Objective: To relate health literacy of adults from primary health care with type 2 diabetes mellitus and sociodemographic and clinical variables.

Method: Descriptive analytical cross-sectional study with 169 participants aged 18 to 65 with type 2 diabetes mellitus, from six primary care units in the Metropolitan Region of Curitiba, Paraná, Brazil. Data collection took place from July 2023 to March 2024, and a sociodemographic and clinical questionnaire was used, as well as subscales six and nine of the Health Literacy Questionnaire, Brazilian version. Data were analyzed descriptively and using Student's t-test, Mann-Whitney, Anova, Kruskal-Wallis, and Spearman tests.

Results: Of the 169 participants, the mean age was 56.5 ± 6.2 years. There was a significant association between the ability to interact with health professionals and male gender (p = 0.057), fasting blood glucose ≤ 130 mg/dL (p = 0.033), and between education and understanding health information and knowing what to do (p = <0.001). A weak correlation was found between understanding health information and knowing what to do and education and family income (r = 0.50 and 0.35, respectively) and significant value with glycated hemoglobin (p = 0.031).

Conclusion: There was a relationship between health literacy and male gender, education, family income, and glycemic values. These results can contribute to the development of educational actions aimed at strengthening health literacy.

Introduction: Dialysis social workers (DSWs) educate and advocate for end-stage kidney disease (ESKD) patients during the kidney transplantation (KT) process. However, little is known about the barriers DSWs face as they help patients get waitlisted and how to best support their efforts. We interviewed DSWs across New York (NY) State to examine their experiences, supports, and challenges in helping dialysis patients progress through KT education, referral, and evaluation.

Methods: We conducted semi-structured interviews with DSWs in NY State who had participated or expressed interest in a program designed to educate DSWs about KT and used rapid qualitative analysis to identify themes.

Findings: We interviewed 17 DSWs. Seven themes emerged: (1) DSWs report involvement in KT interest assessment, education, referral, and evaluation support, (2) DSWs report varying nephrologist support in helping patients progress to KT, (3) DSWs perceive social support and adherence as key factors in KT centers' eligibility determinations, (4) DSWs have knowledge gaps around living donation and appreciate learning about KT from transplant centers and non-profit organizations, (5) Patients express KT concerns and DSWs counsel them about these concerns, (6) DSWs report solutions to help patients complete KT evaluation appointments, and (7) DSWs report communication deficiencies between dialysis centers and transplant centers, and patients.

Conclusions: Education for DSWs, support from nephrologists, and resources to help patients complete KT evaluation steps facilitated DSW engagement throughout the pre-transplant process, underscoring the need for multi-level, cross-disciplinary programs to support these efforts.

Diet therapy can help alleviate chronic pancreatitis symptoms. The quality of diet therapy content in Internet videos varies markedly. Evaluating and assessing these videos is crucial for providing reliable patient education. This study aims to analyze 102 Internet videos regarding dietary therapy for chronic pancreatitis on media platforms in China (Bilibili, Weibo, and Tiktok) and rate their content, reliability, and quality. Videos were categorized into 3 sources: hospital or university officials, medical doctors, and independent users. An 8-point scale was used to score content (smoking, drinking, eating frequency, overeating, and nutrient intake [high-quality protein, low fat, nutrition, and dietary fiber]). An adapted DISCERN tool was used to assess reliability, with the Global Quality Scale employed to measure quality. Among the 102 videos analyzed, 34 (4, 9, and 21 from hospital or university officials, medical doctors, and independent users, respectively) were rated as low quality, 37 (8, 12, and 17 from hospital or university officials, medical doctors, and independent users, respectively) were rated as moderate quality, and 31 (7, 19, and 6 from hospital or university officials, medical doctors, and independent users, respectively) were rated as high quality. Thus, among 102 videos from TikTok, Weibo, and Bilibili, only 31 (30.4%) were considered high quality based on reliability and quality assessments, and some were misleading. Our findings suggest nearly 70% of health videos fail to meet high-quality standards, highlighting critical needs for improved content moderation across media platforms. Medical professionals and institutions should be encouraged to produce more high-quality Internet videos with comprehensive content to better guide and support patients with pancreatitis in adopting effective dietary therapy.

