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Page 1
. 2023 Mar 20.
doi: 10.1001/jamainternmed.2023.0070. Online ahead of print.

Assessment of Patient Education Delivered at Time of Hospital Discharge

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Assessment of Patient Education Delivered at Time of Hospital Discharge

Shreya P Trivedi et al. JAMA Intern Med. .

Abstract

Importance: Patient education at time of hospital discharge is critical for smooth transitions of care; however, empirical data regarding discharge communication are limited.

Objective: To describe whether key communication domains (medication changes, follow-up appointments, disease self-management, red flags, question solicitation, and teach-back) were addressed at the bedside on the day of hospital discharge, by whom, and for how long.

Design, setting, and participants: This quality improvement study was conducted from September 2018 through October 2019 at inpatient medicine floors in 2 urban, tertiary-care teaching hospitals and purposefully sampled patients designated as "discharge before noon." Data analysis was performed from September 2018 to May 2020.

Exposures: A trained bedside observer documented all content and duration of staff communication with a single enrolled patient from 7 am until discharge.

Main outcomes and measures: Presence of the key communication domains, role of team members, and amount of time spent at the bedside.

Results: Discharge days for 33 patients were observed. Patients had a mean (SD) age of 63 (18) years; 14 (42%) identified as White, 15 (45%) were female, and 6 (18%) had a preferred language of Spanish. Thirty patients were discharged with at least 1 medication change. Of these patients, 8 (27%) received no verbal instruction on the change, while 16 of 30 (53%) were informed but not told the purpose of the changes. About half of the patients (15 of 31, 48%) were not told the reason for follow-up appointments, and 18 of 33 (55%) were not given instructions on posthospital disease self-management. Most patients (27 of 33, 81%) did not receive guidance on red-flag signs. While over half of the patients (19 of 33, 58%) were asked if they had any questions, only 1 patient was asked to teach back his understanding of the discharge plan. Median (IQR) total time spent with patients on the day of discharge by interns, senior residents, attending physicians, and nurses was 4.0 (0.75-6.0), 1.0 (0-2.0), 3.0 (0.5-7.0), and 22.5 (15.5-30.0) minutes, respectively. Most of the time was spent discussing logistics rather than discharge education.

Conclusions and relevance: In this quality improvement study, patients infrequently received discharge education in key communication domains, potentially leaving gaps in patient knowledge. Interventions to improve the hospital discharge process should address the content, method of delivery, and transparency among team members regarding patient education.

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. 2023 Jan 29.
doi: 10.1002/ohn.229. Online ahead of print.

Multimodal Analgesia and Patient Education Reduce Postoperative Opioid Consumption in Otology

Affiliations

Multimodal Analgesia and Patient Education Reduce Postoperative Opioid Consumption in Otology

Joann M Butkus et al. Otolaryngol Head Neck Surg. .

Abstract

Objective: This study sought to validate alternative pain management strategies that can reduce reliance on opioids for postoperative pain management in otology.

Study design: Prospective cohort study.

Setting: Single tertiary-care facility.

Methods: Adult patients who underwent outpatient otologic surgery from September 2021 to July 2022 were randomized into treatment cohorts. The opioid monotherapy cohort received a standard opioid prescription. The multimodal analgesia cohort received the same opioid prescription, prescriptions for acetaminophen and naproxen, and additional pain management education with a flyer on discharge. All patients completed a questionnaire 1 week after surgery to evaluate opioid usage and pain scores.

Results: Eighty-six patients completed the study. The opioid monotherapy cohort (n = 42) and multimodal analgesia cohort (n = 44) were prescribed an average of 42.1 ± 20.4 morphine milligram equivalents (MME) and 38.4 ± 5.7 MME, respectively (p = 0.373). Four patients (9.52%) in the opioid monotherapy cohort required opioid refills compared to 1 patient (2.27%) in the multimodal analgesia cohort (p = 0.156). Multivariate analysis demonstrated that the multimodal analgesia cohort consumed significantly fewer opioids on average than the opioid monotherapy cohort (11.9 ± 15.9 MME vs 22.8 ± 28.0 MME, respectively). There were no significant differences in postoperative rehospitalizations (p = 0.317) or Emergency Department visits (p = 0.150). Pain scores on the day of surgery, postoperative day (POD) 1, POD3, and POD7 were not significantly different between cohorts (p = 0.395, 0.896, 0.844, 0.765, respectively).

