality throughout the world. Promoting public awareness about this disease is the most crucial method of its prevention or control. The present study was carried out to determine the health literacy level and its related factors in women with BC. Methods This cross-sectional study was conducted on BC patients undergoing chemotherapy in two teaching hospitals affiliated to Zahedan University of Medical Sciences in 2020. A total of 210 patients referred to these chemotherapy centers were selected by purposive sampling. The data collection tools included a demographic information form and a health literacy questionnaire for Iranian women with BC. The collected data were analyzed using descriptive and inferential statistics (logistic regression) in SPSS-22. p-values less than 0.05 were considered statistically significant. Results The mean total score of the health literacy of women with BC undergoing chemotherapy was 40.35 ± 19.01, which suggests an insufficient health literacy. The health literacy had a significant relationship with variables including university education (OR = 4.41, p = 0.005) and supplementary insurance coverage (OR = 5.83, p < 0.001). Conclusion The findings showed that university education and supplementary insurance coverage are associated with a higher health literacy among women with BC. Improving these factors and paying further attention to their role in the promotion of health literacy can help enhance the health literacy of women with BC.
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Affiliation(s)
- Reyhaneh Sadeghian
- Department of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Mahsa Asadollahi Hamedani
- Department of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Sajad Salehipour
- Department of Nursing, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
| | - Anahita Sarabandi
- Department of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fatemeh Kiani
- Department of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hassan Babamohamadi
- Department of Nursing, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
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Chang JE, Lindenfeld Z, Chang VW. Obesity and Patient Activation: Confidence, Communication, and Information Seeking Behavior. J Prim Care Community Health 2022; 13:21501319221129731. [PMID: 36222682 PMCID: PMC9561656 DOI: 10.1177/21501319221129731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION/OBJECTIVES Patient activation describes the knowledge, skills, and confidence that allow patients to actively engage in managing their health. Prior studies have found a strong relationship between patient activation and clinical outcomes, costs of care, and patient experience. Patients who are obese or overweight may be less engaged than normal weight patients due to lower confidence or stigma associated with their weight. The objective of this study is to examine whether weight status is associated with patient activation and its sub-domains (confidence, communication, information-seeking behavior). METHODS This repeated cross-sectional study of the 2011 to 2013 Medicare Current Beneficiary Survey (MCBS) included a nationally representative sample of 13,721 Medicare beneficiaries. Weight categories (normal, overweight, obese) were based on body mass index. Patient activation (high, medium, low) was based on responses to the MCBS Patient Activation Supplement. RESULTS We found no differences in overall patient activation by weight categories. However, compared to those with normal weight, people with obesity had a higher relative risk (RRR 1.24; CI 1.09-1.42) of "low" rather than "high" confidence. Respondents with obesity had a lower relative risk (RRR 0.82; CI 0.73-0.92) of "low" rather than "high" ratings of communication with their doctor. DISCUSSION AND CONCLUSIONS Though patients with obesity may be less confident in their ability to manage their health, they are more likely to view their communication with physicians as conducive to self-care management. Given the high receptivity among patients with obesity toward physician communication, physicians may be uniquely situated to guide and support patients in gaining the confidence they need to reach weight loss goals.
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Affiliation(s)
- Ji Eun Chang
- New York University, New York, NY,
USA,Ji Eun Chang, College of Global Public
Health, New York University, 708 Broadway, New York, NY 10003, USA.