This study assessed the impact of teach back educational model plus zinc supplementation on asthma children. Eighty-one asthma children hospitalized in Children's Hospital of Soochow University, Suzhou, China from September 2020 to October 2021 were selected, and randomly allocated to a control group and an observation group. The control group took routine treatment, and routine educational modalities. By contrast, the Teach back mode of health education and zinc supplementation were added to the observation group. The results showed significant improvement in time to clinical symptom relief and immunological levels in both groups. However, asthma knowledge score, medication adherence, and asthma symptom control were significantly higher in observation group one month following discharge than in control group. We conclude that teach-back health education improved caregivers' asthma knowledge, children's medication compliance, and asthma symptom control scores in the short term.

Objective: This study aimed to comprehensively evaluate the eHealth literacy of patients with cardiovascular diseases and uncover the associated influencing factors. The findings are intended to lay a solid foundation for formulating targeted strategies to enhance the health literacy of this patient population.

Methods: Between October 2023 and June 2024, a purposive sampling approach was employed to recruit patients with cardiovascular diseases visiting the cardiology department of a tertiary hospital in Shandong Province. The eHealth Literacy Scale (eHEALS) was utilized to assess the eHealth literacy levels of the participants. Based on the assessment results, the subjects were classified into qualified and unqualified groups. Subsequently, logistic regression analysis was conducted to identify the influencing factors underlying eHealth literacy.

Results: The eHealth literacy score among cardiovascular disease patients was 20.46 ± 9.54, with a passing rate of 38.6%. The overall mean score across all items was 2.5 ± 1.19. Specifically, for the sub-domains of internet health information service capabilities and application abilities, evaluation capabilities of internet health information and services, and decision - making capabilities of internet health information and services, the mean scores were 2.49 ± 1.18, 2.67 ± 1.32, and 2.66 ± 1.35, respectively. Findings from binary logistic regression analysis suggest that education level, sleep quality, residing in close proximity to a medical institution (distance < 5 km), prior utilization of medical information websites or search engines, as well as the interaction between proactive health awareness and utilization of medical information websites or search engines, were all influencing factors for the qualification of e - health literacy (p < 0.05). These results underscore the complex interplay of multiple factors in determining patients' eHealth literacy levels, which has important implications for the design and implementation of effective health information dissemination and patient education strategies in the digital age.

Conclusion: Our findings reveal that the eHealth literacy among cardiovascular disease (CVD) patients remains at a relatively low level. This situation underscores the urgent need for interventions aimed at enhancing patients' proactive health awareness and delivering targeted eHealth training programs. Specifically, such initiatives should be designed to enable patients to accurately access, comprehensively understand, critically evaluate, and effectively apply health information in the digital realm. By doing so, we can empower CVD patients to better manage their health in the context of the digital age, ultimately leading to an improvement in their eHealth literacy levels. These efforts are not only crucial for individual patient care but also have broader implications for optimizing health outcomes at a population level.

Objective: This work sought to determine the feasibility, acceptability, and potential effect of the nursing intervention "Knowledge and self-care behaviors of pregnant women in the face of hypertensive disorders of pregnancy - EducaTHE".

Methods: This study is a pilot randomized controlled trial. Sixty pregnant women who were enrolled in the antenatal care program of a health institution participated. They were selected via simple random sampling and assigned to the experimental group (n = 30) and control group (n = 30). The intervention consisted of four educational sessions once a week, while the control group received usual antenatal care. Recruitment, follow-up, and dropout rates were assessed, as well as participant satisfaction. Both groups completed the "Knowledge and Self-Care Behaviors - CoNOCiTHE" and "Determinants of Behavior" scales before and four weeks after the intervention to assess impact.

Results: The recruitment rate was 75.94%, 90% at follow-up and 10% dropouts. Overall satisfaction was 4.82 out of 5. The effect of the intervention showed a significant increase in the level of knowledge and behaviors in the experimental group compared to the control group (77 vs. 69; p< 0.001) and in the determinants of behavior (159 vs. 154; p=0.066), and a large effect size (d-Cliff = 0.7517). These changes were not significant in the control group (p≥0.05).