Conclusion: The addition of patient education, acetaminophen, and naproxen to postoperative opioid prescriptions significantly reduced opioid consumption without affecting pain scores, refill rates, or complication rates after otologic surgery.

Keywords: alternative pain management; multimodal analgesia; opioids; otology; patient education.

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. 2023 Mar 3;10:1092007.
doi: 10.3389/fcvm.2023.1092007. eCollection 2023.

New perspectives in patient education for cardiac surgery using 3D-printing and virtual reality

Affiliations
Free PMC article

New perspectives in patient education for cardiac surgery using 3D-printing and virtual reality

Maximilian Grab et al. Front Cardiovasc Med. .
Free PMC article

Abstract

Background: Preoperative anxiety in cardiac surgery can lead to prolonged hospital stays and negative postoperative outcomes. An improved patient education using 3D models may reduce preoperative anxiety and risks associated with it.

Methods: Patient education was performed with standardized paper-based methods (n = 34), 3D-printed models (n = 34) or virtual reality models (n = 31). Anxiety and procedural understanding were evaluated using questionnaires prior to and after the patient education. Additionally, time spent for the education and overall quality were evaluated among further basic characteristics (age, gender, medical expertise, previous non-cardiac surgery and previously informed patients). Included surgeries were coronary artery bypass graft, surgical aortic valve replacement and thoracic aortic aneurysm surgery.

Results: A significant reduction in anxiety measured by Visual Analog Scale was achieved after patient education with virtual reality models (5.00 to 4.32, Δ-0.68, p < 0.001). Procedural knowledge significantly increased for every group after the patient education while the visualization and satisfaction were best rated for patient education with virtual reality. Patients rated the quality of the patient education using both visualization methods individually [3D and virtual reality (VR) models] higher compared to the control group of conventional paper-sheets (control paper-sheets: 86.32 ± 11.89%, 3D: 94.12 ± 9.25%, p < 0.0095, VR: 92.90 ± 11.01%, p < 0.0412).

Conclusion: Routine patient education with additional 3D models can significantly improve the patients' satisfaction and reduce subjective preoperative anxiety effectively.

Keywords: 3D-printing; cardiac surgery; patient education; preoperative anxiety; virtual reality.

Conflict of interest statement

Author MF was employed by company vr-on GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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. 2023 Mar 17;23(1):147.
doi: 10.1186/s12877-023-03838-w.

Examining the relationship between health literacy and quality of life: evidence from older people admitted to the hospital

Affiliations
Free PMC article

Examining the relationship between health literacy and quality of life: evidence from older people admitted to the hospital

Gholamhossein Mehralian et al. BMC Geriatr. .
Free PMC article

Abstract

Introduction: Literacy has become an increasingly serious problem, especially as it relates to health care. In this regard, health literacy (HL), as a cognitive skill, has proven to be an influential factor to improve of the quality of life (QOL). This study aimed to examine the level of HL and its relationship with the QOL of older people at the time of discharge from the hospital in the south of Iran.

Methods: This descriptive-analytical cross-sectional study included 300 older people admitted and treated in 10 teaching-therapeutic hospitals affiliated with the Shiraz University of Medical Sciences in 2021. The standard Health Literacy for Iranian Adults (HELIA) questionnaire and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were used to collect the required data. Data were analyzed with SPSS software version 23 software using descriptive and inferential statistics, Pearson's correlation coefficient, T-test, ANOVA, and multiple linear regression at p = 0.05.

