scholarly journals The effect of Autonomy-Supportive Patient-Centered Communication on Health Literacy: Exploring the Mediating Role of the Patient Health Engagement Model

Author(s):  
Serena Barello ◽  
Lorenzo Palamenghi ◽  
Guendalina Graffigna

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

Author(s):  
Serena Barello ◽  
Lorenzo Palamenghi ◽  
Guendalina Graffigna

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL; hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients in becoming more and more engaged in their healthcare, thus augmenting their literacy skills. Our main hypothesis is that the well-known relationship between patients’ perceived autonomy supportive healthcare climate and HL skills is mediated by the Patient Health Engagement Model (PHE-model) which describes the patients’ progressive maturation of a psychological readiness to become active players in their healthcare. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking an autonomy-supportive healthcare climate to PHE-model and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of the PHE-model between autonomy-supportive healthcare climate and HL. Results show that the theoretical model has a good fit indexes and that PHE-model fully mediates the relationship between autonomy-supportive healthcare climate and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.


2021 ◽  
Author(s):  
Julie A. Wright ◽  
Julie E Volkman ◽  
Suzanne G Leveille ◽  
Daniel J. Amante

BACKGROUND Self-management of health is becoming increasingly more influenced by Health IT as online patient portals become more common. Patient portals allow patients direct access to their health information and opportunities to engage with their healthcare team. Data suggest that e-Health literacy is an important skill for using portals. Emerging adults (EA; ages 18-29), while generally healthy, are regular users of the healthcare system. A good understanding about their use of online patient portals and how their e-Health literacy skills impact their use is lacking. OBJECTIVE To describe patient portal use and explore the predictors of portal use among a diverse sample of EAs. METHODS A convenience sample, cross-sectional survey study was conducted at two universities. Demographics, healthcare visits, e-Health literacy, patient engagement and use of patient portal features (administrative and clinical) were asked. Logistic regression models were used to examine factors associated with portal use. RESULTS Of the 340 EAs (76% female, 65% white, 47% low income), 54% reported having patient portal access. Of those reporting access, 77% used at least 1 portal feature and 23% reported using none. Significant predictors were patient engagement (OR 1.08, 95% CI 1.04-1.13, p=.001;) and total encounters (OR 1.23, 95% CI 1.05-1.44, p=.009;) but not e-Health literacy. Hispanic and Asian EAs were more likely to be frequent users of clinical portal features than white EAs (Hispanic, OR 2.97, 95%CI 1.03-8.52 p=.043; and Asian, OR 4.28, 95%CI 1.08-16.89, p=.038). CONCLUSIONS Surprisingly, e-Health literacy did not predict use of patient portals in this diverse sample of EAs. Moreover, there may be ethnic differences that are important for healthcare systems to consider. Interventions to promote patient portal use, an essential self-management skill, should include strategies to increase patient engagement with patient portals in EA populations. CLINICALTRIAL N/A


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kirubel Biruk Shiferaw ◽  
Binyam Chakilu Tilahun ◽  
Berhanu Fikadie Endehabtu ◽  
Monika Knudsen Gullslett ◽  
Shegaw Anagaw Mengiste

Author(s):  
Janet Yuen Ha Wong ◽  
Abraham Ka Chung Wai ◽  
Shengzhi Zhao ◽  
Faustina Yip ◽  
Jung Jae Lee ◽  
...  

Objective: We tested a model of individual health literacy, information sharing with family members, personal preventive behaviours and family well-being during COVID-19 pandemic in Hong Kong. Methods: We analysed data of 1501 randomly selected Chinese adults from a cross-sectional survey in Hong Kong from 9 to 23 April 2020. Individual health literacy, COVID-19 information sharing with family members, preventive behaviours against COVID-19 and family well-being were measured. Structural equation modelling analysis tested the proposed model. Findings: COVID-19 information sharing with family members partially mediated the association between individual health literacy and personal preventive behaviours. The direct effect of .24 was shown and indirect effect through COVID-19 information sharing with family members was small with .03 (Z = 3.66, p < .001). Family well-being was associated with personal preventive behaviours against COVID-19. The model was adjusted for sex, age, and socioeconomic status factors and had good fit with RMSEA = .04, CFI = .98, TLI = .96, and SRMR = .02. Conclusion: COVID-19 information sharing with family members was a partial mediator between individual health literacy and personal preventive behaviours against COVID-19. Strategies for enhancing health literacy and preventive measures against COVID-19 are needed to promote family well-being in the pandemic.


