Acceptance of illness mediate the effects of health literacy on self-management behaviour

Background: Self-management is crucial for blood pressure control and subsequent disease prevention. Health literacy and acceptance of illness may contribute to self-management behaviour; in addition, acceptance of illness may mediate the effects of health literacy on self-management behaviour among patients with hypertension. Objective: The aims of the research were to examine whether health literacy and acceptance of illness were associated with both pharmacological and non-pharmacological management behaviour and examine the possible mediating effects of the acceptance of illness in patients with hypertension. Methods: Hierarchical regression analysis was conducted to analyse the relationships between health literacy, acceptance of illness, pharmacological and non-pharmacological management behaviours. Mediation effects were examined by the PROCESS macro. Results: This was a cross-sectional study. A total of 478 hypertensive patients completed measures of health literacy, acceptance of illness, self-management, social support, depression, physical function and demographic and clinical characteristics. Functional, communicative, critical health literacy and acceptance of illness showed positive associations to pharmacological and non-pharmacological management behaviour. Acceptance of illness mediated the relationships between three types of health literacy, pharmacological and non-pharmacological management but the effects size and pathway differed. In detail, functional health literacy influenced pharmacological and non-pharmacological management behaviour mainly by indirect effects mediated by the acceptance of illness, but communicative and critical health literacy influenced pharmacological and non-pharmacological management behaviour mainly by direct effects. Conclusions: Acceptance of illness mediated the relationships between three types of health literacy and self-management. Health literacy and acceptance of illness should be addressed when taking measures to improve patients’ self-management behaviour.

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Validity and reliability of the Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale in patients undergoing bariatric surgery in Sweden: a prospective psychometric evaluation study

BMJ Open ◽

10.1136/bmjopen-2021-056592 ◽

2021 ◽

Vol 11 (11) ◽

pp. e056592

Author(s):

Maria Jaensson ◽

Erik Stenberg ◽

Yuli Liang ◽

Ulrica Nilsson ◽

Karuna Dahlberg

Keyword(s):

Bariatric Surgery ◽

Health Literacy ◽

Psychometric Evaluation ◽

Evaluation Study ◽

Functional Health ◽

Functional Health Literacy ◽

Validity And Reliability ◽

Factor Solution ◽

Cross Sectional ◽

Critical Health Literacy

ObjectivesThe aim was to psychometrically test and evaluate the Swedish functional health literacy scale and the Swedish communicative and critical health literacy scale in patients undergoing bariatric surgery.DesignA prospective cross-sectional psychometric study.SettingPatients from three bariatric centres in Sweden were consecutively included in this study.ParticipantsA total of 704 patients undergoing bariatric surgery filled in the questionnaires preoperatively. Inclusion criteria were scheduled for primary bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) and greater than 17 years, proficiency in Swedish.Primary and secondary measuresPsychometric outcomes of the Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale.ResultsThere was a higher proportion of females (74.4%, n=523) to males (25.6%, n=180). The mean age was 42 years (SD 11.5). Limited functional health literacy and limited communicative and critical health literacy (including both inadequate and problematic health literacy) was reported in 55% (n=390) and 40% (n=285), respectively. Cronbach alpha for the Swedish Functional Health Literacy scale was α=0.86 and for the Swedish Communicative and Critical Health Literacy scale, α=0.87. Construct validity showed weak to negative correlations between the Swedish Functional Health Literacy scale and income, education and SF-36/RAND36 summary scores. Confirmatory factor analysis showed a one-factor solution for the Swedish Functional Health Literacy scale and a two-factor solution for the Swedish Communicative and Critical Health Literacy scale.ConclusionsThe Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale are valid and reliable to use for patients undergoing bariatric surgery in a Swedish context. Measuring dimensions of health literacy can be used as a guide for the development of health literacy friendly patient information in patients undergoing bariatric surgery.

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Assessing Knowledge-Based and Perceived Health Literacy Among Japanese Adolescents: A Cross-Sectional Study

Global Pediatric Health ◽

10.1177/2333794x20944311 ◽

2020 ◽

Vol 7 ◽

pp. 2333794X2094431

Author(s):

Takashi Tsubakita ◽

Nobuo Kawazoe ◽

Mahoko Ichikawa ◽

Satoko Matsumoto ◽

Masumi Sugawara

Keyword(s):

High School Students ◽

Health Literacy ◽

Slight Modification ◽

Cross Sectional Study ◽

Functional Health ◽

School Students ◽

Cross Sectional ◽

Critical Health Literacy ◽

Knowledge Based ◽

Japanese Adolescents

Health literacy assessment is a major aspect of planning health education for adolescents. We evaluated the health literacy of Japanese adolescents using both perceived and knowledge-based health literacy scales. Study questionnaires were administered to 773 junior and senior high school students aged 12 to 18 years. We tested a model describing the hierarchical relations between functional, communicative, critical, and knowledge-based health literacy using path analysis. Critical health literacy was found to be influenced by functional, communicative, and knowledge-based health literacy, while functional and knowledge-based health literacy were correlated. The model, with slight modification, was supported. The result indicates that perceived functional health literacy scores did not directly correlate with higher perceived critical health literacy; rather, they only informed critical health literacy when participants had high knowledge-based health literacy.