Results: The mean scores of Hl and QOL for older people were 48.22 ± 9.63 (out of 100) and 61.59 ± 12.43 (out of 120), respectively. Moreover, there was a significant direct correlation between the participants' HL and their QOL (r=0.388, p<0.001). All dimensions of HL, including comprehension (β=0.461, p<0.001), decision-making and behavior (β=0.434, p<0.001), access (β=0.397, p<0.001), reading skill (β=0.362, p=0.002), and assessment (β=0.278, p=0.004), were significant relationship with QOL. A statistically significant difference was revealed between the mean scores of HL regarding the participants' gender (p=0.04) and level of education (p=0.001). Furthermore, the mean scores of QOL were significantly different with regard to older people's gender (p=0.02), marital status (p=0.03), level of education (p=0.002), and income (p=0.01).

Conclusion: The findings revealed the participants' inadequate HL and average QOL. Considering the relationship of HL with QOL, it is recommended to develop comprehensive programs and effective interventions to develop HL skills and subsequently improve QOL among older people.

Keywords: Health literacy; Hospital; Iran; Older people; Quality of life.

Conflict of interest statement

The authors declare that they have no competing interests.

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. 2023 Mar;16(1):30-37.
doi: 10.1080/17538068.2022.2026054. Epub 2022 Feb 1.

Evaluating first year residents' communication skills: a health literacy curriculum needs assessment

Affiliations

Evaluating first year residents' communication skills: a health literacy curriculum needs assessment

Zach Budesa et al. J Commun Healthc. 2023 Mar.

Abstract

Background: High quality communication skills are necessary for competent and ethical practice. When patients present with low health literacy, physicians' skills may be lacking, which can put patients' safety and satisfaction at risk. The authors' developed and executed a simulation-based needs assessment following conflicting internal reports about the communications skills of new residents.

Methods: The current study recruited first year residents (N = 30) during the 2019 first post-graduate year (PGY-1) orientation at a southeastern university hospital simulation center. The residents completed an Objective Structured Clinical Examination (OSCE) which focused on obtaining informed consent from a patient's health care proxy who presented with limited literacy and health literacy and poor communication skills. After completing the OSCE, the residents, simulated patients (SP), and independent observers assessed the residents' performance.

Results: Residents assessed their performance higher when compared with the ratings from independent observers and patient raters. Residents who spent more time with SPs were given higher ratings by the SPs and independent observers. Finally, residents' ratings of themselves had a positive correlation with their reported confidence, but no correlation between self-confidence and the ratings provided by SPs or observers.

Conclusion: PGY-1 residents demonstrate a continued need for health literacy and informed consent education, despite faculty believing that these skills were covered enough in medical school. These residents also demonstrated limited self-assessment ability or skills below the expectations of health literacy experts. Curriculum changes included improving the focus on health literacy, communication skills, and additional practice opportunities throughout their internship year.

Keywords: Health literacy; curriculum; informed consent; internship and residency; simulation training.

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. 2022 Dec;15(4):309-312.
doi: 10.1080/17538068.2022.2142443. Epub 2022 Nov 3.

Shining a light on disability and health communication

Affiliations

Shining a light on disability and health communication

Jennifer A Manganello. J Commun Healthc. 2022 Dec.

Abstract

Examining health inequities in the context of communication related to health and health care is important for creating health equity. There has been an increasing number of studies conducting health communication research to address inequities, but research that has prioritized people with disabilities remains limited. Over the past year, there has been a growing focus on disability and health research, including peer-reviewed papers in this volume. The health communication field can build on this momentum to continue to focus on disability in topics related to health information, misinformation, health literacy, interpersonal communication, media campaigns, media representation, digital health, communication technologies, and more.

Keywords: Disability.

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. 2023 Feb 23;11:1038019.
doi: 10.3389/fpubh.2023.1038019. eCollection 2023.

Development and validation of a Systemic Sclerosis Health Literacy Scale

Affiliations
Free PMC article

Development and validation of a Systemic Sclerosis Health Literacy Scale

Meng Zhuang et al. Front Public Health. .
Free PMC article

Abstract

Background and aim: Health literacy levels are strongly associated with clinical outcomes and quality of life in patients with chronic diseases, and patients with limited health literacy often require more medical care and achieve poorer clinical outcomes. Among the large number of studies on health literacy, few studies have focused on the health literacy of people with systemic sclerosis (SSc), and there is no specific tool to measure health literacy in this group. Therefore, this study plans to develop a health literacy scale for patients with SSc.

