Association between Health Literacy, Patient Activation, and Functional Capacity in Individuals with Rheumatoid Arthritis

Oliveira, Isabela Viana; Kakehasi, Adriana María; Neves, Carina de Morais; Silva, Hágabo Mathyell; Gonçalves, Thuane Sales; Aredes, Raquel de Moura; Oliveira, Djenane Ramalho de

doi:10.2174/1874312902115010001

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…While Oliveira et al . [ 18 ] observed the relationship between functional disability and patient activation, our study findings did not support this relationship.…”

Section: Discussioncontrasting

confidence: 93%

“…Participants in our study had lower average PAM scores than those reported by Oliveira et al . [ 18 ] in a Brazilian study. While Oliveira et al .…”

Section: Discussionmentioning

confidence: 99%

“…Surveys in multiple sclerosis, diabetes and chronic obstructive pulmonary disease (COPD) have identified factors commonly associated with patient activation in those conditions, including illness perceptions, anxiety, participants’ knowledge about their condition, engagement with routine check-ups and positive health behaviours [ 13–17 ]. In rheumatology, there was one study conducted in Brazil that included patient activation in a quest to assess factors associated with functional disability [ 18 ]. The same study found that high patient activation was negatively associated with functional disability as measured by the HAQ [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with patient activation in inflammatory arthritis: a multisite cross-sectional study

Jones

Ndosi

Hunt

et al. 2021

Rheumatology Advances in Practice

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Objectives Patient activation covers the skills, abilities and behaviour that impact how able and willing someone is to take an active role in self-managing their health. This study explored clinical and psychosocial factors associated with patient activation in rheumatology patients. Methods This was a cross-sectional study using postal survey methods. Participants with inflammatory rheumatic conditions were from six rheumatology centres in England. Patient activation was captured using the Patient Activation Measure (PAM). Twenty-nine explanatory factors were tested for potential association with patient activation in univariable and multivariable analyses. In preliminary multivariable analyses, factors found to have an association with patient activation at a P < 0.1 level were entered into the final multivariable model. Those that remained significant at a P < 0.05 level were considered associated with patient activation. Results The sample comprised 251 participants (74% female) with a mean age of 59.31 years (s.d. 12.69), disease duration of 14.48 years (s.d. 12.52) and a PAM score of 58.3 (s.d. 11.46). Of the 29 candidate factors, 25 were entered into a preliminary multivariable analysis. In the final multivariable analysis, four factors (self-efficacy, the illness belief that treatment will control participants’ condition and two dimensions of health literacy) were significantly associated with patient activation. This final model accounted for 40.4% of the variance in PAM scores [F(4, 246) = 41.66, P < 0.001]. Conclusions Patient activation is important in managing rheumatic conditions. Our data confirm that self-efficacy and health literacy are particular targets for patient activation interventions.

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“…While Oliveira et al . [ 18 ] observed the relationship between functional disability and patient activation, our study findings did not support this relationship.…”

Section: Discussioncontrasting

confidence: 93%

“…Participants in our study had lower average PAM scores than those reported by Oliveira et al . [ 18 ] in a Brazilian study. While Oliveira et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with patient activation in inflammatory arthritis: a multisite cross-sectional study

Jones

Ndosi

Hunt

et al. 2021

Rheumatology Advances in Practice

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“…32 Four other studies from the United Kingdom, Italy, Singapore, Brazil and Iran only reported mean PAM without categorization. 13,[32][33][34][35][36] Lofland et al assessed the PAM in patients who initiated biologics and the impact of adequate shared decision-making. 37 A higher mean PAM was observed in patients who had adequate shared decisionmaking (p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

The Patient Activation Measure in Patients with Rheumatoid Arthritis: A Systematic Review and Cross-Sectional Interview-Based Survey

Juffali¹,

Almalag²,

Alswyan³

et al. 2022

PPA

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Introduction/Objective: The patient activation measure (PAM) is considered a reliable tool for measuring patient activation. This study aimed to systematically review the scientific literature regarding the use of PAM −13 in rheumatology patients and to compare PAM scores in patients with rheumatoid arthritis (RA) following two different practices at a single institution with previously published studies. Methods: The study consisted of a systematic review of articles reporting the PAM-13 in patients with RA, followed by a crosssectional study evaluating PAM scores between standard rheumatology clinics and specialized rheumatology clinics (SRCs). The correlation between PAM levels and other variables, such as demographics, disease characteristics, and treatment, was assessed. Results: Nineteen studies, published between 2012 and 2022, met the inclusion criteria. The studies in this review had inconsistent results and quality, with patient activation in RA ranging from 29 to 76. A total of 197 patients with confirmed RA diagnoses were interviewed (response rate, 88%). Most were female (n=173, 88%) and older than 40 years (n=150, 76%). The average patient activation score was 64.9 (standard deviation, 15.7). Most participants had level 3 and 4 patient activation measures (n=71 [36%] and n=72[37%], respectively). Patients who were attending SRCs also had borderline higher PAM levels. Patients with high PAM scores tended to be older, have active disease, and were taking corticosteroids. Conclusion: Adequate activation of patients was observed from our center, which was higher than that reported in most published literature. The PAM of patients with RA was variable according to the systematic review. Longitudinal interventional studies should be considered to improve activation in patients with low scores.

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“…Current research on health literacy levels in patients with rheumatic diseases has focused on systemic lupus erythematosus and rheumatoid arthritis (26,27). The findings show an association between patient health literacy and disease activity, medication adherence, functional status, and additional health outcomes (28)(29)(30). We found only one study related to SSc patient health literacy, which, unlike traditional health literacy studies, was an assessment of e-health literacy, focusing on assessing patients' use of e-health resources and need for web-based support (31).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a Systemic Sclerosis Health Literacy Scale

Zhuang

Li²,

Chen³

et al. 2023

Front. Public Health

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Background and aimHealth 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.MethodsThis 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.ResultsOur 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.ConclusionThe Systemic Sclerosis Health Literacy Scale may become a valid tool to evaluate the health literacy level of patients with SSc.

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Association between Health Literacy, Patient Activation, and Functional Capacity in Individuals with Rheumatoid Arthritis

Cited by 6 publications

References 31 publications

Factors associated with patient activation in inflammatory arthritis: a multisite cross-sectional study

Factors associated with patient activation in inflammatory arthritis: a multisite cross-sectional study

The Patient Activation Measure in Patients with Rheumatoid Arthritis: A Systematic Review and Cross-Sectional Interview-Based Survey

Development and validation of a Systemic Sclerosis Health Literacy Scale

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