Health literacy profiles of adults with multiple chronic diseases: A cross-sectional study using the Health Literacy Questionnaire

Nurs Health Sci. 2020 Dec;22(4):1153-1160. doi: 10.1111/nhs.12785. Epub 2020 Oct 25.

Abstract

Health literacy is multidimensional, comprising functional, communicative, and critical thinking dimensions. Understanding health literacy is crucial for clinicians to develop effective health education strategies. In this study, we examined the multiple dimensions of health literacy in Vietnamese adults with chronic comorbidities. A cross-sectional sample of 600 patients, aged ≥18 years with a diagnosis of at least two chronic diseases (cardiovascular conditions, chronic kidney disease, or diabetes), completed the Health Literacy Questionnaire, an instrument assessing nine distinct domains. Descriptive and parametric tests were performed to analyze the health literacy levels for various demographic characteristics. Generalized linear models using backward modelling explored factors associated with higher health literacy. The lowest scoring domains were "Healthcare provider support" and "Appraisal of health information." In multivariate models greater health literacy was associated with those <65 years, having a postsecondary degree or higher level of education, greater income, urban residence, being cared for by spouses/children, and having fewer comorbidities. To improve health literacy, clinicians in primary and acute healthcare settings should build supportive relationships with patients and assist them with understanding and appraising health information.

Keywords: comorbidity; health literacy; multiple chronic disease; patient education Vietnam.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Literacy / classification*
  • Health Literacy / standards
  • Health Literacy / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Multiple Chronic Conditions / classification
  • Multiple Chronic Conditions / psychology*
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Socioeconomic Factors
  • Surveys and Questionnaires