scholarly journals A cross-sectional analysis of health literacy: patient- versus family doctor-reported and associations with self-efficacy and chronic disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stephanie Stock ◽  
Sibel Altin ◽  
Farah Nawabi ◽  
Daniele Civello ◽  
Arim Shukri ◽  
...  

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.

Author(s):  
Nevena Todorovic ◽  
Aleksandra Jovic-Vranes ◽  
Bosiljka Djikanovic ◽  
Natasa Pilipovic-Broceta ◽  
Nadja Vasiljevic ◽  
...  

Health literacy (HL) has become an important area of research. The aim of this study was to evaluate the HL of primary healthcare patients in the Republic of Srpska (RS), Bosnia and Herzegovina (B&H) and to identify socioeconomic and health factors associated with HL. This cross-sectional study among 768 patients was conducted in two healthcare centres between March and May 2017, using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Analysis was done using descriptive and inferential statistics (a chi-squared test and logistic regression). Inadequate and marginal HL was found in 34,6% of respondents. Socioeconomic and self-reported health factors were significantly related to HL. An age of 55 years and over (OR 1.02), living in a rural environment (OR 2.25), being divorced (OR 3.32), being insufficiently physically active (OR 1.29), having poor income (OR 1.96), having more than three chronic diseases (OR 1.94), and poor health (OR 1.59) were significantly corelated with inadequate and marginal HL. The results of our study indicate that a low level of HL is related to the elderly, having a divorce, having a rural residence, poor income, having more than three chronic diseases, poor health, and insufficient physical activity. Further evaluation, monitoring, and activities to improve HL are of great importance for patients’ health outcomes.


2019 ◽  
Author(s):  
Huanyan Wang ◽  
Lei Shi ◽  
Xuanye Han ◽  
Jinchan Zhang ◽  
Lihua Fan

Abstract Background: The family doctor system has gained rapid ground worldwide. In recent years, China has been actively exploring family doctor-type contracted services. The purpose of this study was to explore the influencing factors of Contracted Family Doctors Services (CFDS) from the perspectives of community health service providers, administrators and medical staff, and it provides a strong basis for the development and promotion of CFDS. Methods: A combination of quantitative and qualitative methods was adopted in this study. A cross-sectional survey was conducted among community health service providers and administrators in 12 community health service centers across four provinces (Zhejiang, Anhui, Beijing, and Shanghai) of China. A total of 389 people took the survey. Ultimately, 320 questionnaires were valid. The effective response rate was 82.3%. A total of 36 consumers were interviewed through in-depth interviews. The total effective rate 100.0%. Exploratory factor analysis, confirmatory factor analysis, and expert consultation were used to analyze the influencing factors of CFDS. Results: The factors influencing CFDS from the perspectives of medical staff were divided into four dimensions, with the following weighting coefficients: national government (31.87%), community health service agency factors (24.73%), consumers-related factors (22.58%), and contracted doctor-related factors (20.82%). The factors influencing CFDS from the perspectives of patients/consumers were national policy factors, contracted team factor, and consumers-related factors. Conclusions: National governments, community health agencies, community health workers, and consumers play an important role in the advancement of CFDS. Therefore, the development of CFDS needs to consider the rights and interests of all stakeholders involved.


2021 ◽  
Vol 9 (1) ◽  
pp. 113
Author(s):  
Bahtiar Bahtiar ◽  
Wiwi Saputri ◽  
Rostika Salenda Paseleng ◽  
Muh Akbar ◽  
Restu Abady

The elderly are vulnerable to experience health problems and physical deterioration characterized by high rates of chronic diseases among the elderly. Health literacy ability becomes crucial for the elderly with chronic diseases to treat and maintain their health. This study was aimed to describe the literacy levels of the elderly with chronic diseases during the COVID-19 pandemic in Makassar. The method of study was a descriptive survey with a cross-sectional study. The research population is elderly with chronic diseases in Makassar city, and the samples are 124 elderly with age ≥60 years old and suffering chronic diseases more than six months in two selected sub-district. The research was conducted a cross-sectional survey, and descriptive univariate data analysis was used. The instrument was used Indonesia's health literacy short-form survey questionnaire (HLS-EU-SQ10-IDN). The result of this study reveals that the health literacy levels vary: insufficient criteria by 33.99%, problematic criteria by 49.2%, sufficient criteria by 16.1%, and perfect criteria by 0.8%. The results prove that the health literacy level of the elderly with chronic diseases is insufficient. This study concluded that the dominant level of the health literacy of the elderly with chronic diseases is inadequate and problematic. Health education program to improve their literacy is necessarily improved during the COVID-19 outbreak


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jie Li ◽  
Jie Li ◽  
Peipei Fu ◽  
Yan Chen ◽  
Xue Tang ◽  
...  

