scholarly journals The Influence of Health Literacy and Depression on Diabetes Self-Management: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
D. Maneze ◽  
B. Everett ◽  
C. Astorga ◽  
D. Yogendran ◽  
Y. Salamonson

Despite an increasing focus on health literacy in the clinical setting and in the literature, there is still ongoing debate about its influence on diabetes self-management. The aim of the study was to examine the relationships of sociodemographic, clinical, and psychological factors on health literacy and diabetes self-management. A cross-sectional survey was undertaken on 224 patients with type 2 diabetes at two diabetes centres in Sydney, Australia. Findings showed that people with low health literacy were more likely to (a) have lower educational attainment; (b) be migrants; and (c) have depressed mood. Unexpectedly, those who metHbA1cthreshold of good glucose control were more likely to have low health literacy. Predictors of low diabetes self-management included (a) younger age group (AOR: 2.58, 95% CI: 1.24–4.64); (b) having postsecondary education (AOR: 2.30, 95% CI: 1.05–5.01); (c) low knowledge of diabetes management (AOR: 2.29, 95% CI: 1.25–4.20); and (d) having depressed mood (AOR: 2.30, 95% CI: 1.30–4.06). The finding that depressed mood predicted both low health literacy and low diabetes self-management stresses the importance of screening for depression. Increasing people’s understanding of diabetes self-management and supporting those with depression are crucial to enhance participation in diabetes self-management.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Tajdar ◽  
Dagmar Lühmann ◽  
Regina Fertmann ◽  
Tim Steinberg ◽  
Hendrik van den Bussche ◽  
...  

Abstract Background Low health literacy is believed to be associated with behaviours that increase the risk of type 2 diabetes. But there is limited knowledge on the relation between health literacy (HL) and diabetes risk, and whether improving HL could be a potential prevention strategy. Therefore, the main purpose of this study was to examine the link between HL and diabetes risk among non-diabetic adults. Methods We used data from the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany. One thousand, two hundred and fifty-five non-diabetic subjects aged 18–60 years were eligible. The German Diabetes Risk Score (GDRS, ranging 0 to 123 points) was used to determine the individual risk of type 2 diabetes. The short version of the European Health Literacy Questionnaire (HLS-EU-Q16, ranging 0 to 16 points) was applied to assess the individual self-reported HL. Subjects were asked to self-estimate their diabetes risk, which was then compared with the calculated GDRS. Descriptive statistics were calculated to investigate group differences in the GDRS and self-estimated diabetes risk. Linear as well as logistic regression models were performed to analyse potential influencing variables of the GDRS as well as incorrect self-estimated diabetes risk. In three nested statistical models for each outcome, these analyses were adjusted for age, gender, educational level and the presence of chronic conditions. Results According to the criteria of the GDRS, 996 (79.4%) subjects showed “low risk”, 176 (14.0%) “still low risk”, 53 (4.2%) “elevated risk”, and 30 (2.4%) “high to very high risk” to develop type 2 diabetes within the next 5 years. In the statistical models including all control variables, subjects with “inadequate HL” scored 2.38 points higher on the GDRS (95% CI 0.378 to 4.336; P = 0.020) and had a 2.04 greater chance to estimate their diabetes risk incorrectly (OR 2.04; 95% CI 1.33 to 3.14; P = 0.001) compared to those with “sufficient HL”. Conclusion The risk of type 2 diabetes is increased in people with inadequate self-reported HL. People with high diabetes risk and inadequate HL might be provided with educational programs to improve diabetes knowledge and reduce behavioural risk factors.


2019 ◽  
Vol 29 (5) ◽  
pp. 285-292 ◽  
Author(s):  
Suhyun Kim ◽  
Yeoungsuk Song ◽  
Jihyun Park ◽  
Sonja Utz

Diabetes self-management is an important part of patient care for those with diabetes. The purpose of this study was to explore patients’ experiences with diabetes self-management education and how these experiences differed by health-literacy levels. A descriptive qualitative design was conducted. In 2016, 20 patients with diabetes who took a formal diabetes self-management course at a university hospital in South Korea were interviewed. A conventional content analysis was conducted. Patients with low health-literacy misunderstood diabetes management, showed passive attitudes towards seeking information, and had difficulty obtaining detailed information. Patients with high health-literacy wanted systematic, in-depth, individualized counselling on lifestyle modifications and medications. Patients’ experiences with diabetes self-management education revealed differences in their health-literacy dimensions. In addition to practising health-literacy precautions, the content and delivery of diabetes self-management education need to be accommodated according to patients’ health-literacy levels to obtain better outcomes.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048983
Author(s):  
Tianyu Jiang ◽  
Xudong Zhou ◽  
Leesa Lin ◽  
Yanzheng Pan ◽  
Yuyuan Zhong ◽  
...  

