Inadequate Health Literacy Level Research Articles

Factors Influencing Duration of Breastfeeding: Insights from a Prospective Study of Maternal Health Literacy and Obstetric Practices.

Numerous factors concerning early breastfeeding abandonment have been described, including health literacy (HL). This study's objective was to analyze factors related to early breastfeeding abandonment (<6 months). This prospective multicentric study examined the duration of breastfeeding at 6 months postpartum and was conducted in four different regions of Spain from January 2021 to January 2023. A total of 275 women participated in this study, which focused on maternal HL and obstetric practices. A decrease in the breastfeeding rate was observed from hospital discharge (n = 224, 81.5%) to the sixth month postpartum (n = 117, 42.5%). A Cox regression analysis revealed that inadequate HL levels, lack of mobilization during labour, and induced labour were significantly associated with early breastfeeding cessation (p = 0.022, p = 0.019, and p = 0.010, respectively). The results highlight that women with adequate HL had a 32% lower risk of early breastfeeding abandonment. In comparison, mobilization during labour and induction of labour were linked to a 32.4% reduction and a 53.8% increase in this risk, respectively. These findings emphasize the importance of considering obstetric and HL factors when addressing the breastfeeding duration, indicating opportunities for educational and perinatal care interventions.

Health literacy in migrants: the SPRINT2 project

Abstract Introduction Migrants generally reported lower levels of health literacy (HL) thus increasing their difficulties in accessing and interacting with the healthcare system. This study, carried out within the SPRINT2 project, aims to assess the HL level of 2 samples of asylum seekers and refugees residing in Tuscany, and to examine the relationship among HL, educational interventions, COVID-19 risk perception and preventive behaviours Materials and Methods Questionnaires were administered to a sample of refugees and asylum seekers (group A) between June and September 2021 and to another sample between April and September 2022 (group B) which participated at least in one health-related educational intervention. The Italian version of HLS-EU-Q16 was used to measure HL Results Among 171 subjects belonging to group A 25% had an inadequate HL level. Group B consisted of 102 respondents of which 37% had an inadequate HL level. Group B compared with group A had higher percentages of respondents who considered COVID-19 a serious health problem (58.8% vs 41.1%), very likely to be infected by SARS-COV-2 (58.2% vs 29.6%) and who thought quarantine compliance (89.7% vs 75.9%), the use nasopharyngeal swabs (78.4% vs 61.2%), and to get COVID-19 vaccination (89.4% vs 66.1%) were very important preventive measures. HL was found to be significantly associated (p &amp;lt; 0.05) with COVID-19 risk perception and propensity for handwashing, face mask use, and social distancing. At multivariate logistic analysis, low educational level and residing in Italy for less than 2 years were found to be predictors of inadequate HL level (OR 2,7 CI 95% 1,22-6,13; OR 3,9 CI 95% 1,93-7.79, respectively). Conclusions Our findings suggest that HL and educational interventions are important factor to improve healthy behaviours. Structured educational interventions to increase HL levels will be an important contribution in the process of inclusion and integration of migrants thus reducing health related inequalities. Key messages • The level of health literacy among migrants is most influenced by their educational level and length of stay in Italy. • Health literacy and educational interventions are important factor to improve healthy behaviours.

