Health Literacy Levels Of Patients Research Articles

Development and Validation of the Health Literacy Assessment Instrument for Patients with Chronic Pain.

A suitable health literacy assessment instrument for patients with chronic pain (HLCP) in China with good instrument's psychometric properties is required. A theoretical framework for the HLCP was developed by adopting the hierarchical model of health literacy proposed by Nutbeam. The reliability and validity of the HLCP were tested in a cross-sectional survey of 237 chronic pain patients from three pain clinics and wards of Grade-3A hospitals in Zhejiang Province, China. The discriminant degree method, correlation analysis method, factor analysis method (exploratory factor analysis), half reliability, and other methods were utilized to screen items for inclusion in the final version of HLCP, and the fitness of the model was subsequently evaluated by confirmatory factor analysis. Cronbach's alpha value and test-retest with two-week intervals were used to test the internal consistency and retest reliability of the HLCP. In the exploratory factor analysis, three domains, functional health literacy (10 items), interactive health literacy (14 items), and critical health literacy (7 items), comprising 31 items in total, were finally loaded; the model was determined to explain 70.9% of the total variance. HLCP's effective assessment of the health literacy level of patients with chronic pain and its acceptable reliability and validity were revealed through the results.

Differences in health literacy level of patients from public and private hospitals: a cross-sectional study in Turkey

ObjectivesPolicy-making based on a health literacy approach makes it a priority to develop people-centered public health strategies and programs, particularly in the time of COVID-19 across the world. This is the first study to assess health literacy levels of patients visiting public and private hospitals in Turkey and also compares these levels with sociodemographic and health-related variables by hospital type to suggest health policies aimed at improving the health literacy skills for patients with different socio-economic backgrounds. Study designThis is a cross-sectional study. MethodsThe study was conducted on 948 outpatients from both hospital types in 2018. Health literacy was assessed using the validated Turkish version of the European Health Literacy Survey Questionnaire with 47 items. The level of health literacy and sociodemographic factors influencing it were analyzed using correlation and binary logistic regression tests. Patients from private hospital had better health literacy index score compared with the public hospital. ResultsThe health-related variables, such as self-reported health and the presence of long-term illness, and sociodemographic characteristics, including education, age, and gender, were associated with health literacy for both public and private hospitals. Age and education were important predictors, whereas gender, long-term disease condition, self-reported health, and perceived income status were statistically significant variables for adequate health literacy in both hospital types. ConclusionsParticipants from private hospital had better health literacy than that of public hospital. These findings could be used to help health policy makers to improve the current health literacy policy for patients and develop strategies by stakeholders for reducing barriers to obtaining health-related information.

The Effect of Health Literacy Levels on Successful of Smoking Cessation Therapy: A Survey Study

Aim: In this study, it was aimed to evaluate the effect of the health literacy levels of patients given smoking cessation treatment on the success of smoking cessation treatment. Methods: In this study, 152 participants between the ages of 18-70 applied to a tertiary hospital smoking cessation outpatient clinic. The Fagerström Test for Nicotine Dependence was used to determine the level of cigarette addiction of the participants, and the European Health Literacy Scale was used to evaluate the levels of health literacy. Results: When the health literacy levels of the participants with cigarette addiction were evaluated, 38 (25%) were inadequate, 64 (42.1%) were problematic. When the participants' smoking cessation status and general health literacy levels were compared, it was found to be statistically significant. It was determined that as the health literacy level increased, the success rates of individuals increased in smoking cessation therapy. Conclusions: We have shown that increasing the level of health literacy is effective in increasing the success of smoking cessation treatment. Increasing health literacy should be part of the fight against smoking. This effect should be demonstrated by future studies on large populations. Keywords: smoking cessation, health literacy, addiction

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

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.

