Abstract

We set out to measure the health literacy (HL) of COPD patients using the Short Test of Functional Health Literacy (S-TOFHLA), perception-based screening questions (BHLS), and a specific disease knowledge test (COPD-Q). Our main focus is the relationship between functional HL and patients’ disease-knowledge, which contributes to the clarification of the relationship between the different kinds of HL. In two prospective observational studies, 151 COPD patients (80 males, mean age: 62 ± 9 years) completed a questionnaire containing HL measurements, psychological tests (e.g., the Self-Control and Self-Management Scale), and questions regarding subjective health status. Medical data of the patients from the MedSole system were added. The HL scores of the COPD patients were compared to a representative sample using a t-test. Furthermore, correlations of HL with demographic, psychological, and medical variables were calculated within the patient group. The relations among the different HL measurements were tested by chi-square trials. COPD patients had significantly lower HL, as measured by S-TOFHLA. Younger and higher educated patients possessed higher S-TOFHLA scores. Unlike the demographic variables, general self-management showed significant correlations with both BHLS and with COPD-Q. Out of the medical variables, objective health status was associated with BHLS and COPD-Q. Neither BHLS nor S-TOFHLA had a correlation with COPD-Q, but they correlated with each other. We found S-TOFHLA to be a better tool in the medical context. There is a clear gap between self-perceived/functional HL and the necessary disease knowledge. Rehabilitation care for patients with lower HL was more advantageous.

Highlights

  • A report by the United States Institute of Medicine identified health literacy (HL), which consists of diverse skills, to be one of the most important means to improve population health [1]

  • In the representative Hungarian sample, 14.3% showed less than adequate HL in S-TOFHLA [6], while among chronic obstructive pulmonary disease (COPD) patients, 46.3% had inadequate or marginal health literacy

  • These results confirmed Hypothesis 1 (H1), which claims that Hungarian COPD patients show a lower level of HL than the population at large

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Summary

Introduction

A report by the United States Institute of Medicine identified health literacy (HL), which consists of diverse skills (e.g., reading, counting, communication, critical thinking), to be one of the most important means to improve population health [1]. Health literacy was found to be negatively related to hospitalization [2] and positively related to health behaviors, such as medication adherence [3,4] or self-management, in a variety of chronic diseases [5]. The first empirical studies on the Hungarian validation of HL measurements were published in 2016 [6,7], and still, not much is known about its role in coping with chronic diseases.

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