2020 ◽  
Vol 2 (1) ◽  
pp. 37-44
Author(s):  
Koawo Edjah ◽  
Francis Ankomah ◽  
Ebenezer Domey ◽  
John Ekow Laryea

AbstractStress is concomitant with students’ life and can have a significant impact on their lives, and even how they go about their academic work. Globally, in every five visits by patients to the doctor, three are stress-related problems. This study examined stress and its impact on the academic and social life among students of a university in Ghana. The descriptive cross-sectional survey design was employed. Using the stratified and simple random (random numbers) sampling methods, 500 regular undergraduate students were engaged in the study. A questionnaire made up of Perceived Stress Scale and Students’ Life Satisfaction Scale was used to gather data for the study. Frequencies, percentages, means and standard deviation, and Structural Equation Modeling (SEM), with AMOS were used for the analyses. It was found that majority of the students were moderately stressed. Paramount among the stressors were academic stressors, followed by institutional stressors, and external stressors. Stress had a significant positive impact on the academic and social life of students. It was concluded that undergraduate students, in one way or the other, go through some kind of stress during the course of their study. It was recommended that the university, through its Students’ Affairs, and Counselling Sections, continue to empower students on how to manage and deal with stress in order to enhance their academic life.


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.


2020 ◽  
pp. 1356336X2098077
Author(s):  
Cassandra Iannucci ◽  
K Andrew R Richards ◽  
Ann MacPhail

This study develops an understanding of the relationships among personal accomplishment, resilience, and teaching multiple school subjects role conflict (TMSS-RC) among Irish post-primary, multi-subject teachers. A theoretically informed conceptual framework was developed to explain the relationships among personal accomplishment, resilience, and the sub-domains of TMSS-RC: status conflict, schedule conflict, and energy expenditure. Participants included 259 post-primary teachers across Ireland who were responsible for teaching physical education and at least one other school subject concurrently. Participants completed a 46-item, cross-sectional survey consisting of a demographics questionnaire, the TMSS-RC scale, the personal accomplishment subscale from the Maslach Burnout Inventory–Educators Survey, and the 10-item version of the Connor–Davidson Resilience Scale. Concurrent confirmatory factor analysis was first used to confirm the psychometric quality of the hypothesised factor structure. Results indicated that the hypothesised model was a good fit for the data. Structural equation modelling was then used to examine and verify the hypothesised relationships of the conceptual model. Results supported the model with mediation, which showed good model fit: C3(129) = 174.97, p = 0.004, χ 2/df = 1.36; root mean square error of approximation = 0.044 (90% confidence interval = 0.031, 0.057; p = 0.770), standardised root mean square residual = 0.058; non-normed fit index = 0.974; comparitive-fit index (CFI) = 0.978. Collectively, results indicate that as teachers’ levels of personal accomplishment and resilience increase, their experiences of TMSS-RC decrease. This suggests that stress as a result of teaching multiple school subjects concurrently can be reduced with an increase in teachers’ perceived levels of personal accomplishment and resiliency.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mordecai Chrysostom Matto

Purpose This paper aims to examine the influence of records management on the performance of procurement management units (PMUs) in Tanzania. Design/methodology/approach To meet the objective of the study, cross-sectional survey design and quantitative approaches were used for data collection and analysis. Preliminary analysis of the data was carried out using descriptive statistics and structural equation modelling was then used to analyse the influence of records management standards on procurement performance. The data were collected from 164 government PMUs in Tanzania. Findings The findings revealed that records management attributes significantly affect procurement performance in Tanzania. Furthermore, government policy and integrity factors confound the association between records management and procurement performance. Practical implications The policymakers and practitioners of public procurement are required to be aware of records management principles and how each related factor influences the performance of PMUs. They should emphasise proper storage and housing, equipment, arrangement and access and implement electronic records management. Originality/value This study shows how the ISO 15489 model can be applied to public procurement processes. This study also provides the lesson that procurement records need to be protected to ensure their authenticity, reliability, integrity and useability.


2021 ◽  
Author(s):  
Rubeena Zakar ◽  
Sarosh Iqbal ◽  
Muhammad Zakria Zakar ◽  
Florian Fischer

BACKGROUND Amid to the COVID-19 pandemic, digital health literacy (DHL) has become a significant public health concern. OBJECTIVE This research aims to assess information seeking behavior, as well as the ability to find relevant information and deal with DHL among university students in Pakistan. METHODS An online-based cross-sectional survey, using a web-based interviewing technique, was conducted to collect data on DHL. Simple bivariate and multivariate linear regression was performed to assess the association of key characteristics with DHL. RESULTS The results show a high DHL related to COVID-19 in 54.3% of students. Most of the Pakistani students demonstrated ~50% DHL in all dimensions, except of reliability. Multivariate findings showed that gender, sense of coherence and importance of information were found to be significantly associated with DHL. However, a negative association was observed with students’ satisfaction with information. CONCLUSIONS This led to the conclusion that critical operational and navigations skills are essential to achieve COVID-19 DHL and cope with stress, particularly to promote both personal and community health. Focused interventions and strategies should be designed to enhance DHL amongst university students to combat the pandemic.


Sign in / Sign up

Export Citation Format

Share Document