School principals stress, wellbeing, and health literacy during the Pandemic

Abstract Background Mental health of school principals is poorly researched in public health, despite principals being critical to the success of sustainable school development. They are the key agents enabling and leading the implementation of school health promotion, which elevates the importance of their mental health state. Evidence shows that principals are more likely to suffer from work-related stress and psychological strain, but given the additional stress during the Covid-19 pandemic, their mental health was more at risk. Health literacy could be an asset in the interplay of mental health and stress. The aim of this study is to examine the associations between principals’ corona-specific health literacy and their perceived stress, wellbeing, and psychosomatic complaints. Methods As part of the international COVID-HL school principal survey, an online study among German school principals in four federal states was conducted during the third infection wave (Mar-Apr 2021). Health literacy, perceived stress, wellbeing, and psychosomatic complaints were measured using self-report tools. Descriptive statistics, variance with subsequent post-hoc analyses and effect sizes were computed. Results A total of N = 2186 principals completed the survey, with 60.5% showing an adequate, 31.4% a problematic and 8.1% an inadequate health literacy level. Welch's ANOVA indicated significant differences between the health literacy levels and perceived stress (F(2, 423.734) = 69.51, p &amp;lt; 0.001; η2 = 0.06) as well as wellbeing (F(2, 407.343) = 33.463, p &amp;lt; 0.001; η2 = 0.034). One-way ANOVA showed significant differences between health literacy and psychosomatic complaints (F(2, 1775) = 15.94, p &amp;lt; 0.001; η2 = 0.018). Conclusions The findings emphasize that health literacy could be an asset for principals’ mental health, suggesting to include health literacy more frequently to public mental health promotion interventions. This will require an acknowledgment from public health and educational policies.

Health literacy and hypertension among middle and elderly aged population in Myanmar: A cross-sectional study

Background: Hypertension and cardiovascular diseases are highly prevalence and the leading causes of deaths in Myanmar. There are no previous studies that focus on health literacy and hypertension in Myanmar. Objectives: This study aimed to identify the prevalence of hypertension and association between health literacy and hypertension among middle and elderly aged in Mandalay Region, Myanmar.Methods: An analytical cross-sectional study was conducted among middle aged and elderly population in 3 townships of Mandalay Region, Myanmar. A multiple logistics regression was used to determine the association between hypertension and determinant factors after controlling the effects of co-variates presenting adjusted OR and 95% confidence interval.Results: Of the total 410 respondents, the prevalence of hypertension was 21.95 %. Where, 39.02% had inadequate health literacy level of hypertension. The factors significantly associated with hypertension were inadequate and problematic health literacy (AOR= 2.74, 95%CI: 1.43 - 5.21), age 50-59 years (AOR= 3.70, 95%CI: 1.71 -7.97), ≥ 60 (AOR= 4.48, 95%CI: 2.22 - 9.04), unemployed (AOR= 2.40, 95%CI: 1.23 - 4.68), overweight (AOR= 3.85, 95%CI: 1.84 – 8.07), and obesity (AOR= 6.00, 95%CI: 2.75 - 13.08), salty foods consumption (AOR= 3.12, 95%CI: 1.68 – 5.79), sweet fruits consumption (AOR= 4.00, 95%CI: 1.95 – 8.19), consuming food cooked with sesame or peanut oil (AOR= 2.03, 95%CI: 1.06 – 3.87) and alcohol consumption (AOR= 7.43, 95%CI: 3.56 - 15.49), no depression (CESD &lt; 16) (AOR= 2.65, 95%CI: 1.37 – 5.09).Conclusion: The concerned organizations should provide health literacy to address increasing pattern of hypertension and prevention and health promotion activities should be encouraged. Further studies with operational research or longitudinal study design are recommended to provide the better understanding of the relationship between health literacy, other factors, and hypertension among middle and elderly aged.

Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study.

Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24–48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.

The Relationship Between Health Literacy and Quality of Life, Attitudes and Perceptions of Covid-19 and Vaccination Among Patients with Systemic Autoimmune Diseases.

This study aimed to evaluate health literacy in patients (n=395) with systemic autoimmune diseases (SAD) and analyze their relationships with health-related quality of life (HRQoL), attitudes and beliefs about Covid-19 and vaccination, and perceptions of changes in medical care during the pandemic. This study was cross-sectional and the majority (81%) of particpants resided in Spain. An anonymous online survey was distributed to an online SAD association. Health literacy was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the SF-36 tool was used to assess HRQoL. More than half of patients (57.7%) have inadequate health literacy and the mean health literacy level was 9.63(5.66). Patients with inadequate health literacy levels presented the lowest HRQoL scores in all SF-36 domains (p < .001). Health literacy scores were positively correlated with all SF-36 domains (p < .001). The reservations to get vaccinated against Covid-19 were linked to health literacy level (p = 0.024). There are high levels of inadequate health literacy among patients with SAD and it is associated with worse HRQoL and risk attitudes about Covid-19 vaccination and medical care during the pandemic.

