scholarly journals Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel Boyer ◽  
Yannick Begin ◽  
Julie Dupont ◽  
Mathieu Rousseau-Gagnon ◽  
Nicolas Fernandez ◽  
...  

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

2021 ◽  
Author(s):  
Yannick BEGIN ◽  
Annabel BOYER ◽  
Julie DUPONT ◽  
Mathieu ROUSSEAU-GAGNON ◽  
Nicolas FERNANDEZ ◽  
...  

Abstract Background: Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD).Methods: This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups.Results: Patients on PD had a significantly higher BHLS’score than patients on ICHD (p=0.04). HLQ’s scores differed across the groups: patients on HHD (p=0.01) and PD (p=0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p=0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p<0.001).Conclusion: In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D do Ó ◽  
J Raposo ◽  
A Goes ◽  
I Loureiro

Abstract Background Glycemic control and self-management of diabetes are influenced by a range of factors, including health literacy - the ability to access, understand, appraise, and use health information. This study explored associations between domains of health literacy (HL), glycemic control and perceived general health in people with diabetes. Methodology Cross-sectional study, with 453 people with diabetes,attending the Portuguese Diabetes Association (APDP). We collected information on HL, demographics, glycemic control and self-perception of health. HL was assessed using the Health Literacy Questionnaire. Descriptive and correlational analysis were performed. Results 85.4% consider Feeling understood and supported by healthcare providers but only 54.1% have the Ability to actively engage with healthcare providers and 27.8% feel the Ability to find good health information,66.5% consider Having sufficient information to manage my health but only 38.7% are Understanding health information well enough to know what to do and 28.5% refer the Ability to find good health information. Higher HL scores were associated with better glycemic control and more positive perception of general health(GH) across the following domains: Having sufficient information to manage my health, Appraisal of health information, Ability to find good health information, Actively managing my health and social support for health. The domains Ability to actively engage with healthcare providers and Navigating the healthcare system were also associated with more positive perception of GH. Associations achieved either p &lt; 0.001 or p &lt; 0.05. Considering HL levels, a statistically significant negative association was found with the levels of HbA1c and positive association with perceived general health, even for functional HL. Conclusions The results emphasize the importance of improving the level of HL of people with diabetes in order to improve glycemic control and the perceive General Health Key messages Health literacy is critical for diabetes self-management. People with diabetes need to understand and use health information to promote well-being and diabetes control.


2020 ◽  
Author(s):  
Carly A. Rodriguez ◽  
Alexander Winnett ◽  
Milagros Wong ◽  
Neha Krishnam ◽  
Nicole Ocasio Martínez ◽  
...  

AbstractClinical outcomes among adolescents living with HIV (ALHIV) might be improved by interventions aimed at addressing limited health literacy. We developed a Spanish-language rap video on HIV concepts and examined its acceptability and feasibility as a learning tool among ALHIV in Lima, Peru. Twenty-eight ALHIV receiving care at an urban pediatric hospital and ten stakeholders engaged in the care of adolescents watched the video. Adolescents completed a pre- and post-video questionnaire. We conducted focus groups with ALHIV and in-depth interviews with stakeholders and analyzed transcripts to identify themes. ALHIV described concepts of CD4 cell count and viral load as they were portrayed. Participants reported the video was relatable, accessible, and provided hope that ALHIV could lead healthy lives and advocated for future videos to address topics such as transmission and sexual health. Questionnaires indicated some improvement in viral load knowledge. An HIV health literacy music video intervention was feasible to implement and accepted by ALHIV and their healthcare providers. Communicating HIV knowledge via music videos may be promising; further study is needed to optimize implementation.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Janneke Noordman ◽  
Lotte Schulze ◽  
Ruud Roodbeen ◽  
Gudule Boland ◽  
Liesbeth M. van Vliet ◽  
...  