Conclusion: This study shows the feasibility and acceptability of the intervention in the maternal population, as well as the potential ef-fect of improving knowledge and self-care behaviors in the face of hypertensive disorders of pregnancy. Therefore, it is rec-ommended to use these types of educational interventions in maternal and perinatal nursing care.

Objective: To develop and evaluate the usability of a serious game as an educational tool for promoting the health of children and adolescents with cancer.

Methods: The Contextualized Instructional Design (CID) methodology was applied to develop the serious game, structured in five stages: analysis, design, development, implementation, and evaluation. Usability assessment included children and adolescents diagnosed with cancer in a public federal referral hospital in a city in Northeastern Brazil, from April to June 2024. A sociodemographic questionnaire and the System Usability Scale with values ranging from 0 to 100 points were used.

Results: The serious game, entitled Oncoped: on the health journey, is an educational and playful board game that contains eight personalized Paper Toys, 35 houses, and 100 cards divided into multiple-choice questions about cancers, diagnosis, treatments, and challenges; and cards containing information and care tips. The usability assessment was carried out by 12 hospitalized children and 3 adolescents, who after using the game filled out the information on the scale, resulting in a mean score of 95.16 points.

Conclusion: The serious game Oncoped: on the health journey is a fun and playful educational tool that provides effective and active learning. The educational technology received an excellent usability assessment among the game's target audience. Thus, it was found that the tool is innovative and has good acceptability for teaching and promoting the health of children and adolescents with cancer.

Introduction: Emergency department visits are common following bariatric surgery and may be partially preventable. Health literacy and general self-efficacy are factors that may influence health-seeking behaviors in these patients. This study aimed to assess whether health literacy and general self-efficacy are associated with an increased frequency of emergency department visits after bariatric surgery.

Methods: Patients who underwent bariatric surgery at a single hospital from 2018 to 2020 were evaluated for their health literacy and general self-efficacy levels before surgery. Data on emergency department visits within the patient's residential region were evaluated over a three-year period, with repeated emergency department visits for abdominal pain as the primary outcome.

Results: During the follow-up period, 69 of 231 patients (29.9%) had at least one emergency department visit for abdominal pain, and 20 patients (8.7%) had three or more visits. Inadequate functional health literacy (OR 5.56, 95% CI 1.80-17.19, p = 0.003) and inadequate communicative and critical health literacy (OR 10.48, 95% CI 3.13-35.08, p < 0.001) were both significantly associated with an increased risk of repeated emergency department visits over the three-year period. No significant association was found between low general self-efficacy and the frequency of emergency department visits.

Conclusions: Inadequate health literacy is associated with an increased risk of repeated emergency department visits for abdominal pain following bariatric surgery.

Digital health literacy is a basic requirement for the use of digital health solutions. However, it is not yet sufficiently present among users, so that appropriate programmes are needed to promote it. The aim of this study is to investigate the effect of online self-learning platforms on digital health literacy. In a two-armed randomised controlled trial (RCT) with n = 40, participants were assigned to an intervention group (IG) and a control group (CG). The eHealth Literacy Scale (eHEALS) and an adapted version were used to assess digital health literacy. The effect was compared to before and to the control group after using the online self-learning platform. After the intervention digital health literacy improved in the intervention group (p < .001) in both scores and was higher in eHEALS-Score (p = .047) and eService-Score (p = .000) than in the control group. The results indicate that digital services should become increasingly relevant for promoting digital health literacy in the population.

Introduction: People with dementia and carers face challenges in understanding and managing medications at discharge. This study aimed to develop user-centered, co-designed medication management guidance tools to enhance medication management literacy post-hospitalization for these populations.

Methods: A four-phase, multi-methods study integrating experience-based co-design: (1) literature review, qualitative study, and survey; (2) expert advisory panels involving people with dementia; (3) focus groups with people with dementia, carers, and healthcare professionals; and (4) quantitative readability and suitability analysis.

Results: Two tools were developed: a simplified medication management guide for people with dementia and a carer-focused guide. Topics included shared decision-making, informed consent, and medications that can affect cognition. Participants valued the use of simple and active language, goal-of-care discussions, and the right to second opinion. Tools were acceptable for use from admission and during hospitalization.