Health literacy among older adults in Switzerland: cross-sectional evidence from a nationally representative population-based observational study.

Despite being widely regarded as a major cause of health inequalities, little is known regarding health literacy and its association with certain personal characteristics among older adults in Switzerland. To fill this gap, this study assesses health literacy and its associations with individuals' social, regional, and health characteristics in a nationally representative sample of adults aged 58 years and older in Switzerland. We use data of 1,625 respondents from a paper-and-pencil self-completion questionnaire (cooperation rate: 94.3%) that was administered as part of wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland. Health literacy is measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). The scale includes 16 items whose dichotomised responses allow the construction of different indices and sub-indices aimed at measuring various aspects of health literacy. We use multivariable regressions to explore how respondents' sociodemographic characteristics are independently associated with health literacy. Overall, 6.8% of the respondents had inadequate health literacy, 24.6% problematic health literacy, and 68.6% sufficient health literacy. There were significant associations between health literacy and individuals' gender, education, economic situation, and self-rated health. Women had higher levels of health literacy than men (p <0.001). Moreover, a higher education level (p <0.001), fewer financial difficulties (p<0.01), and higher self-rated health (p <0.001) were positively correlated with adequate/higher levels of health literacy. One-third of older citizens have difficulties managing health-related issues in Switzerland. Individuals with low education, financial difficulties, and bad self-rated health are particularly at risk of being disadvantaged due to their inadequate health literacy level. These findings call for targeted interventions, such as using simplified health or eHealth information tools, improved patient-provider communication and shared decision-making, promoting lifelong learnings activities and health literacy screening for older patients to increase low health literacy and mitigate its consequences, thereby alleviating remaining social health inequalities in the Swiss population.

P126: HEALTH LITERACY AND DISEASE KNOWLEDGE IN YOUNG PERSONS WITH SICKLE CELL DISEASE

Background: People living with Sickle Cell Disease (SCD) often suffer excruciating painful episodes, which can be triggered by infection, extreme weather conditions or stress, and lead to frequent hospital admissions (1,2). Having the requisite knowledge about the disease and adequate health literacy may be beneficial for early recognition of symptoms, avoidance of triggers of these painful episodes and overall management of the condition (3). This is a pilot study in preparation for a larger study to examine relationships between health literacy, disease knowledge and health outcomes in young persons with SCD. Aim: This pilot study aimed to test the use of a French version of The Health Literacy Measure for Adolescents (HELMA) questionnaire and a sickle cell disease-specific knowledge questionnaire to assess the health literacy and disease knowledge levels of young people with SCD in a clinical setting in West Africa. Methods: Young patients (aged 15 to 24 years) attending a routine Hematology clinic of The University Hospital (CNHU) in Benin and who could speak French were invited to participate in a questionnaire study. An SCD knowledge questionnaire was developed by administering a survey to 7 medical doctors to gather questions they considered relevant for young patients living with SCD. These responses formed the basis of the questionnaire with 18 questions. Of these, 17 questions were given a score of 1 point while 1 question was given a score of 6 points giving a total of 23 points, with a score greater than 16 indicating high knowledge. The HELMA questionnaire was translated into French. It consists of 44 items transferred to a score from 0 to 100. A score of over 66 is considered an adequate health literacy level. Results: A total of 27 patients were recruited for the study (17 males, 63%). The mean age of the patients was 20 years (range: 15–24 years). Most of the patients in this sample (n=17, 63%) were attending secondary schools, 33% (n=9) were in tertiary institutions while 4% (n=1) had completed primary education. The average time used to complete the SCD questionnaire was 6 minutes (range: 4–8 minutes) while most of the patients completed the health literacy questionnaire after 30 minutes (range: 25–35 minutes). Few patients (n=3; 11%) scored less than 16 points on the SCD knowledge questionnaire indicating a high SCD knowledge in this group, while most of the patients (n=20, 73%) had a score of less than 66 on the HELMA questionnaire indicating inadequate health literacy levels. Summary/Conclusions: This study suggests that it may be challenging to use the HELMA in a clinical setting due to the long duration needed for the administration. A shorter version of the HELMA for use in a clinical setting might be helpful. However, the sickle cell disease-specific questionnaire is suitable to assess patients’ knowledge about their condition in a clinical setting.

