Background Health Literacy (HL) is the knowledge and competence to access, understand, appraise, and apply health information for health judgment. We analyze for the first time HL level of Catalonia’s population. Our objective was to assess HL of population in our area and to identify social determinants of HL in order to improve the strategies of the Healthcare Plan, aimed at establishing a person-centered system and reducing social inequalities in health. Methods This was a cross-sectional study based on the Health Survey for Catalonia (ESCA, Enquesta de Salut de Catalunya ), which included the 16 items of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). The statements in the questionnaire cover three different health literacy domains: Health Care, Disease Prevention, and Health Promotion. HL was categorized in three levels: Sufficient, Problematic and Inadequate. Chi-square tests were performed to compare the percentages of subjects with adequate or inadequate HL across sociodemographic and health-related variables. Variables showing significant differences were included in a stepwise logistic regression to predict inadequate HL level. Results The questionnaire was administered to 2433 subjects aged between 15 and 98 years old (mean of 45.9 years, SD 18.0). Overall, 2059 subjects (84.6%) showed sufficient HL, 250 (10.3%) inadequate HL, and 124 (5.1%) problematic HL, with no significant differences between men and women ( p = 0.070). A logistic regression analysis showed that low health literacy is associated with a lower level of education (OR 2.08, CI 95% 1.32–3.28, p = 0.002), low socioeconomic status (OR 2.11, CI 95% 1.42–3.15, p < 0.001) and a physical limitation to perform everyday activities (OR 2.50, CI 95% 1.34–4.66, p = 0.004). We also found a more modest association with low physical activity, having a self-perceived chronic disorder and performing preventive activities. Conclusions Catalonia has a high percentage of subjects with sufficient HL. Education level, socioeconomic status and physical limitations were the factors with the strongest contribution to inadequate or problematic health literacy. Although these results are likely to be country-specific, the factors identified will allow policymakers of areas with similar socioeconomic profiles to identify groups with high risk of problematic or inadequate HL, which is essential for a successful patient-centered model of care.
BackgroundActive and Healthy Ageing (AHA) is the process of optimizing opportunities related to health, participation, and safety in order to improve quality of life. The approach most often used to measure AHA is Rowe and Kahn’s Satisfactory Ageing model. Nonetheless, this model has limitations. One of the strategic objectives of the WHO Global Strategy and Action Plan (2016) is to improve Healthy Ageing measurement. Our objectives were to compare two models of assessing AHA and further compare the results by country and sociodemographic variables.MethodsThis was a cross-sectional, observational analysis of a representative sample of the general population aged 50 years and older in Europe. The data analysed were obtained by the Study of Health, Ageing and Retirement in Europe (SHARE). The dependent variable was AHA and its dimensions, measured using the Rowe and Kahn AHA model (AHA-B) and the authors’ model based on the WHO definition (AHA-BPS). A descriptive analysis and multivariate models of binary logistical regression were developed.ResultsThe sample consisted of 52,641 participants (mean age 65.24 years [SD = 10.18; Range = 50–104], 53.2% women). Healthy Ageing prevalence in the AHA-B model was 23.5% (95%CI = 23.1%-23.9%). In the AHA-BPS model, this prevalence was 38.9%. In both models, significant variations were observed between countries, and were distributed along a north-western to south-eastern gradient. The sociodemographic variables associated with the absence of AHA were advanced age, female sex, death of spouse, low educational level, lack of employment, and low financial status. Comparing the two models, the strength of association between absence of AHA and advanced age (85 years and older) was four times greater in the AHA-B model.ConclusionsOur results showing differences between these two models provide evidence that the AHA-BPS model does not penalize older age and is more likely to characterize AHA from a health promotion perspective.
Health literacy has been defined by the World Health Organization as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Its importance in reducing inequalities makes health literacy a thematic area that should be addressed in the training of professionals in the fields of healthcare, Social Work and Education. The objective of this study was to define the health literacy levels of students from the Universities of Girona and Barcelona (Spain) and the Regional Institute of Social Work in Perpignan (France). A cross-sectional study was conducted among students of Nursing, Social Work, Primary Education and Special Education in the 2017–2018 academic year. Sociodemographic and academic variables were considered and the HLS-EU-Q16 questionnaire was used to study health literacy levels. In total, 219 students with an average age of 24.9 participated. Of these, 64.4% were studying Social Work, 23.7% Nursing, 5.9% Primary Education, and 5.9% Special Education. Of the total sample, 36.5% were classified as sufficient in health literacy. The total average score of the health literacy index was 11.1; 13.2 among Nursing students; 10.5 among Social Work students; 10.1 among Primary Education students, and 10.1 among Special Education students (p < 0.001). Nursing students obtained the best results and healthcare was the highest rated subdomain, more than disease prevention and health promotion.
Aim To examine the sense of coherence among registered nurses and its relationship with health and work engagement. Background Sense of coherence is a global orientation to view life as structured, manageable and meaningful and have the capacity to cope with stressful situations. A high sense of coherence score indicates that an individual can understand, manage and attribute meaning to events in his or her life as well as in the work environment. Registered nurses face many workplace stressors that may be easier to manage with a strong sense of coherence; however, the effect of this score on their self‐reported health status and work engagement remains unknown. Methods In a cross‐sectional study, 109 registered nurses working in a long‐term care setting responded to a self‐administered questionnaire. Social support, work‐related family conflicts, sense of coherence, self‐reported health status and work engagement variables were analysed using multiple linear regression models. Results Nurses with a high sense of coherence score reported no work‐related family conflicts (mean difference −6.91; 95% CI −10.65 to −3.18; p = .000), better health (r = .408) and greater work engagement (r = .223), compared to their peers with lower sense of coherence. The association between sense of coherence and self‐reported health was confirmed by linear regression modelling (β = .276, p = .003). Conclusions Nurses with a higher sense of coherence had better health and greater work engagement. The work engagement variable showing the highest association with sense of coherence was dedication. Implications for Nursing Management Implementing interventions that increase sense of coherence among nurses can increase commitment to their work, to the institution and to building more engaged teams.
Background: Most elderly people wish to grow old at their own homes. The sociodemographic characteristics; home and neighbourhood conditions; and the social services support and networks are determinants in the possibility of “ageing in place”. The present study aimed to explore the ageing in place phenomenon, as well as the enablers and barriers that interact in a healthy ageing from the perspective of the elderly connected to local entities. Methods: A generic qualitative design was proposed in the Health Region of Girona in Catalonia (Spain). Seventy-one elderly people were purposefully selected. Six focus groups were conducted, and data were thematically analysed. Results: Three key themes were generated: (1) Participants experienced ageing differently. The physical and mental health, the family environment and financial stability were key elements for life quality. (2) The perception of the elderly’s role in the community depended on their age, health status and attitude towards life. (3) The participants identified several enablers and barriers to healthy ageing in place. Conclusions: The promotion of older people’s autonomy and wellbeing, together with the creation of an active network of health and social services, may improve the possibility for elderly to age at home and avoid or delay institutionalisation.
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