ObjectivesTo describe the situation of COVID-19-related stigma towards patients with COVID-19 and people from the city of Wuhan in China and to assess the associations between COVID-19-related stigma, health literacy and sociodemographic characteristics during March 2020, the early stage of the pandemic.DesignA cross-sectional online survey.SettingThe study surveyed 31 provinces in China.ParticipantsThis study surveyed 5039 respondents in China.Outcome measuresPublic stigma towards both patients with COVID-19 and Wuhan residents was measured. Binary logistic regression was used to identify the factors associated with public COVID-19-related stigma.ResultsAmong the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in as holding a stigmatising attitude towards patients with COVID-19, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, which was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (adjusted OR (aOR)=2.03, 95% CI (1.05 to 3.92)) and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI (1.08 to 3.37); aOR=1.88, 95% CI (1.08 to 3.29)) were more likely to stigmatise patients with COVID-19. People who were male, aged 41–50 and had difficulty understanding information (aOR=2.08, 95% CI (1.17 to 3.69)) were more likely to stigmatise people from Wuhan.ConclusionsPatients with COVID-19 and Wuhan residents suffered stigma at both the individual and the community levels. Those who had low health literacy, who lived in areas with a large number of COVID-19 cases and who were of ethnic minorities were more likely to stigmatise others. Tailored interventions are encouraged to improve health literacy and consequently to reduce public COVID-19-related stigma.


2021 ◽  
Author(s):  
Julie A. Wright ◽  
Julie E Volkman ◽  
Suzanne G Leveille ◽  
Daniel J. Amante

BACKGROUND Self-management of health is becoming increasingly more influenced by Health IT as online patient portals become more common. Patient portals allow patients direct access to their health information and opportunities to engage with their healthcare team. Data suggest that e-Health literacy is an important skill for using portals. Emerging adults (EA; ages 18-29), while generally healthy, are regular users of the healthcare system. A good understanding about their use of online patient portals and how their e-Health literacy skills impact their use is lacking. OBJECTIVE To describe patient portal use and explore the predictors of portal use among a diverse sample of EAs. METHODS A convenience sample, cross-sectional survey study was conducted at two universities. Demographics, healthcare visits, e-Health literacy, patient engagement and use of patient portal features (administrative and clinical) were asked. Logistic regression models were used to examine factors associated with portal use. RESULTS Of the 340 EAs (76% female, 65% white, 47% low income), 54% reported having patient portal access. Of those reporting access, 77% used at least 1 portal feature and 23% reported using none. Significant predictors were patient engagement (OR 1.08, 95% CI 1.04-1.13, p=.001;) and total encounters (OR 1.23, 95% CI 1.05-1.44, p=.009;) but not e-Health literacy. Hispanic and Asian EAs were more likely to be frequent users of clinical portal features than white EAs (Hispanic, OR 2.97, 95%CI 1.03-8.52 p=.043; and Asian, OR 4.28, 95%CI 1.08-16.89, p=.038). CONCLUSIONS Surprisingly, e-Health literacy did not predict use of patient portals in this diverse sample of EAs. Moreover, there may be ethnic differences that are important for healthcare systems to consider. Interventions to promote patient portal use, an essential self-management skill, should include strategies to increase patient engagement with patient portals in EA populations. CLINICALTRIAL N/A


Author(s):  
Amelia Hyatt ◽  
Allison Drosdowsky ◽  
Trista Koproski ◽  
Donna Milne ◽  
Meri Rametta ◽  
...  

Abstract Objective Health literacy is a significant public health concern, particularly given the increased complexity of chronic disease health management and health system navigation, and documented associations between low health literacy and poor health outcomes. This study therefore aimed to identify the proportion and characteristics of outpatients visiting a specialist cancer hospital who report low health literacy and/or low cancer health literacy. Method This study used a cross-sectional survey administered verbally with patients attending a specialist cancer hospital located in Melbourne, Australia over a two-week period. Process data on conducting health literacy screening within a clinical setting was collected. Results Those identified with inadequate general health literacy were different to those identified with low cancer-specific health literacy, although overall both proportions were low. Cross-sectional screening of patients was difficult, despite utilising verbal surveying methods designed to increase capacity for participation. Conclusion Health literacy screening using the tools selected was not useful for identifying or describing patients with low health literacy in this setting, given the disparity in those categorised by each measure. Practice Implications Until the theoretical construct of health literacy is better defined, measurement of health literacy may not be clinically useful.