Do health literacy levels of nursing students change throughout the study programme? A cross-sectional study

ObjectivesThe aim of this research was to analyse if the level of health literacy (HL) of nursing students changes throughout the study programme.DesignA cross-sectional study with anonymous self-reporting was conducted.Participants/setting329...

Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy.

Background: Health Literacy (HL) is one of the main determinants of health and is crucial for the prevention of noncommunicable diseases, by influencing key health-related behaviours. The aim of the present study was to assess the role of HL and sociodemographic factors in predicting the adoption of two healthy behaviours—physical activity and fruits and vegetables consumption. Methods: This study was conducted on the Tuscan population subsample of the Italian Behavioral Risk Factor Surveillance System in 2017–2018. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results: About 40% of the 7157 interviewees reported an inadequate or problematic HL level. Female sex, poor financial status, foreign nationality, and low education were associated with a problematic HL level, while an inadequate HL level was associated with being 50–69 years old, low education level, foreign nationality, poor financial status and unemployment or inactive status. Inadequate HL level was a strong predictor of both eating less than three portions of fruits/vegetables per day and not engaging in sufficient PA during leisure times. Conclusions: Our findings showed that an inadequate level of HL could negatively affect physical activity and diet, independently from the other sociodemographic conditions, confirming the role of HL as a relevant social determinant of health.

Health literacy of parents/caregivers of paediatric surgical patients: A study on 1000 individuals

Purpose:There is a paucity of studies concerning health literacy (HL) of parents/guardians of patients in paediatric surgery. The purpose of our study is to measure HL levels of parents/guardians of paediatric surgery patients and to explore the determinants of low HL levels in this population.Materials and Methods:We conducted a cross-sectional study from December 2016 to July 2018 through in-person interviews of parents/guardians of paediatric surgical patients. Sociodemographic and clinical data were recorded, and HL levels were calculated using a validated tool (HLS-EU-Q16). In order to examine the impact of various sociodemographic variables and clinical data on HL, a multivariate regression model was run.Results:A total of 1000 participants were recruited (recruitment rate 93.5%). Slightly less than half (44.2%) presented problematic or inadequate HL levels. The results of the regression analysis showed that nationality other than Greek (β = −2.180, P < 0.001) and lower health insurance status (β = −0.461, P < 0.05) were associated with lower HL levels. HL was found positively associated with the educational level of the parent (β = −0.775, P < 0.001) and being a health professional (β = 1.791, P < 0.001).Conclusion:The prevalence of low HL levels in the parents/guardians of paediatric surgical patients is high and should not be neglected both in the pre-operative and post-operative setting. Communication should be tailored to the specific needs of each individual to achieve better engagement and quality of care.

Health literacy and diabetes self-care in individuals with type 2 diabetes in Turkey

AimThe aim of this study was to examine the relationship between health literacy and diabetes self-care in individuals with type 2 diabetes. MethodsThis cross-sectional study was conducted with 207 individuals with Type 2 diabetes at a diabetes outpatient clinic of a foundation university hospital in Istanbul, Turkey. The data were collected using a sociodemographic and illness characteristics questionnaire, the Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q-TR), and the Diabetes Self-Care Scale (DSCS). Data were analyzed using descriptive statistics, one-way ANOVA, Student’s t-test, Pearson correlation test, and multiple regression analysis. ResultsIt was found that 81.5% of individuals with type 2 diabetes were at an inadequate or limited and problematic level of health literacy. The DSCS mean scores of patients with an inadequate health literacy level were significantly lower than that of patients at other levels of health literacy. It was determined that education level, exercise status, and HLS-EU-Q-TR scores were significantly related to diabetes self-care (R² = 0.245, p < 0.001). ConclusionThe study found that individuals with type 2 diabetes had higher diabetes self-care if they had a high education level, regularly exercised, or had high HLS-EU-Q-TR mean scores.