Methods: This study included 428 SSc patients from the outpatient and inpatient departments of the Department of Rheumatology and Immunology, the first affiliated Hospital of Anhui Medical University and the first affiliated Hospital of University of Science and Technology of China. The formulation of the scale was completed by forming the concept of health literacy of SSc patients, establishing the item pool, screening items, and evaluating reliability and validity. Classical measurement theory was used to screen items, factor analysis was used to explore the construct validity of the scale, and Cronbach's alpha coefficient was used to assess the internal consistency.

Results: Our study population was predominantly middle-aged women, with a male to female ratio of 1:5.7 and a mean age of 51.57 ± 10.99. A SSc Health Literacy scale with 6 dimensions and 30 items was developed. The six dimensions are clinic ability, judgment/evaluation information ability, access to information ability, social support, treatment compliance and application information ability. The Cronbach's alpha coefficient of the scale is 0.960, retest reliability is 0.898, split-half reliability is 0.953, content validity is 0.983, which has good reliability and validity.

Conclusion: The Systemic Sclerosis Health Literacy Scale may become a valid tool to evaluate the health literacy level of patients with SSc.

Keywords: chronic disease; health literacy; populations; scale; systemic sclerosis.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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. 2023 Feb 25;20(5):4172.
doi: 10.3390/ijerph20054172.

Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors

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Free PMC article

Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors

Andreia Costa et al. Int J Environ Res Public Health. .
Free PMC article

Abstract

Although the health literacy level of the general population was described recently, little is known about its specific levels among older adults in Portugal. Therefore, this cross-sectional study aimed to investigate the levels of health literacy demonstrated by older adults in Portugal and explore associated factors. Using a randomly generated list of telephone numbers, adults aged 65 years or more living in mainland Portugal were contacted in September and October 2022. Sociodemographic, health and healthcare-related variables were collected, and the 12-item version of the European Health Literacy Survey Project 2019-2021 was used to measure health literacy. Then, binary logistic regression models were used to investigate factors associated with limited general health literacy. In total, 613 participants were surveyed. The mean level of general health literacy was (59.15 ± 13.05; n = 563), whereas health promotion (65.82 ± 13.19; n = 568) and appraising health information (65.16 ± 13.26; n = 517) were the highest scores in the health literacy domain and the dimension of health information processing, respectively. Overall, 80.6% of respondents revealed limited general health literacy, which was positively associated with living in a difficult household financial situation (4.17; 95% Confidence Interval (CI): 1.64-10.57), perceiving one's own health status as poorer (7.12; 95% CI: 2.02-25.09), and having a fair opinion about a recent interaction with primary healthcare services (2.75; 95% CI: 1.46-5.19). The proportion of older adults with limited general health literacy in Portugal is significant. This result should be considered to inform health planning according to the health literacy gap of older adults in Portugal.

Keywords: aging; health literacy; health promotion; healthcare.

Conflict of interest statement

The authors declare no conflict of interest.

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. 2023 Feb 22;20(5):3922.
doi: 10.3390/ijerph20053922.

Digital Health Literacy and Person-Centred Care: Co-Creation of a Massive Open Online Course for Women with Breast Cancer

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Free PMC article

Digital Health Literacy and Person-Centred Care: Co-Creation of a Massive Open Online Course for Women with Breast Cancer

Yolanda Álvarez-Pérez et al. Int J Environ Res Public Health. .
Free PMC article

Abstract

The diagnosis of breast cancer (BC) can make the affected person vulnerable to suffering the possible consequences of the use of low-quality health information. Massive open online courses (MOOCs) may be a useful and efficient resource to improve digital health literacy and person-centred care in this population. The aim of this study is to co-create a MOOC for women with BC, using a modified design approach based on patients' experience. Co-creation was divided into three sequential phases: exploratory, development and evaluation. Seventeen women in any stage of BC and two healthcare professionals participated. In the exploratory phase, a patient journey map was carried out and empowerment needs related to emotional management strategies and self-care guidelines were identified, as well as information needs related to understanding medical terminology. In the development phase, participants designed the structure and contents of the MOOC through a Moodle platform. A MOOC with five units was developed. In the evaluation phase, participants strongly agreed that their participation was useful for the MOOC's development and participating in the co-creation process made the content more relevant to them (experience in the co-creation); most of the participants positively evaluated the content or interface of the MOOC (acceptability pilot). Educational interventions designed by women with BC is a viable strategy to generate higher-quality, useful resources for this population.