Evaluation of the health literacy levels of patients applying to Family Medicine outpatient clinics

Evaluation of the health literacy levels of patients applying to Family Medicine outpatient clinics

Evaluation of the factors affecting the health literacy levels of patients admitted to family health centers

Evaluation of the factors affecting the health literacy levels of patients admitted to family health centers

Investigation of Health Literacy Level of Patients who Admitted to A Tertiary Training and Research Hospital

Investigation of Health Literacy Level of Patients who Admitted to A Tertiary Training and Research Hospital

Assessing health professionals\u2019 perception of health literacy in Rhode Island community health centers: a qualitative study

BackgroundLimited health literacy is linked with poor health behaviors, limited health care access, and poor health outcomes. Improving individual and population health outcomes requires understanding and addressing barriers to promoting health literacy.MethodsUsing the socio-ecological model as a guiding framework, this qualitative study (Phase 1 of a larger ongoing project) explored the interpersonal and organizational levels that may impact the health literacy levels of patients seeking care at federally qualified community health centers (FQCHCs) in Rhode Island. Focus groups were conducted with FQCHC employees (n = 37) to explore their perceptions of the health literacy skills of their patients, health literacy barriers patients encounter, and possible strategies to increase health literacy. The focus groups were audio-recorded and transcribed, and transcripts were coded using a process of open, axial, and selective coding. Codes were grouped into categories, and the constant comparative approach was used to identify themes.ResultsEight unique themes centered on health literacy, sources of health information, organizational culture’s impact, challenges from limited health literacy, and suggestions to ameliorate the impact of limited health literacy. All focus group participants were versed in health literacy and viewed health literacy as impacting patients’ health status. Participants perceived that some patients at their FQCHC have limited health literacy. Participants spoke of themselves and of their FQCHC addressing health literacy through organizational- and provider-level strategies. They also identified additional strategies (e.g., training staff and providers on health literacy, providing patients with information that includes graphics) that could be adopted or expanded upon to address and promote health literacy.ConclusionsStudy findings suggest that strategies may need to be implemented at the organizational-, provider-, and patient- level to advance health literacy. The intervention phase of this project will explore intervention strategies informed by study results, and could include offering health literacy training to providers and staff to increase their understanding of health literacy to include motivation to make and act on healthy decisions and strategies to address health literacy, including the use of visual aids.

Functional health literacy in renal replacement therapy: an integrative review

Abstract Objective To analyze the instruments available to identify the functional health literacy level of patients submitted to renal replacement therapy. Methods Integrative review carried out by searching publications in the PubMed, Scientific Electronic Library Online, Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases between October 2017 and January 2018. Full original articles in English, Spanish, or Portuguese made available from 2010 to the moment the search was performed were included. The descriptors used in [...]

The Relationship Between Health Literacy Level and Self-Care Behaviors in Patients with Diabetes.

BackgroundThe most important factor in controlling diabetes is self-care behaviors; improving self-care behaviors is the first step in helping patients to better control and manage their diseases and health literacy is recognized as a vital and important indicator of outcomes and costs in healthcare. Therefore, the effectiveness of health-care systems requires that people have the desirable health literacy level. Therefore, this research intended to study the relationship between health literacy levels in patients with diabetes and their self-care behaviors.Patients and MethodsThis analytical cross-sectional study was conducted during two months on 400 patients with diabetes selected using the census method in diabetes clinics in Mashhad County. Information was collected through a demographic survey questionnaire, the Health Literacy Questionnaire and a self-care behavior questionnaire. Data analysis was performed using SPSS 21 and Spearman correlation coefficient, the independent t-test, and ANOVA.ResultsThe total mean score for self-care was 33.52 (SD±13.27). There was a significant relationship between self-care and health literacy in this study (P <0.05) so that people with higher levels of self-care literacy had better self-care behaviors. There was also a significant relationship between education level and monthly income and self-care behaviors and health literacy (P <0.001).ConclusionPatients received an average score for self-care behaviors. Given the impact of health literacy on patients’ self-care behaviors, and considering its inclusion in educational, therapeutic, and caregiver programs, it is possible to reduce complications in patients, and improve their quality of life, by improving their self-care behaviors. Special attention should also be paid to health literacy levels of the audience when designing the related educational programs.