Health Literacy in Female – Association with Socioeconomic Factors and Effects on Reproductive Health

Abstract The aim of the study is to assess the health literacy of women who are using health services within the Gynecology Obstetric Clinic “Narodni Front” in Belgrade. Testing of health literacy was conducted as a cross-sectional study in the period October-November 2012. As instruments of research the following questionnaires are used: Short Test of Functional Health Literacy in Adults and General information questionnaire of respondents who referred to the demographic, social and economic characteristics of respondents, self-assessment of health, use of health services, health knowledge and behavior in the area of reproductive health. Inadequate health literacy level is registered in every ten respondents. The education level of the respondents proved to be a significant predictor of health literacy. Demographic and socio-economic characteristics of the patients (age, occupation, marital status) as well as self-evaluation of the health status were not significantly related to the health literacy. Health literacy respondents did not significantly dependent on risk behaviors related to reproductive health. The level of health literacy is consistent with the knowledge of subjects in the field of protection of reproductive health. Health literacy as the ability to function within the health care system is equally certain by individual characteristics and skills, characteristics of the health and education systems as well as a wide range of social and cultural factors. Health literacy is more systematic than individual problem, so it requires a broader social action.

Health Literacy Risk in Older Adults With and Without Mild Cognitive Impairment.

BackgroundThe relationship between an increasing elderly population and wide-ranging neurological conditions has led to heightened rates of cognitive function impairment. Some researchers have found that health literacy risk may be associated with cognitive impairment in older adults.ObjectivesThe purpose of this study was to delineate the difference in health literacy risk between older adults with mild cognitive impairment and those with normal cognitive function.MethodsWe conducted a survey study to explore the health literacy risk in older adults with and without mild cognitive impairment. Data were collected from 412 subjects between 60 and 91 years of age (260 without and 152 with mild cognitive impairment) between June and December 2016 in China. Cognitive function was measured using the Mini-Mental Status Examination, Montreal Cognitive Assessment, Global Deterioration Scale, Activities of Daily Living, and Hamilton Depression Rating Scale. Health literacy was measured using the Chinese Citizen Health Literacy Questionnaire.ResultsThe scores of total health literacy and its three dimensions (basic health knowledge and mind, basic skills, and health lifestyle and behavior) were lower in those with mild cognitive impairment. Older adults with normal cognitive function had adequate or marginal health literacy levels, whereas those with mild cognitive impairment had marginal or inadequate health literacy levels. Using multiple logistic regression analysis, we found that health literacy risk, education level, age, marital status, and body mass index were independent risk factors for mild cognitive impairment.DiscussionThese results suggest that low health literacy may be a predictor of mild cognitive impairment. Screening for lower health literacy risk should be included in multidimensional geriatric evaluation.

A Systematic Review and Meta-Analysis of Health Literacy in the Iranian Population: Findings and Implications

Context: Health literacy includes social and cognitive skills determining individuals’ motivation to obtain and understand health information, thus empowers them to promote healthy behaviors. The exact level of health literacy in the Iranian population is unknown, as different Iranian studies have reported different health literacy rates in the Iranian population. Objectives: Therefore, this study aimed to investigate health literacy in the Iranian population by systematically combining and analyzing findings from the previous studies. Data Sources: A total of 26 articles in Persian and in English, published up to December 2017 were reviewed. Searching for articles with the keywords prevalence, abundance, health literacy, and Iran was conducted in the following national and international databases: Scientific Information Database (SID), Medline, Magiran,Web of Science, ScienceDirect, Google Scholar, PubMed, and Scopus. The data were analyzed using the meta-analysis method and a random effects model. The heterogeneity among the studies was examined using the I2 statistic. All the analyses were performed using the STATA 12 software. Results: The highest levels of health literacy were for the region 1 of Iran, including the following provinces: Alborz, Tehran, Qazvin, Mazandaran, Semnan, Golestan, and Gom (46.7% with 95% CI: 25.7 - 67.7). Moreover, pregnant women (37.4% with 95% CI: 27 - 53.3) had the highest level of health literacy. In contrast, older people (60.2% with 95% CI: 43.7 - 76.8) and patients with diabetes (55.4% with 95% CI: 35.6 - 75.2) had the lowest health literacy levels. Conclusions: The lowest health literacy level was in older people and patients with diabetes. Therefore, it seems necessary to provide education for communitiesandgroups with inadequate health literacy levels, especially older peopleandpatients with chronic diseases to improve their health.