Keywords: MOOC; breast cancer; digital health literacy; health education; person-centred care.

Conflict of interest statement

The authors declare no conflict of interest.

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. 2023 Feb 21;20(5):3808.
doi: 10.3390/ijerph20053808.

Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women

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Free PMC article

Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women

María Jesús Valero-Chillerón et al. Int J Environ Res Public Health. .
Free PMC article

Abstract

Background: Despite international efforts to protect and promote exclusive breastfeeding (EBF) for infants up to six months of age, global rates of EBF continue to fall short of the targets proposed by the WHO for 2025. Previous studies have shown a relationship between the level of health literacy and the duration of EBF, although this relationship was not determinant, probably due to the use of a generic health literacy questionnaire. Therefore, this study aims to design and validate the first specific breastfeeding literacy instrument.

Methods: A Breastfeeding Literacy instrument was developed. Content validation was carried out by a group of 10 experts in health literacy, breastfeeding or instrument validation, obtaining a Content Validity index in Scale (S-CVI/Ave) of 0.912. A multicentre cross-sectional study was carried out in three Spanish hospitals to determine the psychometric properties (construct validity and internal consistency). The questionnaire was administered to 204 women during the clinical puerperium.

Results: The Kaiser-Meier-Oklin Test (KMO = 0.924) and Bartlett's Test of Sphericity (X2 = 3119.861; p ≤ 0.001) confirmed the feasibility of the Exploratory Factor Analysis, which explained 60.54% of the variance with four factors.

Conclusions: The Breastfeeding Literacy Assessment Instrument (BLAI) consisting of 26 items was validated.

Keywords: breastfeeding; breastfeeding literacy; questionnaires; validation study.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

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. 2023 Mar 10;22(1):42.
doi: 10.1186/s12939-023-01858-x.

Influence of health literacy on health outcomes of different social strata-- an empirical study based on the data of China's health literacy investigation

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Free PMC article

Influence of health literacy on health outcomes of different social strata-- an empirical study based on the data of China's health literacy investigation

Huifang Yu et al. Int J Equity Health. .
Free PMC article

Abstract

Background: Health literacy has always been considered as an important factor to promote people's health, but does it have a significant effect on health across all social strata and especially lower social strata? This study aims to analyze the influences of health literacy on health outcomes of different social strata, and then infer whether improving health literacy can reduce health disparities among different social strata.

Methods: Utilizing health literacy monitoring data from a city in Zhejiang Province in 2020, the samples are divided into three social strata according to the socioeconomic status score: low, middle and high social stratum, to compare whether there are significant differences in health outcomes between population with lower and higher health literacy among different social strata. In the strata with significant differences, control the confounding factors to further verify the influence of health literacy on health outcomes.

Results: In low and middle social strata, there are significant differences between population with lower and higher health literacy, when considering the two types of health outcomes (chronic diseases and self-rated health), but in high social stratum, this difference is not significant. After controlling the relevant variables, the influence of health literacy on the prevalence of chronic diseases is statistically significant only in low social stratum, and the health literacy is negatively correlated with the prevalence of chronic diseases(OR = 0.722, P = 0.022). In addition, there are statistical significances for positive impact of health literacy on self-rated health in both low and middle social strata (OR = 1.285, P = 0.047; OR = 1.401, P = 0.023).

Conclusion: Compared with high social stratum, the influence of health literacy on health outcomes of low social stratum (chronic diseases) or both middle and low social strata (self-rated health) is more significant, and both are to improve the health outcomes. This finding suggests that improving residents' health literacy may be an effective way to alleviate the health disparities among different social strata.

Keywords: Health disparities; Health literacy; Heath outcomes; Social stratum; Socioeconomic status.

Conflict of interest statement

The authors declare no competing interests.