Development of medication-related counselling skills in senior medical students: a checklist-based approach

BackgroundEffective communication between healthcare providers and patients has been established as a vital element in medication compliance and patient safety. Medical curricula worldwide include medication-related counselling skill as a learning outcome for medical graduates. However, this aspect of health-care training is frequently informal and poorly structured in most medical schools. This paper provides an interesting view of students’ experiences of using a checklist-based approach to develop and practice patient counselling in relation to prescribed medications.MethodsThe authors describe introduction of a thirteen item “Patient Education Checklist” (PEC) as part of an optional checklist based exercise (CBE) in year 4 and 5 clinical blocks. Students consulted PEC to discuss relevant practical issues related to medication intake with their patients. Students were expected to submit reflective case summaries regarding their experience of using PEC to counsel patients over a two-week period. The textual data from student submissions was analysed using inductive content analysis.ResultsWe received 13 year4 and 17 year5 student submissions. A content analysis of student reflections identified four dominant themes 1.Enhancement in self-confidence in relation to patient education (86.7%), 2. PEC perceived useful for patient counselling (83.3%), 3. Recognising variation in health literacy levels of patients (50%), 4.Fear of overloading the patient with information (23.3%). Students realised the need to present the medication related knowledge in simple language and tailor the amount of information as per patients’ understanding. Student reflections included interesting observations about the wide variation in health literacy of patients and insights into patients’ concerns and frequent misconceptions about medicines.ConclusionStudents perceived PEC as a useful tool in adding focus and structure to student patient interactions. They report that it substantially improved their confidence and added quality to patient encounters. Future research is required to assess the effect of CBE on medication compliance and therapeutic outcome. PEC might serve as a useful resource for pharmacy and nursing students.

Low health literacy levels in patients with chronic retinal disease

BackgroundA patient’s health literacy is fundamental for navigating the health system and managing disease. This study aimed to compare the health literacy levels of patients with chronic retinal disease in Denmark.MethodsThis cross-sectional questionnaire study used the validated HLS-EU-Q16 questionnaire to determine the health literacy of 225 patients with age-related macular degeneration (AMD), diabetic macular edema (DME) or retinal vein occlusion (RVO), receiving intravitreal treatment at the retinal clinic, Zealand University Hospital, Denmark. Patients were consecutively included as participants for the study. All patients had the option of having the survey read aloud to them.ResultsHealth literacy levels between the patient groups did not differ significantly, however, the proportion of patients with poor health literacy was high—65% of AMD patients, 73% of DME patients, and 63% of patients with RVO.ConclusionsLow health literacy of patients with retinal disease signify a need for more health literacy research in the field of retinal diseases, to secure that patients have the timely and appropriate knowledge and competencies to manage their condition.

Actual and perceived patient health literacy: How accurate are residents' predictions?

Health literacy has repeatedly been shown to be associated with a multitude of negative health outcomes. Previous research has shown that patient health literacy levels are hard to predict by physicians and that assessment tools used to measure health literacy may be outdated or lacking. The purpose of this study is to replicate and extend the findings of previous research by examining residents’ ability to predict health literacy levels in patients and to use a newer validated measure of health literacy. A total of 38 patient encounters were included in this study. Patients were administered the Health Literacy Skills Instrument-Short Form to assess health literacy levels. Twenty resident physicians conducted visits with study participants and were asked to predict the health literacy of their patients. Results indicated that, consistent with previous research, residents’ predictions of patient health literacy were not consistent with patient health literacy levels as measured by the Health Literacy Skills Instrument-Short Form. Implications of these findings and future directions are discussed.

Cardiac rehabilitation program and health literacy levels: A cross-sectional, descriptive study.