Adult Functional Health Literacy and its Related Factors: A Cross-Sectional Study

Background and aims: Health literacy (HL) can affect individual health, health communication and error in taking medicine. The aim of this study was to determine the level of HL and associated factors among Iranian adults. Methods: In this cross-sectional study, 240 participants over 18 years of age referring to health centers in Hamadan, west of Iran in 2015 were selected by multistage random sampling. HL was assessed by the Test of Functional Health Literacy in Adults (TOFHLA). The questionnaire was completed by a trained interviewer. The independent variables were structural and intermediate social factors based on the Commission on Social Determinants of Health (CSDH). Data were analyzed by using IBM SPSS version 22. Results: Average age of the participants was 30.88 ±7.38 years and 75.4% of the them were female. The total score of HL was 64.58 ±16.71 (range: 23.82-98.98). Overall, 31.7% (n=76) of the participants had adequate HL level, 32.5% (n=78) had borderline HL level and 35.8% (n=86) had inadequate HL level. Additionally, participants with higher educational levels had higher HL scores than those with lower educational levels (P&lt;0.001). HL score was significantly higher in males than in females (P=0.017). Conclusion: HL level seems to be inadequate among Iranian adults in the west of Iran. Moreover, enhancing social determinants such as educational level seems to increase HL. The results highlighted the necessity for change and improvement in adults’ HL.

Health literacy levels of the workers in a steel factory: A cross sectional study in Turkey

Health literacy is important as it shows the degree to which a person understands and interprets medical information and makes the appropriate health decision. The workers of steel factories are often faced with health information and issues in their work place related to personal protection, occupational hazards and occupational injuries. Therefore, it is important to demonstrate the health literacy of the workers to ensure health literacy responsive work places. This paper aims to show the health literacy level of the steel factory male workers in Turkey.In this study, in order to measure the health literacy level of men, REALM and NVS scales were used. Additionally, questions related to socio-demographics and the health information sources and General Health Questionnaire were applied. For the analysis, chi-square and ANOVA tests were used.Of the participants, the mean age was 34.9±8.8 (min.–max.=18–53), the mean scores were 64.0±2.1, 3.2±1.2, and 1.5±0.8, respectively for REALM, NVS and GHQ scales. According to REALM scale, 8.1% (n=20) of the workers had limited health literacy. Whereas, in the NVS scale, 5.7% (n=14) had inadequate health literacy, and 55.1 % (n=136) had limited health literacy.At least one of every ten workers had limited or inadequate health literacy level. The results should be taken into consideration by the healthcare providers and policymakers while implementing health promotion interventions to increase the health literacy level of the workers.

The relationship between health literacy and disease specific costs in subjects with chronic obstructive pulmonary disease (COPD)

Aim In the present study, we aimed to investigate the relationship between health literacy levels and disease specific costs in subjects with chronic obstructive pulmonary disease (COPD) who were staged according to GOLD. Methods This was a descriptive study. The Health Literacy Scale of the European Union was filled out by all of the participants. Costs related to COPD were taken into account. Results Compared to health literacy, the total cost of health care and the cost of admission to the emergency room seemed to be higher for subjects with inadequate health literacy levels than for subjects with significant levels of illness (p = .05 and p = .006, respectively). As the number of comorbidities increased, total and emergency department admission costs increased (p < .001 and p = .003, respectively). There was a difference between GOLD stages according to total, pulmonary disease and emergency service costs. Conclusions In this study, it was determined that health literacy is an important factor affecting health expenditures with COPD subjects. With the improvement of health literacy, subjects are expected to reduce the overall cost burden of the disease.