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Effects of an eHealth Intervention on Patient-Provider Interaction and Functional Health Literacy in Adults With Hypertension

SAGE Open Nursing ◽

10.1177/23779608211005863 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110058

Author(s):

Ronald L. Hickman ◽

John M. Clochesy ◽

Marym Alaamri

Keyword(s):

Health Literacy ◽

Community Dwelling ◽

Attention Control ◽

Functional Health ◽

Self Management ◽

Functional Health Literacy ◽

Convenience Sample ◽

Management Interventions ◽

Modifiable Factors

Introduction Hypertension is a life-limiting, chronic condition affecting millions of Americans. Modifiable factors, quality of the patient-provider interaction and functional health literacy, have been linked to effective hypertension self-management. However, there has been limited interventional research targeting these modifiable factors. Electronic hypertension self-management interventions, in particular those incorporating virtual simulation, may positively influence the quality of the patient-provider interaction and functional health literacy status of adults with hypertension. Yet there is a dearth of evidence examining the efficacy of eHealth interventions targeting these modifiable factors of hypertension self-management. Objective Evaluate the effects of two electronic hypertension self-management interventions on the quality of the patient-provider interaction and functional health literacy in adults with hypertension. Methods A convenience sample of community-dwelling adults (>18 years) with hypertension were recruited and randomized to an avatar-based simulation (eSMART-HTN) or a video presentation on hypertension self-management (attention control). Participants were administered questionnaires to capture demographic characteristics, the quality of the patient-provider interaction, and functional health literacy. Questionnaire data were collected at baseline, and then monthly across three months. Two separate repeated measures analysis of covariance models were conducted to assess the effects of the interventions across the time points. Results The sample included 109 participants who were predominately middle-aged and older, nonwhite, and female. Scores for the quality of the patient-provider interaction demonstrated significant within-group changes across time. However, there were no significant differences in the quality of the patient-provider interaction or functional health literacy scores between experimental conditions while adjusting for covariates. Conclusion An avatar-based simulation (eSMART-HTN) intervention proved to have a positive effect on patient-provider interaction compared to an attention control condition. Although the results are promising, future research is needed to optimize the effectiveness of eSMART-HTN and enhance its efficacy and scalability in a larger cohort of adults with hypertension.

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Health Literacy of Parents and Carers in a Regional Community: A Cross-Sectional Study

International Quarterly of Community Health Education ◽

10.1177/0272684x211022572 ◽

2021 ◽

pp. 0272684X2110225

Author(s):

Matthew J. Leach ◽

Sue Nichols ◽

Sven Trenholm ◽

Martin Jones

Keyword(s):

Health Literacy ◽

Primary School ◽

Tertiary Education ◽

Functional Health ◽

Cross Sectional ◽

Healthy Development ◽

School Aged Children ◽

Australian Community ◽

Literacy Scores ◽

The Impact

Background Supporting a child’s healthy development is determined, in part, by a parent’s ability to seek, access, interpret and effectively utilize health information. This aspect of parenting draws on a set of skills referred to as health literacy. Objective To assess the level of health literacy among parents/carers in a regional South Australian community. Methods Parents/carers of primary school-aged children, residing in Whyalla, South Australia, were invited to complete the 13-item All Aspects of Health Literacy Survey. Results 155 parents/carers completed the survey (79% mothers). Most participants were English-speaking (97%), employed (62%) and had 2–3 children (62%), with 52% completing tertiary education. Median total health literacy scores were mostly in the moderate-high range (median 27, IQR 26,27), as were critical health literacy scores (median 7, IQR 6,8). Higher scores were reported for functional health literacy (median 8, IQR 7,9), communicative health literacy (median 9, IQR 8,9) and empowerment health literacy (median 4, IQR 3,5). Conclusions Our findings reveal modest levels of health literacy among a sample of parents/carers of primary school-aged children in a regional South Australian community. Further work is needed to understand the differential effect of parental health literacy on child health outcomes, and the types of strategies that may mitigate the impact of these barriers on a child’s healthy development.