| | | | - Virginia W. Chang
- New York University, New York, NY,
USA,NYU Grossman School of Medicine, New
York, NY, USA
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Kanu C, Brown CM, Rascati K, Moczygemba LR, Mackert M, Wilfong L. General versus disease-specific health literacy in patients with breast cancer: a cross-sectional study. Support Care Cancer 2022; 30:5533-5538. [PMID: 35316403 DOI: 10.1007/s00520-022-06988-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/13/2022] [Indexed: 11/25/2022]
Abstract
Health literacy is recognized as a critical factor affecting communication across the continuum of cancer care and plays a key role in patients' ability to meaningfully discuss their condition with healthcare providers. However, there is no consensus on the best approach to measure health literacy in clinical practice. The aims of this study were to compare general and disease-specific measurements of health literacy in patients with breast cancer as well as examine their relationships with patient-provider communication. During office visits, patients with HER-2 + breast cancer who received care at oncology clinics with value-based models of care completed a survey including the 6-item cancer health literacy tool (CHLT-6), 6-item newest vital sign (NVS), 2 items measuring difficulty of patient-provider communication, and 11 demographic/clinical items. The mean age of 146 participants was 57.1 ± 10.8 years. Most participants had adequate general health literacy as measured by the NVS (79%) and a high probability of adequate cancer health literacy (≥ 0.7) as measured by the CHLT-6 (92%). Most patients easily communicated with healthcare providers (90.2%) and understood information they provided (83.5%). However, there was no significant relationship between patient-provider communication and health literacy. Both the CHLT-6 and NVS may be useful tools to assess the health literacy of patients with cancer in clinical practice. Study findings of adequate health literacy and ease of communication might have been influenced by the value-based care models adopted by participating clinics. Further research in more diverse samples of patients with cancer and different types of oncology practice settings is warranted.
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Affiliation(s)
- Chisom Kanu
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA.
| | - Carolyn M Brown
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Karen Rascati
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | | | - Michael Mackert
- Moody College of Communication, University of Texas at Austin, Austin, TX, USA
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Hoadley A, Bass SB, Chertock Y, Brajuha J, D’Avanzo P, Kelly PJ, Hall MJ. The Role of Medical Mistrust in Concerns about Tumor Genomic Profiling among Black and African American Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052598. [PMID: 35270290 PMCID: PMC8909390 DOI: 10.3390/ijerph19052598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/13/2022]
Abstract
Tumor genomic profiling (TGP) is used in oncology practice to optimize cancer treatment and improve survival rates. However, TGP is underutilized among Black and African American (AA) patients, creating potential disparities in cancer treatment outcomes. Cost, accuracy, and privacy are barriers to genetic testing, but medical mistrust (MM) may also influence how Black and AA cancer patients perceive TGP. From December 2019 to February 2020, 112 Black and AA adults from two outpatient oncology sites in Philadelphia, PA without a known history of having TGP testing conducted completed a cross-sectional survey. Items queried included sociodemographic characteristics, clinical factors, patient-oncologist relationship quality, medical mistrust, and concerns about TGP. A k-means cluster analysis revealed two distinct psychographic clusters: high (MM-H) versus low (MM-L) medical mistrust. Clusters were not associated with any sociodemographic or clinical factors, except for age (MM-H patients older than MM-L patients, p = 0.006). Eleven TGP concerns were assessed; MM-H patients expressed greater concerns than MM-L patients, including distrust of the government, insurance carriers, and pharmaceutical companies. TGP concerns varied significantly based on level of medical mistrust, irrespective of sociodemographic characteristics. Targeted communications addressing TGP concerns may mitigate disparities in TGP uptake among those with medical mistrust.
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Affiliation(s)
- Ariel Hoadley
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA; (S.B.B.); (J.B.); (P.D.); (P.J.K.)
- Correspondence:
| | - Sarah Bauerle Bass
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA; (S.B.B.); (J.B.); (P.D.); (P.J.K.)
| | - Yana Chertock
- Fox Chase Cancer Center, Cancer Prevention and Control Program, Department of Clinical Genetics, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (Y.C.); (M.J.H.)
| | - Jesse Brajuha
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA; (S.B.B.); (J.B.); (P.D.); (P.J.K.)
| | - Paul D’Avanzo
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA; (S.B.B.); (J.B.); (P.D.); (P.J.K.)
| | - Patrick J. Kelly
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA 19122, USA; (S.B.B.); (J.B.); (P.D.); (P.J.K.)
| | - Michael J. Hall
- Fox Chase Cancer Center, Cancer Prevention and Control Program, Department of Clinical Genetics, 333 Cottman Avenue, Philadelphia, PA 19111, USA; (Y.C.); (M.J.H.)
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