2021 ◽  
Vol 9 (1) ◽  
pp. 113
Author(s):  
Bahtiar Bahtiar ◽  
Wiwi Saputri ◽  
Rostika Salenda Paseleng ◽  
Muh Akbar ◽  
Restu Abady

The elderly are vulnerable to experience health problems and physical deterioration characterized by high rates of chronic diseases among the elderly. Health literacy ability becomes crucial for the elderly with chronic diseases to treat and maintain their health. This study was aimed to describe the literacy levels of the elderly with chronic diseases during the COVID-19 pandemic in Makassar. The method of study was a descriptive survey with a cross-sectional study. The research population is elderly with chronic diseases in Makassar city, and the samples are 124 elderly with age ≥60 years old and suffering chronic diseases more than six months in two selected sub-district. The research was conducted a cross-sectional survey, and descriptive univariate data analysis was used. The instrument was used Indonesia's health literacy short-form survey questionnaire (HLS-EU-SQ10-IDN). The result of this study reveals that the health literacy levels vary: insufficient criteria by 33.99%, problematic criteria by 49.2%, sufficient criteria by 16.1%, and perfect criteria by 0.8%. The results prove that the health literacy level of the elderly with chronic diseases is insufficient. This study concluded that the dominant level of the health literacy of the elderly with chronic diseases is inadequate and problematic. Health education program to improve their literacy is necessarily improved during the COVID-19 outbreak


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Francisca Mibei ◽  
Felicity Daniels

A worldwide high prevalence of low health literacy has been reported, and despite the emergence of health literacy as a better determinant of health than socio-economic status, it is alarming that little attention is being accorded to training health workers on health literacy practices. This study thus sought to describe the health literacy knowledge and experiences of nursing students gained during training in order to establish a basis that will inform future health literacy training. A descriptive cross-sectional survey was carried out using a questionnaire to establish the health literacy knowledge and experience of 82 nursing students. Data were analysed using descriptive as well as inferential statistics. The students exhibited unsatisfactory health literacy knowledge as measured by the questionnaire, with an average score of 73 per cent, with knowledge gaps in some areas – for example with regard to the effect of low health literacy on patient health outcomes and identification of patients with low health literacy. Their health literacy experience was also lacking, with students only reporting some experience in the use of written materials in providing patient education. The results portray that the emphasis of health literacy in the curriculum failed to have a sufficient effect on health literacy knowledge.


2020 ◽  
Author(s):  
Hongyan Liu ◽  
Chengbin Wu ◽  
Yu Zhao ◽  
Weiyun Lai ◽  
Yong Zhao ◽  
...  

Abstract Background: Improving health literacy is the key to chronic disease prevention and improved interventions. However, little is known about the status of health literacy and its influencing factors in patients with chronic diseases. Accordingly, this study aimed to explore the different aspects and factors influencing health literacy among patients with chronic diseases in Chongqing, China.Methods: A cross-sectional survey was conducted in areas of Chongqing using the 2018 National Questionnaire on Health Literacy of Residents administered to 27,336 patients with chronic diseases. The research investigated the prevalence and factors of health literacy in patients with chronic diseases in Chongqing, China using χ 2 tests and logistic regression analysis.Results: Among the participants (n = 27,336), 51.3% were males and 48.7% were females. Only a small number of patients with chronic diseases were health literate (21.6%). Regression analyses indicated that inadequate health literacy was associated with rural area residents (OR: 0.92), minorities (OR: 1.31), farmers (OR: 1.18), nonlocal registered permanent residents (OR: 1.05), and patients with self-rated unhealthy status (OR: 1.80). Patients with chronic diseases aged 25–34 (OR = 1.18) and 35–44 (OR = 1.18) were more likely to have health literacy than patients with chronic diseases aged 65–69. Illiterate or slightly literate patients (OR = 0.10) were less likely to have health literacy than patients who were in the junior college or had a bachelor’s degree or above. Patients with an average annual household income of less than 3,000 yuan (OR = 0.65) were all less likely to have health literacy than patients with an average annual household income of more than 15,000 yuan.Conclusions: Health literacy of patients with chronic conditions remains at a low level and varies significantly with their demographic and sociological characteristics. Therefore, developing and adopting appropriate health promotion programs would be necessary to improve the health literacy of all patients with different types of chronic diseases.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029357
Author(s):  
Hannelore Storms ◽  
Bert Aertgeerts ◽  
Frank Vandenabeele ◽  
Neree Claes