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HEALTH LITERACY OF INDIVIDUALS UNDERGOING DIALYSIS THERAPY

Texto & Contexto - Enfermagem ◽

10.1590/1980-265x-tce-2017-0418 ◽

2019 ◽

Vol 28 ◽

Author(s):

Jéssica Naylla de Melo Bezerra ◽

Sara Rebeca de Oliveira Lessa ◽

Marcelo Francisco do Ó ◽

Givaneide Oliveira de Andrade Luz ◽

Anna Karla de Oliveira Tito Borba

Keyword(s):

Health Literacy ◽

Univariate Analysis ◽

Cross Sectional Study ◽

Functional Health ◽

P Value ◽

Functional Health Literacy ◽

Cross Sectional ◽

Exact Test ◽

Independent Variables ◽

Adequate Health Literacy

ABSTRACT Objective: to assess the functional levels of health literacy in individuals undergoing dialysis. Method: a cross-sectional study with 42 patients of the Nephrology Unit of a public hospital in Recife, Brazil, from May to August 2016. Data were collected through scripted interviews and chart analysis. Functional health literacy was measured using the Brazilian version of the Short-Test of Functional Health Literacy in Adults questionnaire. Data analysis was performed using the Statistical Package for Social Sciences (SPSS®) software, version 18.0, with a univariate analysis to verify the association between independent variables and functional health literacy levels using Fisher's exact test. Results: 80.9% of the patients presented inadequate health literacy and 19.1% presented adequate health literacy. The number of correct answers remained between 0-18 in the reading comprehension and in the scheduling appointment card. Among the independent variables, only marital status (p-value=0.018) and personal income (p-value=0.009) were factors associated with the worst scores in the test, indicating that these variables influence the increase in inadequate literacy. Conclusion: the prevalence of inadequate functional literacy was high, reflecting difficulties in understanding and processing health information, which may interfere with therapeutic management and self-care.

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Health Literacy in Female – Association with Socioeconomic Factors and Effects on Reproductive Health

Serbian Journal of Experimental and Clinical Research ◽

10.2478/sjecr-2018-0055 ◽

2020 ◽

Vol 21 (2) ◽

pp. 127-132

Author(s):

Milena Maricic ◽

Radmila Amanovic Curuvija ◽

Milos Stepovic

Keyword(s):

Health Literacy ◽

Reproductive Health ◽

Health Services ◽

Social Action ◽

Health Knowledge ◽

General Information ◽

Individual Characteristics ◽

Functional Health ◽

Cross Sectional ◽

Wide Range

AbstractThe aim of the study is to assess the health literacy of women who are using health services within the Gynecology Obstetric Clinic “Narodni Front” in Belgrade. Testing of health literacy was conducted as a cross-sectional study in the period October-November 2012. As instruments of research the following questionnaires are used: Short Test of Functional Health Literacy in Adults and General information questionnaire of respondents who referred to the demographic, social and economic characteristics of respondents, self-assessment of health, use of health services, health knowledge and behavior in the area of reproductive health. Inadequate health literacy level is registered in every ten respondents. The education level of the respondents proved to be a significant predictor of health literacy. Demographic and socio-economic characteristics of the patients (age, occupation, marital status) as well as self-evaluation of the health status were not significantly related to the health literacy. Health literacy respondents did not significantly dependent on risk behaviors related to reproductive health. The level of health literacy is consistent with the knowledge of subjects in the field of protection of reproductive health. Health literacy as the ability to function within the health care system is equally certain by individual characteristics and skills, characteristics of the health and education systems as well as a wide range of social and cultural factors. Health literacy is more systematic than individual problem, so it requires a broader social action.

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Role of Health Literacy on Menstrual Hygiene Practice among the Girl Students

Journal of Health Promotion ◽

10.3126/jhp.v7i0.25518 ◽

2019 ◽

Vol 7 ◽

pp. 83-90

Author(s):

Shanti Prasad Khanal

Keyword(s):

Health Literacy ◽

Functional Health ◽

Hygiene Practice ◽

Staff Nurse ◽

Cross Sectional ◽

Menstrual Hygiene ◽

Adequate Health Literacy ◽

Health Literacy Level ◽

Cross Sectional Design

The main aim of this study was to find out the role of health literacy on menstruation hygiene practice of campus girls. The population of this study were girls studying health and physical education in Surkhet Campus and HA/Staff Nurse in SEDA Campus. Surkhet was selected by proportional stratified sampling. This study followed descriptive and cross-sectional design. The study used two tools Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Self Administrated Questionnaire for collecting data. It was found that health literacy among girls of study area is not satisfactory. The findings indicate that 53.93 percent respondents have adequate health literacy. Adequate health literacy level of girls of HA/Staff nurse, aged 16-18 years and 19-21 years and Chhetri and Janajati had adequate health literary. The findings support that higher proportions of the adequate health literate respondents have good menstruation hygiene practice than inadequate health literate respondents. Finally, the results indicated that health literacy among the girls is inadequate, that calls more concern to the matter of health literacy in educational programs.