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. 2023 Mar 10;25:e41615.
doi: 10.2196/41615.

Development and Internal Validation of the Digital Health Readiness Questionnaire: Prospective Single-Center Survey Study

Affiliations
Free article

Development and Internal Validation of the Digital Health Readiness Questionnaire: Prospective Single-Center Survey Study

Martijn Scherrenberg et al. J Med Internet Res. .
Free article

Abstract

Background: While questionnaires for assessing digital literacy exist, there is still a need for an easy-to-use and implementable questionnaire for assessing digital readiness in a broader sense. Additionally, learnability should be assessed to identify those patients who need additional training to use digital tools in a health care setting.

Objective: The aim of the development of the Digital Health Readiness Questionnaire (DHRQ) was to create a short, usable, and freely accessible questionnaire that was designed from a clinical practice perspective.

Methods: It was a prospective single-center survey study conducted in Jessa Hospital Hasselt in Belgium. The questionnaire was developed with a panel of field experts with questions in following 5 categories: digital usage, digital skills, digital literacy, digital health literacy, and digital learnability. All participants who were visiting the cardiology department as patients between February 1, 2022, and June 1, 2022, were eligible for participation. Cronbach α and confirmatory factor analysis were performed.

Results: A total number of 315 participants were included in this survey study, of which 118 (37.5%) were female. The mean age of the participants was 62.6 (SD 15.1) years. Cronbach α analysis yielded a score of >.7 in all domains of the DHRQ, which indicates acceptable internal consistency. The fit indices of the confirmatory factor analysis showed a reasonably good fit: standardized root-mean-square residual=0.065, root-mean-square error of approximation=0.098 (95% CI 0.09-0.106), Tucker-Lewis fit index=0.895, and comparative fit index=0.912.

Conclusions: The DHRQ was developed as an easy-to-use, short questionnaire to assess the digital readiness of patients in a routine clinical setting. Initial validation demonstrates good internal consistency, and future research will be needed to externally validate the questionnaire. The DHRQ has the potential to be implemented as a useful tool to gain insight into the patients who are treated in a care pathway, tailor digital care pathways to different patient populations, and offer those with low digital readiness but high learnability appropriate education programs in order to let them take part in the digital pathways.

Keywords: adherence; assessment; digital access; digital divide; digital health; digital health intervention; digital literacy; digital skills; health literacy; participation; telemedicine.

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. 2023 Mar 10;23(1):98.
doi: 10.1186/s12905-023-02223-4.

A structural equation model linking health literacy, self-efficacy, and quality of life in patients with polycystic ovary syndrome

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Free PMC article

A structural equation model linking health literacy, self-efficacy, and quality of life in patients with polycystic ovary syndrome

Yunmei Guo et al. BMC Womens Health. .
Free PMC article

Abstract

Background: Health literacy is a crucial factor that affects health outcomes. Understanding the current status of health literacy among patients with polycystic ovary syndrome (PCOS) is the basis for helping patients better manage risk factors and improve their health outcomes. This study aimed to explore the status of and factors influencing health literacy in patients with PCOS, and to validate the pathway between health literacy, quality of life, and self-efficacy for these patients.

Methods: A cross-sectional study was conducted using a convenience sample of 300 patients with PCOS in the gynecology outpatient clinic of a tertiary hospital in Zunyi from March to September 2022. Data on health literacy, demographic features, quality of life, and self-efficacy were collected. Multiple stepwise linear regression was conducted to assess the risk factors associated with health literacy for the study participants. A structural equation model was used to construct and validate the pathways.

Results: Most participants exhibited low health literacy (3.61 ± 0.72), and only 25.70% had adequate health literacy. Multiple regression analysis revealed that the main factors associated with health literacy among participants included Body Mass Index (BMI) (B = -0.95, p < 0.01), education (B = 3.44, p < 0.01), duration of PCOS (B = 4.66, p < 0.01), quality of life (B = 0.25, p < 0.01), and self-efficacy (B = 0.76, p < 0.01). Multiple fit values indicated that the model fit the data effectively. The direct effect of health literacy on self-efficacy and quality of life was 0.06 and 0.32, respectively. The indirect effect of health literacy on quality of life was -0.053, and the total effect of health literacy on quality of life was 0.265.

