Health literacy level in a various nephrology population from Qu\xe9bec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

Annabel Boyer,Mathieu Rousseau-Gagnon,Fabrice Mac-Way,Julie Dupont,Maryam Demian,David Simonyan,Yannick Begin,Mohsen Agharazii,Nicolas Fernandez

doi:10.1186/s12882-021-02464-1

Annabel Boyer, Mathieu Rousseau-Gagnon + Show 7 more

Open Access

https://doi.org/10.1186/s12882-021-02464-1

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Abstract

BackgroundHealth 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).MethodsThis 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.ResultsPatients 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).ConclusionIn 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.

Highlights

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
Diabetes seemed to be more prevalent in patients on HD and those in the predialysis clinic
Employment status was lower in patients on in-center hemodialysis (ICHD) (7.6%) and was higher for those on home hemodialysis (HHD) (56.2%)

Summary

Introduction

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). Health literacy is defined by the World Health Organization (WHO) as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health” [1]. Health literacy is especially important in nephrology due to the complexity of the high number of comorbidities, and the need for self-management skills [5, 6] These include adherence to a restrictive diet as well as a complex medication regimen, and attendance at multiple appointments with healthcare providers. Patients with end-stage kidney disease (ESKD) are required to make important decisions about the specific type of kidney replacement therapy (KRT) they would like to undergo (in-centre hemodialysis, peritoneal dialysis or home hemodialysis)

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