In Portugal, cardiovascular diseases stand out among the main causes of morbidity, disability, and mortality, with an expectation of growth up to the year 2025. A descriptive, exploratory study was carried out with patients in a cardiac rehabilitation program from an institution in the northern region of Portugal; 103 participants were randomly selected for the study. The data collection took place from February to April 2017. The majority of respondents presented a low level of literacy (inadequate and problematic). The profiles of the participants were characterized by the predominance of married males, with a mean age of 69 years. The participants considered doctors and nurses as the professionals who contribute the most to the increase of their health literacy. These health professionals have the opportunity and the responsibility to increase the health literacy levels of patients. It is known that low levels of health literacy are a problem throughout the European Union. Portugal's general population reflects this reality, and this study contributed to the conclusion that cardiac rehabilitation patients also present worrying levels of health literacy.

State of health literacy in higher education (M.H.S.A &amp; M.H.A programs) in the U.S.

This article was migrated. The article was not marked as recommended. Only 12% of the American adults are considered proficiently health literate. Limited health literacy is known to be associated with avoidance of seeking access to healthcare and poor adherence of healthcare instructions. While majority of the research of has been focused on the health literacy level of patients, nurses, and the physicians, few studies have focused on hospital CEOs. While hospital CEOs come with diverse educational backgrounds, Master of Health Services Administration (M.H.S.A) and Master of Health Administration (M.H.A) are known as programs that "groom" future leaders in healthcare. This is why this paper examines if M.H.S.A and M.H.A programs put much emphasis on health literacy. Descriptive analysis was done to examine top 5 ranked M.H.S.A and M.H.A programs' vision, mission statements, and competency models and whether there was any mention of the word 'health literacy.' The result shows that none of the selected programs' vision, mission statements, and competency models mentioned anything in regards to 'health literacy.' If programs fail to stress the importance of health literacy, future hospital CEOs will lack the knowledge regarding the importance of health literacy.

Health literacy and surgery expectations in total hip and knee arthroplasty patients

ObjectivesThis study assessed patients’ health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers. MethodsA convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study. ResultsResults demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery. ConclusionsPractices should be aware that caregivers may not be any better equipped to consume and use complicated patient education materials than the patient they are assisting. Additionally, lower health literacy, rather than or in addition to race or social factors, may contribute to disparities in opting for THA/TKA because of lower expectations for walking after surgery. Practice implicationsHealthcare practices should develop patient educational materials that are easy for all patients and caregivers to understand, especially those with low health literacy. Additional patient education and counseling may help patients with low health literacy realistically align their expectations and mitigate barriers to consenting to surgery due to low expectations.

Health literacy of patients admitted for elective surgery

AimPatients with limited health literacy have poorer surgical outcomes. However, current studies assessing the prevalence of limited health literacy in patients expecting surgery are small scale. We aimed to provide insight into the health literacy level of patients undergoing planned surgery.Subject and MethodsPatients aged ≥18 years visiting the preoperative screening department were approached in the waiting area and invited to participate in a brief interview including the Functional Communicative Critical Health Literacy (FCCHL).ResultsIn total, 225 patients (84.9% response) were studied. Based on the FCCHL, 37.3% of the patients were classified as having limited health literacy. The mean score in the critical domain (2.7 ± 0.9) was lower than scores in the functional (3.3 ± 0.6) and communicative (3.3 ± 0.6) domains.ConclusionMore than one third of the patients admitted to the hospital for surgery had limited health literacy. Healthcare professionals should be aware of the different health literacy levels and tailor their information provision strategies accordingly.

Health Literacy Rates in a Population of Patients with Rheumatoid Arthritis in Southwestern Ontario.

