Abstract

Abstract Background and Aims Depression and anxiety is common in dialysed patients (Ng et al., 2015; de Brito et al., 2019) and associated with decreased quality of life, worse health outcomes and increased mortality (Schouten et al., 2019, Lopes at al., 2002). Health literacy (HL) as the ability to gain access, understand, and use information to promote and maintain good health (WHO, 1998) may be hampered by emotional problems such as depression and anxiety. The aim of our study is to examine the association of HL with depression and anxiety in dialysed patients in Slovakia. Method Cross-sectional study on 542 dialysed patients (mean age = 63.6, males = 60.7%) was conducted in 20 dialysis clinics in Slovakia from January to November 2018. Socio-demographic data, data on 9 domains of HL and data on depression and anxiety were collected by questionnaires. Hierarchical cluster analysis was used to create three clusters of patients (low, moderate, high HL). Depression and anxiety was dichotomized as 0-no/low symptoms and 1-moderate/severe symptoms. Association of HL clusters with depression and anxiety was analysed using logistic regression adjusted for age and gender. Results We found that patients in low HL cluster and moderate HL cluster were more likely to have moderate/severe symptoms of depression and anxiety than patients in high HL cluster. Odds ratio (OR) for depression for low HL cluster: 7.60; 95% Confidence Interval (CI): 2.88 – 20.06; p<0.000 and for moderate HL cluster: OR: 4.85; 95% CI: 1.87 – 12.56; p<0.001. OR for anxiety for low HL cluster: 3.14; 95% CI:1.55 – 6.35; p<0.001 and for moderate HL cluster: OR 2.16;95% CI: 1.10 – 4.24; p<0.05. Conclusion Patients with lower levels of HL suffer from anxiety and depression more than patients with higher levels of HL. These findings point to the need of regular screening of emotional problems such as depression and anxiety and their treatment as they may hamper capacities of dialysed patients for self-management as well as effective treatment of the disease from the perspective of healthcare providers.

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