Abstract Background Patients have a ‘need to know’ (instrumental need) and a ‘need to feel known’ (affective need). During consultations with patients with limited health literacy (LHL) in the palliative phase of their disease, both the instrumental and the affective communication skills of healthcare providers are important. The study aims to explore instrumental and affective communication between care providers and LHL patients in the palliative phase of COPD or cancer. Methods In 2018, consultations between LHL patients in the palliative phase of cancer or COPD and their healthcare providers were video-recorded in four hospitals in the Netherlands. As there was no observation algorithm available for this setting, several items were created to parameterize healthcare providers’ instrumental communication (seven items: understanding, patient priorities, medical status, treatment options, treatment consequences, prognosis, and information about emotional distress) and affective communication (six items: hope, support, reassurance, empathy, appreciation, and emotional coping). The degree of each item was recorded for each consultation, with relevant segments of the observation selected and transcribed to support the items. Results Consultations between 17 care providers and 39 patients were video-recorded and analyzed. Care providers primarily used instrumental communication, most often by giving information about treatment options and assessing patients’ care priorities. Care providers assessed patients’ understanding of their disease less often. The patients’ prognosis was not mentioned in half the consultations. Within the affective domain, the care providers did provide support for their patients; providing hope, reassurance, empathy, and appreciation and discussing emotional coping were observed less often. Conclusions Care providers used mostly instrumental communication, especially treatment information, in consultations with LHL patients in the palliative phase of cancer or COPD. Most care providers did not check if the patient understood the information, which is rather crucial, especially given patients’ limited level of health literacy. Healthcare providers did provide support for patients, but other expressions of affective communication by care providers were less common. To adapt the communication to LHL patients in palliative care, care providers could be less wordy and reduce the amount of information, use ‘teach-back’ techniques and pay more attention to affective communication.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2251-2251 ◽  
Author(s):  
Lisa Shook ◽  
Lori E Crosby ◽  
George F. Atweh

Abstract Introduction Sickle cell disease (SCD) is an inherited, lifelong disease affecting red blood cells. In the US, SCD affects approximately 100,000 individuals. SCD is typically diagnosed at birth with newborn screening, and the burden of disease management during childhood, including prevention of complications, medication management including decision-making about treatments, and navigating the healthcare system, falls to the caregiver. As life expectancy with SCD increases well into adulthood, this responsibility progressively transitions to adolescents in tandem with transition to adult care. Health literacy is defined by the Institute of Medicine as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions”. This includes understanding medication instructions, consent forms, patient education materials, and navigating complex healthcare systems. Understanding healthcare providers’ verbal and written instructions, and asking medical providers questions are also important aspects. Additionally, individuals with a chronic illness must understand and self-manage needs specific to their condition, including recognizing critical signs and symptoms. Research has demonstrated a relationship between low health literacy and poor outcomes in a number of chronic illnesses. However to our knowledge, there is not published research specifically about SCD and health literacy. Methods Caregivers of children ages newborn – 18 years old with a confirmed diagnosis of SCD were recruited at the Cincinnati Comprehensive Sickle Cell Center (CCSCC), and adolescents/young adults (14-22 years old) with SCD were recruited at the CCSCC and the University of Cincinnati Adult Sickle Cell clinic. Caregivers completed a demographic survey and Newest Vital Sign (NVS) health literacy test. Adolescents/young adults completed the REALM-Teen and demographic survey. Results To date, 56 caregivers have participated in the study with the majority being the child’s mother; the majority of these caregivers' children have Hb SS (Hb SS 71%; Hb SC 27% SB+beta thal 2%). Demographics showed that 56% of participants completed high school/GED; 21% obtained a bachelors’ degree, and 14% obtained a master’s degree. Over 95% of caregivers reported confidence in understanding information from healthcare providers, and over 85% reported “always understanding prescription directions.” Additionally, 90% reported being comfortable asking a healthcare provider questions during a clinic visit. Consistent with this, NVS results indicated that 93% of caregivers had “adequate” or “limited” health literacy and only 7% had a “high likelihood of limited health literacy”. To date, 50 adolescents/young adults have participated in the study: Hb SS (54%), Hb SC (20%), SB+Beta Thal (6%), beta thal intermedia (2%), and unknown Hb on self-report (16%). REALM-Teen results showed that the majority (52%) of adolescents/young adults obtained a health literacy score equivalent to the 6th-7th grade levels; 20% scored consistent with an 8th-9th grade level; 18% scored at the10th grade level and above; 6% scored at the less than 3rd grade level, and 4% scored at the 4th-5th grade level. In contrast to this, 66% of adolescent/young adult respondents reported that they usually understand medical information from healthcare providers, and 72% reported that they “always” understand prescription directions. Discussion/Implications Health literacy assessments of caregivers of children with SCD demonstrated overall “higher than average” health literacy. However, the average health literacy level of adolescents and adults with SCD appears to be much lower (6th-7th grade level). The study is continuing to enroll participants so this could change with a larger sample size. Despite this limitation, this study highlights the importance of understanding health literacy levels of caregivers and adolescents/young adults with SCD and the need to tailor patient education materials to meet health literacy needs. Disclosures: No relevant conflicts of interest to declare.