To determine the rate of low health literacy in the rheumatoid arthritis (RA) population in southwestern Ontario. For the study, 432 patients with RA were contacted, and 311 completed the assessment. The health literacy levels of the participants were estimated using 4 assessment tools administered in the following order: the Single Item Literacy Screener (SILS), the Medical Term Recognition Test (METER), the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Shortened Test of Functional Health Literacy in Adults (STOFHLA). The rates of low literacy as estimated by STOFHLA, REALM, METER, and SILS were 14.5%, 14.8%, 14.1%, and 18.6%, respectively. All 4 assessment tools were statistically significantly correlated. STOFHLA, REALM, and METER were strongly correlated with each other (r = 0.59-0.79), while SILS only demonstrated moderate correlations with the other assessment tools (r = 0.33-0.45). Multiple linear regression and binary logistic regression analyses revealed that low levels of education and a lack of daily reading activity were common predictors of low health literacy. Using a non-English primary language at home was found to be a strong predictor of low health literacy in STOFHLA, REALM, and METER. Male sex was found to be a significant predictor of poor performance in REALM and METER, but not STOFHLA. Low health literacy is an important issue in the southwestern Ontario RA population. About 1 in 7 patients with RA may not have the necessary skills to become involved in making decisions regarding their personal health. Rheumatologists should be aware of the low health literacy levels of patients with RA and should consider identifying patients at risk of low health literacy.

How well do patients understand written instructions?: health literacy assessment in rural and urban rheumatology outpatients.

The aim of this study was to assess health literacy (word recognition and comprehension) in patients at a rural rheumatology practice and to compare this to health literacy levels in patients from an urban rheumatology practice.Inclusion criteria for this cross-sectional study were as follows: ≥18-year-old patients at a rural rheumatology practice (Mid-North Coast Arthritis Clinic, Coffs Harbour, Australia) and an urban Sydney rheumatology practice (Combined Rheumatology Practice, Kogarah, Australia). Exclusion criteria were as follows: ill-health precluding participation; poor vision/hearing, non-English primary language. Word recognition was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). Comprehension was assessed using the Test of Functional Health Literacy in Adults (TOFHLA). Practical comprehension and numeracy were assessed by asking patients to follow prescribing instructions for 5 common rheumatology medications.At the rural practice (Mid-North Coast Arthritis Clinic), 124/160 patients agreed to participate (F:M 83:41, mean age 60.3 ± 12.2) whereas the corresponding number at the urban practice (Combined Rheumatology Practice) was 99/119 (F:M 69:30, mean age 60.7 ± 17.5). Urban patients were more likely to be born overseas, speak another language at home, and be employed. There was no difference in REALM or TOFHLA scores between the 2 sites, and so data were pooled. REALM scores indicated 15% (33/223) of patients had a reading level ≤Grade 8 whereas 8% (18/223) had marginal or inadequate functional health literacy as assessed by the TOFHLA. Dosing instructions for ibuprofen and methotrexate were incorrectly understood by 32% (72/223) and 21% (46/223) of patients, respectively.Up to 15% of rural and urban patients had low health literacy and <1/3 of patients incorrectly followed dosing instructions for common rheumatology drugs.There was no significant difference in word recognition, functional health literacy, and numeracy between rural and urban rheumatology patients.

Validation of the Dutch functional, communicative and critical health literacy scales

ObjectiveWhile most existing health literacy (HL) measures focus primarily on reading comprehension, the functional, communicative and critical HL scales from Ishikawa et al. [19] aim to measure a broader HL spectrum. The objective of this study was to evaluate the validity of the Dutch translation of this instrument. MethodsTwo survey studies (n=79 and n=209) and one cognitive interview study (n=18) were performed among samples of breast cancer patients and patients with rheumatic diseases. ResultsAnalyses showed the scales measured three distinct factors and convergent validity was satisfactory for communicative and critical HL. Nevertheless, the comprehension of the items and the suitability of the response options raised some problems. ConclusionThe HL scales seem promising to measure a broad definition of HL. By revising some of the items and response options as proposed in this article, the scale will become more understandable for people with low HL skills, which might increase the content validity and the distributional properties of the scale. Practice implicationsThe scale should be revised and revalidated. An improved version should be used in practice to gain insight into HL levels of patients. This will help to develop suitable education programs for people with low HL skills.