Discussion: This study addresses gaps in medication related health literacy tools for dementia care, offering a framework for developing similar resources.

Highlights: Medication management guidance tools have not included people living with dementia or their carers in their development. This study is the first to describe the co-design of medication management guidance tools for people with dementia. Two tools were generated, one for people with dementia and one for carers to extend their agency. This co-design study can serve as a framework to inform the development of future tools for people with dementia and carers.

Aim: Laparoscopic salpingectomy has been widely used in the clinical treatment of benign tubal lesions. This study aims to explore the effects of interactive health education combined with evidence-based pain management nursing on disease cognition, postoperative pain and post-traumatic growth in patients undergoing laparoscopic salpingectomy, in order to provide new insights into clinical nursing for these patients.

Methods: In this retrospective study, 360 patients who underwent laparoscopic salpingectomy in our hospital from January 2022 to December 2023 were included. Patients receiving routine care were included in the control group (n = 213) and patients receiving interactive health education combined with evidence-based pain care were classified under the study group (n = 147). General data, disease cognition, postoperative pain and post-traumatic growth of the two groups were collected and compared.

Results: The awareness rate regarding pathogenesis, cardinal symptom, surgical and postoperative precautions, prevention of complications, medication management, diet management, sleep management, and review time and project in the study group were all significantly higher than those in the control group (p < 0.05). The numerical rating scale (NRS) scores of the study group were lower than those of the control group at 6 h, 12 h, 24 h and 48 h post-surgery (p < 0.001). Before discharge, all dimensions of the post-traumatic growth inventory (PTGI) scores like relating to others, new possibilities, personal strength, spiritual change, and appreciation of life of the study group patients were significantly higher than those of the control group (p < 0.05). The time to get out of bed, exhaust time, and hospitalization stay of the study group patients were significantly shorter than those of the control group (p < 0.05). The total incidence of complications in the study group was significantly lower than that in the control group (p < 0.05).

Conclusions: Interactive health education combined with evidence-based pain management nursing is conducive to improving disease cognition, reducing postoperative pain, enhancing post-traumatic growth, and promoting postoperative recovery in patients undergoing laparoscopic salpingectomy.

Introduction: The navigational health literacy of higher education students is fundamental to effective health management and successful health navigation, thereby improving health outcomes and overall well-being. Assessing the general and navigational health literacy levels of these students is crucial for developing targeted interventions and facilitating informed decision-making on health-related issues. This study aimed to identify the levels of general and navigational health literacy, characterise access to and utilisation of healthcare services, and analyse the differences between the mean general and navigational health literacy indices and determinants among higher education students in the Alentejo region of southern Portugal.

Methodology: A descriptive and cross-sectional study was conducted between 25 May and 12 September 2023 with 1979 higher education students. An online structured questionnaire comprising the Portuguese version of the European Health Literacy Survey Questionnaire - 16 items (HLS-EU-PT-Q16) and the Navigational Health Literacy Scale (HLS19-NAV), both from the European Consortium, was used. Sociodemographic data, presence of chronic disease, perceived health status, perceived availability of money for expenses, and healthcare access and utilisation variables were included. The study data were analysed using independent samples t-test, one-way ANOVA, and post hoc Bonferroni test, followed by multiple linear regression analyses at a significance level of 0.05. Multiple linear regression analysis was performed to identify factors associated with both general and navigational health literacy. The study protocol was approved by the ethics committee of the University of Évora, and all participants provided written informed consent.

Results: Most students (86.8%) exhibited limited general health literacy, while 13.2% demonstrated adequate health literacy. Inadequate navigational health literacy was observed in 73.4% of students. Students with lower mean general and navigational health literacy were more likely to have utilised health services. Students with chronic conditions, recent use of urgent or emergency services, and difficulties in accessing healthcare had lower health literacy. Conversely, those enrolled in health-related courses, those with good financial resources and those who had not used health services during their course had higher health literacy. In addition, lower navigational health literacy was found among displaced students, those with chronic conditions and those who had recently consulted a doctor. Higher navigational health literacy was associated with enrolment in health-related courses and adequate general health literacy.