Evaluation of Health Literacy in Veteran Affairs Outpatient Population: A Focus on Patient Self-Perceived Health Status

Health literacy is of great importance for clinicians to maximize patient involvement and in the effective delivery of healthcare services. Health literacy driven health communication strategies may encourage appropriate and optimal use of healthcare resources and medications. We evaluated health literacy level in veterans with unique population demographics and focused on patient self-perceived health status (SPHS). Veterans (N=194) were enrolled in this cross-sectional study. Only 40% had poor or inadequate health literacy level. Older individuals displayed poorer health literacy level. 57.2% of the patients had good/above SPHS. Patients with good or above SPHS had 1.7 times higher (OR: 1.68, 95% CI=0.79-3.54) compared to patients with below good SPHS. Veterans with hospitalization were 11% less likely (OR=0.89) to report good or adequate health literacy level compared to those not hospitalized. Veterans with good or adequate health literacy level perceived their health status to be better than veterans with poor or inadequate health literacy. Using plain and simple language by providers while counseling patients about their disease and medications, might have a positive ripple effect on the current patient-centered care delivery. Clinicians could use a tailored approach to improve communication with patients.

Abstract: One Third of Plastic and Surgical Patients Have Limited Health Literacy: A Systematic Review and Meta-Analysis

INTRODUCTION: Health literacy has been defined as the extent to which patients are able to understand and act upon health information.1 Limited or inadequate health literacy has been shown to have a negative impact on patient satisfaction, clinical outcomes, and risk of hospitalization.2,3 This complex concept is of high importance for surgeons as their patients have to comprehend the nature, risks and benefits of surgical procedures, adhere to strict perioperative rules, and make complex care decisions about interventions or lack thereof.4 The aim of this review was to evaluate the prevalence of reported inadequate health literacy levels and the measurement tools used in the plastic and surgical patient populations. METHODS: A systematic review and meta-analysis was conducted according to the Cochrane guidelines. Relevant studies reporting health literacy measurements in surgical patient populations were identified from MEDLINE and Embase published from inception until January 14th2017. Two-stage screening and data extraction were performed by two independent reviewers. Data on study design, sample size, patient population, health literacy measurement tool, and prevalence of inadequate health literacy were extracted and analyzed. RESULTS: A total of 934 abstracts were screened, 103 articles were reviewed and 57 met inclusion criteria. Five randomized controlled trials, 8 prospective cohorts, 36 cross-sectional studies were included including only 11 (19.0%) studies published before 2010. 18,894 surgical patients were included in these studies and the prevalence of inadequate health literacy was 32.8% (range 2.8–80.7%, 95%CI: 25.9–40.1). Fifteen (26.3%) studies did not present health literacy measurement results. Numerous health literacy measurement tools were used (16 validated, 6 non-validated). Only five studies pertained to the hand surgery and one to the plastic surgery literature. CONCLUSION: Our review demonstrates a high prevalence of limited health literacy within the plastic and overall surgical patient populations. While there is considerable variation in measurement tools currently being used, our review suggests a great need for patient-education and decision-aid tools for surgical patients with limited health literacy. Reference Citations: 1. Nielsen-Bohlman L, Institute of Medicine. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press; 2004. 2. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Viera A, Crotty K, et al. Health literacy interventions and outcomes: an updated systematic review. Evid Report Technology Assess. 2011;199:1–941. 3. Komenaka IK, Nodora JN, Machado L, Hsu CH, Klemens AE, Martinez ME, et al. Health literacy assessment and patient satisfaction in surgical practice. Surgery. 2014;155:374–383. 4. McCaffery KJ, Smith SK, Wolf M. The challenge of shared decision making among patients with lower literacy: a framework for research and development. Med Decis Making. 2010;30:35–44.