Conclusions: Health literacy was low among patients with PCOS. Healthcare providers should pay more attention to health literacy and to developing the corresponding intervention strategies urgently needed to improve the quality of life and health behavior of patients with PCOS.

Keywords: Health literacy; Quality of life; Self-efficacy; Structural equation model.

Conflict of interest statement

The authors declare that they have no competing interests.

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Review
. 2023 Feb 20;11:1109323.
doi: 10.3389/fpubh.2023.1109323. eCollection 2023.

The role of digital literacy in achieving health equity in the third millennium society: A literature review

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Free PMC article
Review

The role of digital literacy in achieving health equity in the third millennium society: A literature review

Laura Leondina Campanozzi et al. Front Public Health. .
Free PMC article

Abstract

Healthcare in the third millennium is largely delivered through systems involving the use of the technological devices and services, foremost among them telemedicine. For the adequate delivery of digital medicine services, however, it is necessary for users to be digitally literate, that is, able to consciously make use of technology. In order to understand how relevant digital literacy is in determining the effectiveness of e-Health services, we performed a traditional literature review on 3 major databases by combining the terms "Digital Literacy" and "Computer Literacy" with the terms "Telemedicine" and "Telehealth". Starting from an initial library of 1,077 papers, we selected 38 articles. At the outcome of the search, we found that digital literacy is a pivotal element in conditioning the effectiveness of telemedicine and digital medicine services in general, however, with some limitations.

Keywords: computer literacy; digital divide; digital health; digital literacy; e-health literacy.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Editorial
. 2023 Apr;39(2):151400.
doi: 10.1016/j.soncn.2023.151400. Epub 2023 Mar 5.

Building on Health Care Professionals' Research Literacy for Sustained Quality Care

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Editorial

Building on Health Care Professionals' Research Literacy for Sustained Quality Care

Grigorios Kotronoulas. Semin Oncol Nurs. 2023 Apr.
No abstract available

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. 2023 Apr;322:115128.
doi: 10.1016/j.psychres.2023.115128. Epub 2023 Feb 27.

Associations between antenatal education program and mental health outcomes in Taiwan: A population-based cohort study

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Associations between antenatal education program and mental health outcomes in Taiwan: A population-based cohort study

Yu-Ling Chen et al. Psychiatry Res. 2023 Apr.

Abstract

Universal antenatal education has been offered to expectant mothers in Taiwan since 2014. Depression screening is included in the offered education sessions. This study aimed to examine the association of antennal education and depression screening with mental health outcomes, including perinatal depression diagnosis and psychiatrist visits. Data was obtained from the antenatal education records and Taiwan's National Health Insurance claims database. A total of 789,763 eligible pregnant women were included in the current study. The psychiatric-related outcomes were measured between antenatal education and the six-month after delivery. It was found that the antenatal education was widely used in Taiwan, and the attendance rate has increased to 82.6% since its launch. The attenders were more likely to be from disadvantaged backgrounds, and 5.3% of them were screened positive for depressive symptoms. They were also more likely to visit a psychiatrist but less likely to be diagnosed with depression than the non-attenders. Factors including young age, high healthcare utilization, and comorbid psychiatric disorder history were consistently associated with depression symptoms, perinatal depression diagnoses and psychiatrist visits. Further research is needed to understand the reasons for the nonattendance at antenatal education programmes and the barriers to utilizing mental health services.

Keywords: Antenatal depression; Claims data; Depression diagnosis; Postpartum depression; Pregnant women; Psychiatrist visits.

Conflict of interest statement

Declaration of Competing Interest None of the authors have any conflicts of interest to declare.

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. 2023 Mar 3;18(3):e0282083.
doi: 10.1371/journal.pone.0282083. eCollection 2023.