Abstract Background Rural residents with chronic conditions have a stronger need for health services, which should make using family doctor contract services a priority. This study aimed to evaluate the rate of willingness among rural residents with chronic conditions to contract with family doctors and examine its determinants. Methods A cross-sectional study was conducted from May, 2018 to June, 2018 in Shandong Province in China. A total of 769 rural unsigned residents with chronic conditions were included in the analysis. Using the Andersen model as the theoretical framework, logistic regression models were chosen to analyse the factors associated with willingness to contract with family doctors. Results This study found that the rate of willingness to contract with family doctors among chronic patients in rural Shandong was 46.7%. A higher willingness was observed in those living a further distance from the village clinic (more than 600 m: OR = 1.85, 95%CI =1.17–2.93), having received publicity for family doctor contract services (OR = 1.71, 95% CI = 1.06–2.76), reporting need for utilizing a chronic disease management program (OR = 3.36, 95% CI = 2.20–5.23), and reporting need for higher medical insurance reimbursement (OR = 1.91, 95% CI = 1.28–2.83). Conclusions The prevalence of contract willingness was relatively low among unsigned rural residents with chronic conditions in rural Shandong, China. The need factors were powerful factors affecting their willingness to contract with family doctors. The government should therefore strengthen targeted publicity and education to rural residents with chronic conditions and provide targeted healthcare services, such as chronic disease management programs and medical services with higher reimbursement rates, to promote their willingness to contract with family doctors.


2020 ◽  
Author(s):  
Zhaomeng Niu ◽  
Bo Li ◽  
Jessica Willoughby ◽  
Ze Li ◽  
Rongting Zhou

BACKGROUND Empirical research has demonstrated that people frequently use social media for gathering and sharing online health information. Health literacy, social media use, and self-efficacy are important factors that may influence people’s health behaviors online. OBJECTIVE This study aims to examine the associations between health literacy, health-related social media use, self-efficacy and health behavioral intentions online. METHODS We conducted a cross-sectional survey of Chinese adults aged 18 and above (N = 449) to examine predictors of health-related behavioral intentions online including health literacy, social media use, and self-efficacy. Hayes’ PROCESS macro was used to analyze the mediation and moderation models. RESULTS Two moderated mediation models were constructed. Self-efficacy mediated the effects of health literacy (Bindirect=0.213, 95% CI: 0.101 to 0.339) and social media use (Bindirect=0.023, 95% CI: 0.008 to 0.045) on health behavioral intentions on social media. Age moderated the effects of health literacy on self-efficacy (P=.029), while previous experience moderated the effects of social media use on self-efficacy (P<.001). CONCLUSIONS Health literacy and health-related social media use influenced health behavioral intentions on social media via their prior effects on self-efficacy. The association between health literacy and self-efficacy was stronger among younger respondents, whereas the association between health-related social media use and self-efficacy was stronger among those who previously had positive experiences with health information on social media. Health practitioners should target self-efficacy among older population and increase positive media experience related to health. CLINICALTRIAL


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Yiqing Huang ◽  
Fei Qi ◽  
Rui Wang ◽  
Xiaorong Jia ◽  
Yani Wang ◽  
...  

Abstract Background Health literacy is a public health goal which can be used as an independent factor of health outcomes. This study aimed to assess the association between health literacy and health status, as well as the two mediating factors of behavior and self-efficacy among residents aged 15–69 years in Qingdao. Methods A cross-sectional survey was implemented among residents aged 15–69 years (N = 3793) in Qingdao, China. A combination of stratified cluster random and proportional probability sampling methods was used to select subjects for this study. Data were collected using “The Chinese Citizen Health Literacy Questionnaire (2019)”. We proposed a hypothetical model for the relationship between sociodemographic characteristics, health literacy, self-efficacy, health behavior, and health status, and used path analysis to validate the hypothesis. Results The path analysis showed that higher education (β = 0.293) and income (β = 0.135) are positively and directly associated with greater health literacy, which was positively associated with health status (β = 0.057). Health literacy is a direct influencing factor of health behavior (β = 0.070) and self-efficacy (β = 0.099). Health behavior (β = 0.041) and self-efficacy (β = 0.173) exerted a positive direct effect on health status. The model explained 14.1% of variance for health literacy, 3.8% for self-efficacy, 5.7% for health behavior, and 15.0% for health status. Conclusions Health literacy was identified to be a critical factor in health status. The results emphasized that the dissemination of health knowledge, development of healthy behavior, and cultivation of self-efficacy should be jointly promoted to reinforce the level of health status among residents in future work.


2020 ◽  
Author(s):  
Hongyan Liu ◽  
Chengbin Wu ◽  
Yu Zhao ◽  
Weiyun Lai ◽  
Yong Zhao ◽  
...  