Conclusion: The findings highlight the significant influence of demographic and academic factors on general and navigational health literacy among higher education students. The prevalence of limited general and navigational health literacy underscores a significant challenge for students, institutions, and health policy makers. Effective health literacy interventions should take these factors into account. Future research should examine longitudinal changes in health literacy and evaluate the impact of targeted educational programmes.

Care partners of hospitalized persons with dementia often experience significant burden at discharge. This study examined whether dementia care partner health literacy mediates the relationship between education and burden at hospital discharge. Data from 277 care partners in the Family-centered Function-focused Care (Fam-FFC) trial were analyzed using mediation analysis to assess indirect effects of education on burden (Short-Form Zarit Burden Interview [ZBI-12]) through health literacy (Rapid Estimate of Adult Literacy in Medicine-Short Form [REALM-SF]). Analyses were conducted using SPSS and AMOS. For medium education (B = -0.012; 95% CI = -0.019, -0.003), the indirect effect accounted for 18.5% of the total effect, while for high education (B = -0.018; 95% CI = -0.026, -0.006), it accounted for 21.4%, indicating partial mediation. Findings underscore the role of health literacy in reducing care partner burden and highlight the need to address education and literacy disparities to provide effective support at hospital discharge.

In recent years, Artificial Intelligence (AI) is transforming healthcare systems globally and improved the efficiency of its delivery. Countries like Saudi Arabia are facing unique adoption challenges in their public healthcare, these challenges are specific to AI literacy, understanding and effective usage of AI technologies. In addition, cultural, regulatory and operational barriers increase the complication of integrating AI literacy into public healthcare operations. In spite of its critical contribution in enabling sustainable healthcare development, limited studies have addressed these adoption challenges. Our study explores the AI literacy adoption barriers in context to Saudi Arabian public healthcare sector, focusing on its relevance for advancing healthcare operations and achieving Sustainable Development Goals (SDGs). The research aims to identifying and addressing the adoption challenges of Artificial Intelligence literacy within the public healthcare in Saudi Arabia. The research aims to enhance the understanding of AI literacy, its necessity for enhancing healthcare operations, and the specific hurdles that impede its successful AI adoption in Saudi Arabia's public healthcare ecosystem. The research employs a qualitative analysis using the T-O-E framework to explore the adoption challenges of AI literacy. Additionally, the Best-Worse Method (BWM) is applied to evaluate the adoption challenges to AI literacy adoption across various operational levels within Saudi Arabia's public healthcare supply chain. The study uncovers substantial adoption challenges at operational, tactical, and strategic level, including institutional readiness, data privacy, and compliance with regulatory frameworks. These challenges complicate the adoption of AI literacy in the Saudi public healthcare supply chains. The research offers critical insights into the various issues affecting the promotion of AI literacy in Saudi Arabia's public healthcare sector. This evidence-based study provides essential commendations for healthcare professionals and policymakers to effectively address the identified challenges, nurturing an environment beneficial to the integration of AI literacy and advancing the goals of sustainable healthcare development.

Objectives: To explore the chain-mediating roles of negative emotions and caregiver readiness between self-efficacy and e-health literacy among caregivers of patients with lung cancer.

Background: With the rise of Internet health services, caregivers of patients with lung cancer, who are one of the health decision makers, are encountering new challenges. In order to develop appropriate interventions, it is necessary to explore in depth the various influencing factors associated with them.

Design: A cross-sectional survey.

Methods: A total of 293 caregivers of patients with lung cancer were recruited between November 2023 and April 2024 through a convenience sampling method. These participants completed the demographic data questionnaire, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), Caregivers Preparedness Scale (CPS), and eHealth Literacy Scale (eHEALS). Independent samples t-tests and a one-way ANOVA were employed to identify the primary influencing factors. Structural equation modelling was employed to detect the mediating effects of negative emotions and caregiver readiness.

Reporting method: The STROBE checklist was used for this study.