Refusal to participate in research among hard-to-reach populations: The case of detained persons

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Refusal to participate in research among hard-to-reach populations: The case of detained persons

Stéphanie Baggio et al. PLoS One. .
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Abstract

Providing insights on refusal to participate in research is critical to achieve a better understanding of the non-response bias. Little is known on people who refused to participate, especially in hard-to-reach populations such as detained persons. This study investigated the potential non-response bias among detained persons, comparing participants who accepted or refused to sign a one-time general informed consent. We used data collected in a cross-sectional study primary designed to evaluate a one-time general informed consent for research. A total of 190 participants were included in the study (response rate = 84.7%). The main outcome was the acceptance to sign the informed consent, used as a proxy to evaluate non-response. We collected sociodemographic variables, health literacy, and self-reported clinical information. A total of 83.2% of the participants signed the informed consent. In the multivariable model after lasso selection and according to the relative bias, the most important predictors were the level of education (OR = 2.13, bias = 20.7%), health insurance status (OR = 2.04, bias = 7.8%), need of another study language (OR = 0.21, bias = 39.4%), health literacy (OR = 2.20, bias = 10.0%), and region of origin (not included in the lasso regression model, bias = 9.2%). Clinical characteristics were not significantly associated with the main outcome and had low relative biases (≤ 2.7%). Refusers were more likely to have social vulnerabilities than consenters, but clinical vulnerabilities were similar in both groups. The non-response bias probably occurred in this prison population. Therefore, efforts should be made to reach this vulnerable population, improve participation in research, and ensure a fair and equitable distribution of research benefits.

Conflict of interest statement

The authors have declared that no competing interests exist.

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Meta-Analysis
. 2023 Mar 3;18(3):e0282195.
doi: 10.1371/journal.pone.0282195. eCollection 2023.

eHealth literacy and its associated factors in Ethiopia: Systematic review and meta-analysis

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Meta-Analysis

eHealth literacy and its associated factors in Ethiopia: Systematic review and meta-analysis

Sisay Maru Wubante et al. PLoS One. .
Free PMC article

Abstract

Introduction: Electronic health has the potential benefit to the health system by improving health service quality efficiency effectiveness and reducing the cost of care. Having good e-health literacy level is considered essential for improving healthcare delivery and quality of care as well as empowers caregivers and patients to influence control care decisions. Many studies have done on eHealth literacy and its determinants among adults, however, inconsistent findings from those studies were found. Therefore, this study was conducted to determine the pooled magnitude of eHealth literacy and to identify associated factors among adults in Ethiopia through systematic review and meta-analysis.

Method: Search of PubMed, Scopus, and web of science, and Google Scholar was conducted to find out relevant articles published from January 2028 to 2022. The Newcastle-Ottawa scale tool was used to assess the quality of included studies. Two reviewers extracted the data independently by using standard extraction formats and exported in to Stata version11 for meta-analysis. The degree of heterogeneity between studies was measured using I2 statistics. The publication bias between studies also checked by using egger test. The pooled magnitude of eHealth literacy was performed using fixed effect model.

Result: After go through 138 studies, five studies with total participants of 1758 were included in this systematic review and Meta-analysis. The pooled estimate of eHealth literacy in Ethiopia was found 59.39% (95%CI: 47.10-71.68). Perceived usefulness (AOR = 2.46; 95% CI: 1.36, 3.12),educational status(AOR = 2.28; 95% CI: 1.11, 4.68), internet access (AOR = 2.35; 95% CI: 1.67, 3.30), knowledge on electronic health information sources(AOR = 2.60; 95% CI: 1.78, 3.78), electronic health information sources utilization (AOR = 2.55; 95%CI: 1.85, 3.52), gender (AOR = 1.82; 95% CI: 1.38, 2.41) were identified significant predictors of e-health literacy.

Conclusion and recommendation: This systematic review and meta-analysis found that more than half of study participants were eHealth literate. This finding recommends that creating awareness about importance of eHealth usefulness and capacity building to enhance and encouraging to use electronic sources and availability of internet has para amount to solution to increase eHealth literacy level of study participants.

Conflict of interest statement

The authors have declared that no competing interests exist.

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. 2023 Mar 2.
doi: 10.1007/s00380-023-02255-8. Online ahead of print.

Relationship between health literacy and physical function of patients participating in phase I cardiac rehabilitation: a multicenter clinical study

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