Abstract Background: Improving health literacy is the key to chronic disease prevention and improved interventions. However, little is known about the status of health literacy and its influencing factors in patients with chronic diseases. Accordingly, this study aimed to explore the different aspects and factors influencing health literacy among patients with chronic diseases in Chongqing, China.Methods: A cross-sectional survey was conducted in areas of Chongqing using the 2018 National Questionnaire on Health Literacy of Residents administered to 27,336 patients with chronic diseases. The research investigated the prevalence and factors of health literacy in patients with chronic diseases in Chongqing, China using χ 2 tests and logistic regression analysis.Results: Among the participants (n = 27,336), 51.3% were males and 48.7% were females. Only a small number of patients with chronic diseases were health literate (21.6%). Regression analyses indicated that inadequate health literacy was associated with rural area residents (OR: 0.92), minorities (OR: 1.31), farmers (OR: 1.18), nonlocal registered permanent residents (OR: 1.05), and patients with self-rated unhealthy status (OR: 1.80). Patients with chronic diseases aged 25–34 (OR = 1.18) and 35–44 (OR = 1.18) were more likely to have health literacy than patients with chronic diseases aged 65–69. Illiterate or slightly literate patients (OR = 0.10) were less likely to have health literacy than patients who were in the junior college or had a bachelor’s degree or above. Patients with an average annual household income of less than 3,000 yuan (OR = 0.65) were all less likely to have health literacy than patients with an average annual household income of more than 15,000 yuan.Conclusions: Health literacy of patients with chronic conditions remains at a low level and varies significantly with their demographic and sociological characteristics. Therefore, developing and adopting appropriate health promotion programs would be necessary to improve the health literacy of all patients with different types of chronic diseases.


2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Lilla Náfrádi ◽  
Elisa Galimberti ◽  
Kent Nakamoto ◽  
Peter J. Schulz

<em>Background</em>: Medication non-adherence is a major public health issue, creating obstacles to effective treatment of hypertension. Examining the underlying factors of deliberate and non-deliberate non-adherence is crucial to address this problem. Thus, the goal of the present study is to assess the socio-demographic, clinical and psychological determinants of intentional and unintentional non-adherence. <br /><em>Design and methods:</em> A cross-sectional survey was conducted between March, 2015 and April, 2016. The sample consisted of hypertension patients holding at least one medical prescription (N=109). Measurements assessed patients’ medication adherence, health literacy, empowerment, self-efficacy, medication beliefs, and patients’ acceptance of their doctor’s advice, socio-demographic and clinical characteristics. <br /><em>Results</em>: Patients who occasionally engaged in either intentional or unintentional non-adherence reported to have lower adherence selfefficacy, higher medication concern beliefs, lower meaningfulness scores and were less likely to accept the doctor’s treatment recommendations. Patients who occasionally engaged in unintentional nonadherence were younger and had experienced more side effects compared to completely adherent patients. Adherence self-efficacy was a mediator of the effect of health literacy on patients’ medication adherence and acceptance of the doctor’s advice was a covariate. <br /><em>Conclusions</em>: Regarding the research implications, health literacy and adherence self-efficacy should be assessed simultaneously when investigating the factors of non-adherence. Regarding the practical implications, adherence could be increased if physicians i) doublecheck whether their patients accept the treatment advice given and ii) if they address patients’ concerns about medications. These steps could be especially important for patients characterized with lower self-efficacy, as they are more likely to engage in occasional nonadherence.


2021 ◽  
pp. 108482232110084
Author(s):  
Agata Wilk ◽  
Lisa LaSpina ◽  
Linda D. Boyd ◽  
Jared Vineyard

This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p < .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score ( M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score ( M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Chen ◽  
Hongfu Ren ◽  
Na Wang ◽  
Yaqing Xiong ◽  
Fei Xu

Abstract Background To examine associations of socioeconomic position (SEP), separately indicated by education, monthly family average income (FAI) and occupation, with health literacy (HL) among adults in regional China. Methods A cross-sectional survey was conducted among urban and rural adults (aged 25–69 years) who were randomly selected, using the probability proportionate to size sampling approach, from Nanjing municipality of China during October and December of 2016. HL, the outcome variable, was assessed using the Chinese Resident Health Literacy Scale. SEP, our independent variable, was separately measured with educational attainment, monthly family average income and occupation. Logistic regression models were introduced to examine SEP-HL association with odds ratio (OR) and 95% confidence interval (CI). Results Totally, 8698 participants completed the survey. The proportion of participants with unweighted and weighted adequate HL was 18.0% (95%CI = 17.2, 18.8%) and 19.9% (95%CI = 16.6, 23.6%), respectively, in this study. After adjustment for possible confounding factors, each SEP indicator was in significantly positive relation to both unweighted and weight HL level. Participants who obtained 13+ and 10–12 years educational attainment, respectively, had 2.41 (95%CI = 1.60, 3.64) and 1.68 (95%CI = 1.23, 2.29) times odds to record weighted adequate HL compared to their counterparts who were with 0–9 years education. Subjects within upper (OR = 1.92, 95%CI = 1.24, 2.98) and middle FAI tertile (OR = 1.59, 95%CI = 1.19, 2.13), respectively, were more likely to report weighted adequate HL relative to those who were within lower FAI tertile. White collars were more likely to have weighted adequate HL (OR = 1.33, 95%CI = 1.09, 1.61) than blue collars. Conclusions Each of education, FAI and occupation was positively associated with health literacy among urban and rural adults in China. The findings have important implications that different SEP indicators can be used to identify vulnerable residents in population-based health literacy promotion campaigns.


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