10.2196/14889 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14889 ◽  
Author(s):  
Michael M McKee ◽  
Peter C Hauser ◽  
Sara Champlin ◽  
Michael Paasche-Orlow ◽  
Kelley Wyse ◽  
...  

Background Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population. Objective This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions. Methods This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants’ ownership and use of computer and mobile devices and their level of Web-based information use, including health information. Results Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals. Conclusions The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills. International Registered Report Identifier (IRRID) PRR1-10.2196/14889


Author(s):  
Farah Nawabi ◽  
Franziska Krebs ◽  
Vera Vennedey ◽  
Arim Shukri ◽  
Laura Lorenz ◽  
...  

Health literacy plays a crucial role during pregnancy, as the mother’s health behavior influences both her own health and that of her child. To the authors’ best knowledge, no comprehensive overview on evidence of the health literacy of pregnant women and its impact on health outcomes during pregnancy exists. Therefore, this review aims to assess health literacy levels in pregnant women, whether health literacy is associated with outcomes during pregnancy and whether effective interventions exist to improve the health literacy of pregnant women. A systematic literature search was conducted in PubMed and EBSCO, resulting in 14 studies. The results show mixed levels of health literacy in pregnant women. Limited health literacy is associated with unhealthy behaviors during pregnancy. Mixed health literacy levels can be attributed to the recruitment site, the number of participants and the measurement tool used. Quality assessment reveals that the quality of the included studies is moderate to good. The review revealed that randomized controlled trials and interventions to improve health literacy in pregnant women are rare or do not exist. This is crucial in the light of the mixed health literacy levels found among pregnant women. Healthcare providers play a key role in this context, as pregnant women with limited health literacy rely on them as sources of health information.


2019 ◽  
Author(s):  
Michael M McKee ◽  
Peter C Hauser ◽  
Sara Champlin ◽  
Michael Paasche-Orlow ◽  
Kelley Wyse ◽  
...  

BACKGROUND Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population. OBJECTIVE This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions. METHODS This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants’ ownership and use of computer and mobile devices and their level of Web-based information use, including health information. RESULTS Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals. CONCLUSIONS The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14889


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Safoura Taheri ◽  
Mahmoud Tavousi ◽  
Zohre Momenimovahed ◽  
Ashraf Direkvand-Moghadam ◽  
Nazanin Rezaei ◽  
...  

Background: The ability to acquire, process, and understand health information to make informed decisions about health is defined as health literacy. A low level of health literacy disrupts women’s ability to understand and use health information in order to take appropriate and timely measures during pregnancy. Objectives: Due to the importance of health literacy during pregnancy and its direct impact on fetal health, this study was conducted to determine the level of health literacy and its related items among the pregnant women referred to medical and health centers in Tehran. Methods: This descriptive-analytical study was conducted on 270 pregnant women referred to the medical and health centers of Tehran in 2019. The participants in this study were selected by the mixed sampling method (cluster and random methods to select health centers and the convenience method to select participants). Data collection tools included a questionnaire for demographic and midwifery characteristics and a specialized questionnaire for maternal health literacy in pregnancy (MHELIP). Data analysis was performed by SPSS-19 software. Results: The mean age of the participants was 28.16 ± 5.70 years, and the mean gestational age was 24.50 ± 9.25 weeks. The mean score of health literacy among pregnant women was 63.14 ± 9.63, and 48.9% of them had limited (inadequate and insufficient) health literacy. The results showed positive correlations between the total score of health literacy and the demographic variables of age (P = 0.025), education (P = 0.003), and income (0.008), but no significant relationship was found between the mean total score of health literacy and employment status (P = 0.614) or parity (P = 0.614). Conclusions: It was found that limited health literacy had a high prevalence among pregnant women. Given the importance of pregnancy, it seems necessary for healthcare policymakers to design programs to promote women’s health literacy during pregnancy.


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