Results: The total e-health literacy score of caregivers of patients with lung cancer was 29.65 ± 7.11, and there was a correlation between self-efficacy, negative emotions, caregiver readiness, and e-health literacy. The results of the path analysis showed that negative emotions and caregiver readiness had chain-mediating roles between self-efficacy and e-health literacy among caregivers of patients with lung cancer, with the total indirect effect accounting for 31.17% of the total effect.

Conclusions: Caregivers of patients with lung cancer exhibit moderate levels of e-health literacy. This research suggests that self-efficacy not only has a direct and positive influence on e-health literacy but may also amplify it by mediating the interplay between negative emotions and caregiver readiness.

Relevance to clinical practice: Healthcare providers should be cognizant of the negative emotions and readiness displayed by family caregivers in the hospital setting to aid them in cultivating strong health literacy for more efficient management of illness care tasks.

Patient or public contribution: Nurses at the hospitals assisted us in collecting data from family caregivers of patients with lung cancer, and the caregivers actively cooperated in completing the questionnaires.

Aim: To assess Digital Health Literacy (DHL) levels among hypertensive patients.

Design: Cross-sectional study.

Methods: The study, conducted from March to August 2024 among hypertensive patients using convenience sampling, employed a 35-item questionnaire assessing: (I) sociodemographic; (II) physical activity, dietary habits, antihypertensive pharmacological treatment and medical history; (III) online health-related information knowledge and confidence; (IV) DHL, through the HLS₁₉-DIGI questionnaire with subscales on: (i) dealing with digital health information (HL-DIGI), (ii) interaction with digital resources (HL-DIGI-INT), (iii) frequency of digital device use for health (HL-DIGI-DD).

Results: Among 311 participants (mean age 63.9 years, SD = 14.8), 42.1% completed high school, 25.4% held a bachelor's degree and 22.8% were physically inactive. While 49.8% were aware of online health-related information, 28.9% were uncertain and 47.6% lacked confidence in using it for health decisions. On average, participants showed a problematic level of DHL in HL-DIGI, a sufficient level in HL-DIGI-INT, and used digital health devices just over once a week. Older age emerged as a predictor of higher online health-related knowledge and DHL, while higher education level predicted higher knowledge, confidence and DHL. Physical inactivity was associated with lower online health-related information knowledge and confidence.

Conclusions: These findings point to the need to design proactive strategies and implement targeted training and educational interventions to improve DHL in hypertensive patients.

Implications for the profession and/or patient care: Enhancing DHL levels through targeted interventions in patient care allows patients to effectively benefit from digital healthcare, achieve positive health outcomes and reduce disparities in care pathways.

Reporting method: This study adhered to the STROBE checklist for reporting.

Patient or public contribution: Patients were involved as the study population.

Protocol registration: Local Ethical Committee of the University Hospital Company of the Marche Region, Italy (protocol: 2023/279, date: 28/09/2023).

Background: Inhaled medication is the preferred route of administration for patients with chronic obstructive pulmonary disease (COPD). The compliance rate of inhaled medication in patients with COPD is <50%, which increases the risk of acute exacerbations. Considering the complex steps of inhaled medication, improving inhaled medication compliance not only requires consistent medication frequency and medical advice but also an evaluation of whether the patient has mastered the inhaler technique to achieve the correct dose.

Objective: This study aimed to explore the effectiveness of an inhaled medication education program (Inhaling-Health website) based on the Fogg Behavior Model and gamification design on inhaled medication compliance and other health-related outcomes in patients with COPD.

Methods: In a randomized, 2-arm, concurrent parallel design, we enrolled 102 patients with COPD from respiratory medicine clinics at 2 hospitals in Zhejiang Province, China, between April and May 2023. Participants were randomly assigned to either the control group (51/102, 50%) or the experimental group (51/102, 50%). All participants completed the intervention, with 94 participants completing 6 months of follow-up. Two independent-sample 2-tailed t tests and the Mann-Whitney U test were used to analyze group differences, and generalized estimating equations were used to analyze repeated measurements.