ObjectivesTo support patients in their disease management, providing information that is adjusted to patients’ knowledge and ability to process health information (ie, health literacy) is crucial. To ensure effective health communication, general practitioners (GPs) should be able to identify people with limited health literacy. To this end, (dis)agreement between patients’ health literacy and GPs’ estimations thereof was examined. Also, characteristics impacting health literacy (dis)agreement were studied.DesignCross-sectional survey of general practice patients and GPs undertaken in 2016–17.SettingForty-one general practices in two Dutch-speaking provinces in Belgium.ParticipantsPatients (18 years of age and older) visiting general practices. Patients were excluded when having severe impairments (physical, mental, sensory).Main outcome measuresPatients’ health literacy was assessed with 16-item European Health Literacy Survey Questionnaire. GPs indicated estimations on patients’ health literacy using a simple scale (inadequate; problematic; adequate). (Dis)agreement between patients’ health literacy and GPs’ estimations thereof (GPs’ estimations being equal to/higher/lower than patients’ health literacy) was measured using Kappa statistics. The impact of patient and GP characteristics, including duration of GP–patient relationships, on this (dis)agreement was examined using generalised linear logit model.ResultsHealth literacy of patients (n=1375) was inadequate (n=201; 14.6%), problematic (n=299; 21.7%), adequate (n=875; 63.6%). GPs overestimated the proportion patients with adequate health literacy: adequate (n=1241; 90.3%), problematic (n=130; 9.5%) and inadequate (n=4; 0.3%). Overall, GPs’ correct; over-/underestimations of health literacy occurred for, respectively, 60.9%; 34.2%; 4.9% patients, resulting in a slight agreement (κ=0.033). The likelihood for GPs to over-/underestimate patients’ health literacy increases with decreasing educational level of patients; and decreasing number of years patients have been consulting with their GP.ConclusionsIntuitively assessing health literacy is difficult. Patients’ education, the duration of GP–patient relationships and GPs’ gender impact GPs’ perceptions of patients’ health literacy.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18067-e18067
Author(s):  
Jean A. McDougall ◽  
Matthew P. Banegas ◽  
Charles Wiggins ◽  
Ashwani Rajput ◽  
Vi Kien Chiu ◽  
...  

e18067 Background: The high cost of cancer care creates adverse financial consequences for cancer patients, impacting adherence to treatment, clinical outcomes, and quality of life. Prior studies estimate that 40% of colorectal cancer (CRC) patients experience treatment-related financial burden. This study aims to identify factors associated with financial burden and evaluate its relationship with cancer recurrence. Methods: This cross-sectional study identified individuals diagnosed with stages I-III CRC between 2001 and 2012 through the statewide New Mexico Tumor Registry. A comprehensive survey was administered in 2014. Participants were considered to have experienced financial burden if they reported any treatment-related debt accumulation, bankruptcy filing, other financial sacrifices, or inability to pay medical bills. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: Among the 277 CRC survivors who participated in this study, 40% identified as Hispanic and 39% lived in a rural area. Financial burden was reported by 43% of CRC survivors. In a model adjusted for age at diagnosis, sex, race, ethnicity, education, and years since diagnosis, participants who spoke a mixture of English and Spanish (OR: 3.5, 95% CI: 1.3-9.5), those with low health literacy (OR: 2.4, 95% CI: 1.2-4.7), and those with public insurance (OR: 2.2, 95% CI: 1.2-4.4) were more likely to report financial burden. Ethnicity and rural status were not independently associated with financial burden. Six percent (n = 16) of participants experienced a CRC recurrence. Survivors who reported financial burden were 4-times as likely to experience a recurrence (OR: 4.3, 95% CI 1.1-17.7) as those who did not report financial burden. Conclusions: Language, low health literacy, and public insurance may increase the likelihood that CRC survivors experience financial burden. These disparities are alarming given the observed association between financial burden and CRC recurrence. Larger, prospective studies are needed to confirm the association between financial burden and recurrence and to identify potential intervention targets.


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