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Comprehension of the education handout and health literacy of pacemaker users

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2016-0336 ◽

2017 ◽

Vol 70 (3) ◽

pp. 633-639 ◽

Cited By ~ 2

Author(s):

Jackelline Evellin Moreira dos Santos ◽

Virginia Visconde Brasil ◽

Katarinne Lima Moraes ◽

Jacqueline Andréia Bernardes Leão Cordeiro ◽

Gabriela Ferreira de Oliveira ◽

...

Keyword(s):

Health Literacy ◽

Pearson Correlation ◽

Cardiac Pacemaker ◽

Cross Sectional Study ◽

Functional Health ◽

Care Process ◽

Functional Health Literacy ◽

Literacy Assessment ◽

Cognitive Changes ◽

Cross Sectional

ABSTRACT Objective: To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL). Method: Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated. Results: Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition. Conclusion: The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.

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Health literacy and adherence to treatment of patients with heart failure

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2017039803447 ◽

2019 ◽

Vol 53 ◽

Cited By ~ 2

Author(s):

Monica Isabelle Lopes Oscalices ◽

Meiry Fernanda Pinto Okuno ◽

Maria Carolina Barbosa Teixeira Lopes ◽

Ruth Ester Assayag Batista ◽

Cassia Regina Vancini Campanharo

Keyword(s):

Heart Failure ◽

Medication Adherence ◽

Health Literacy ◽

White Women ◽

Patient Adherence ◽

Functional Health ◽

Cross Sectional ◽

Adherence To Medication ◽

Patients With Heart Failure ◽

Medical Questionnaire

ABSTRACT Objective: To relate the level of functional health literacy with adherence and barriers to non-adherence, rehospitalization, readmission and death in patients with heart failure. Method: A cross-sectional, analytical study with patients admitted to the emergency room with a diagnosis of heart failure. Literacy was assessed by the Newest Vital Sign. Patient adherence to medication treatment and barriers to non-compliance were assessed 90 days after discharge by the Morisky-Green test and the Brief Medical Questionnaire, respectively. Results: 100 patients participated in the study. The mean age was 63.3 years (± 15.2), with a predominance of white women. Medication adherence was low in 41.1% of participants, of which 55.9% presented inadequate literacy. Re-hospitalization and death were present in patients with inadequate literacy (p<0.001). Conclusion: The low level of literacy was directly related to lower adherence and the presence of barriers to medication adherence, as well as higher rehospitalization rates and death.

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Pathways Linking Health Literacy to Self-Management in People with Type 2 Diabetes

Healthcare ◽

10.3390/healthcare9121734 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1734

Author(s):

Eun-Hyun Lee ◽

Young Whee Lee ◽

Duckhee Chae ◽

Kwan-Woo Lee ◽

Seongbin Hong ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Social Isolation ◽

Indirect Effect ◽

Self Efficacy ◽

Self Management ◽

Mediation Model ◽

Cross Sectional ◽

Management Interventions

Health literacy is considered to be an emerging determinant of health behaviors and outcomes. The underlying mechanisms linking health literacy to diabetes self-management are currently unclear. This study assessed a mediation model consisting of a direct pathway between health literacy and self-management, and indirect pathways via social isolation only, self-efficacy only, and social isolation and self-efficacy serially in people with type 2 diabetes. A cross-sectional design was employed, and a total of 524 participants were recruited from outpatient clinics of multi-institutions from June 2020 to February 2021. The mediation model was analyzed using the PROCESS macro on SPSS with bootstrap bias-corrected 95% confidence intervals (CIs) with 10,000 bootstrapping iterations. Health literacy positively affected self-management. The estimated indirect effect of health literacy on self-management via social isolation was significant, at 0.018 (95% CI = 0.004–0.036). The indirect effect via self-efficacy was estimated at 0.214 (95% CI = 0.165–0.266). The indirect effect via social isolation and self-efficacy serially was 0.013 (95% CI = 0.006–0.023). The findings of this study suggest that clinical practice can be improved through more comprehensive diabetes self-management interventions that promote all of the components of health literacy, social contacts/networks, and self-efficacy in particular.

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