Results: After the intervention, all outcome measures improved compared to baseline. The generalized estimating equation showed that, compared to the control group, the Inhaling-Health website led to a gradual improvement in total adherence-to-inhaler scores starting from 2 months after the intervention (median 51.00, IQR 49.00-52.25 vs median 50.00, IQR 47.00-51.00; Z=-2.014; P=.04). It had a separate positive effect on inhaler technique. In addition, the website was more effective in reducing the modified Medical Research Council score than routine inhaled medication education, starting from 4 months after intervention (median 1.00, IQR 1.00-2.00 vs median 1.00, IQR 0.00-2.00; Z=-2.260; P=.02). The website was also more effective than the conventional intervention in improving Chronic Obstructive Pulmonary Disease Knowledge Questionnaire scores, beginning at the end of the intervention (mean 6.14, SD 1.83 vs mean 7.06, SD 1.82; t₁=-2.551; P=.01).

Conclusions: The gamified inhaled medication education program based on the Fogg Behavior Model can improve inhaled medication adherence, inhaler technique accuracy, health literacy, lung function, and health-related quality of life; help reduce the severity of dyspnea and COPD physical symptoms; and reduce the risk of acute exacerbations in patients with COPD. This study can provide a reference for inhaled medication education in patients with COPD.

Trial registration: China Clinical Trials Registry (ChiCTR) ChiCTR2300070213; https://www.chictr.org.cn/showprojEN.html?proj=194829.

Dermatologic toxicities resulting from cancer treatments are common, debilitating, and can significantly impact a patient's quality of life. In some cases, these toxicities may require dose adjustments or even discontinuation of treatment. Timely management of dermatologic adverse events (DAEs) is crucial to improving patient outcomes, and educational resources are instrumental in empowering patients to recognize and manage these issues. This cross-sectional survey study aims to characterize patient utilization of and satisfaction with educational resources regarding dermatologic toxicities of cancer treatments. Findings indicate that while 77.5% (n = 110) of patients received information on managing dermatologic toxicities, a larger proportion (n = 123; 86.5%) experienced these side effects. Healthcare providers were the primary source of information (n = 102/110; 92.7%), followed by self-searching on the internet (n = 59/110; 53.6%), and social media (n = 43/110; 39.1%). Despite most patients receiving educational content, patients expressed low satisfaction with both the quality and quantity of information provided, with only 31.3% (n = 41) reporting satisfaction with the amount of information and 33.8% (n = 44) reporting satisfaction with its quality, highlighting a significant gap in resource effectiveness. Notably, patients reported the highest satisfaction with information provided by healthcare providers, suggesting that integrating comprehensive dermatologic education into oncologic care could improve patient satisfaction and outcomes.

Background: Health literacy (HL) promotes the achievement of skills and information useful to endorse health. Food Literacy (FL) is a subtype of HL related to the knowledge necessary to achieve a healthy diet. Methods: This pilot study aimed to assess and improve FL of hospital workers through a survey before and after an educational intervention consisting of nutrition courses, infographics, and updates to the canteen service. FL was evaluated with a questionnaire, and Kruskal-Wallis, Friedman and Wilcoxon test was performed to assess group differences. Results: Of 897 participants, 375 (T1) completed both surveys, while 522 completed only T0. A pairwise comparison stratified by role, age and education revealed a significant improvement in FL scores in the T1 group. Improvements were observed in the T1 group, with overall scores rising from 6.2 ± 2.7 to 6.9 ± 2.1 (p-value < 0.001). An upgrade was noted in healthcare workers (T0 = 6.5 ± 2.2 vs. T1 = 7 ± 2, p-value < 0.001), administrative workers (T0 = 5.5 ± 2.5 vs. T1 = 6.2 ± 2.4, p-value = 0.008), all age groups (T0 = 6.3 ± 2.4 vs. T1 = 6.8 ± 2, p-value = 0.03, T0 = 6.2 ± 2.3 vs. T1 = 6.7 ± 2.2, p-value = 0.02, T0 = 6.2 ± 2.3 vs. T1 = 7 ± 2, p-value = 0.003), low and high education (T0 = 5.7 ± 2.3 vs. T1 = 6.6 ± 2.1, p-value < 0.001, T0 = 6.6 ± 2.3 vs. T1 = 7.1 ± 2 p-value = 0.03). Conclusions: Our survey highlights the efficacy of a multifactorial intervention in enhancing FL and proves the importance of food health promotion within workplaces.