Health Literacy in Glomerulonephritis and Renal Vasculitis Attending Nephrology Clinics

Abstract

<b><i>Aims:</i></b> Glomerulonephritis is one of the leading causes of progressive chronic kidney disease worldwide and treatment requires shared decision-making to improve self-care and plan immunosuppressant therapy. However, information on health literacy (HL) in patients with glomerulonephritis is scanty. We aimed to assess HL in our multiethnic population with glomerulonephritis. <b><i>Methods:</i></b> Single-center cross-sectional study of patients with glomerulonephritis receiving induction immunosuppressants at the ambulatory nephrology clinic and who completed the anonymized self-administered HLS-EU-47 questionnaire. The standardized HL index and domain item mean scores were compared with participant sociodemographic characteristics. <b><i>Results:</i></b> Among 65 patients who attend the clinics over a month, 27 agreed to participate in the survey. After excluding responses with significant missing information, we included 23 participants (16 Chinese, 4 Malay, 2 Indian, and 1 other ethnicity) in the analysis. The median age was 39 (interquartile range 27, 60 years). The median general HL index was 26.2 (19.8, 29.8). The item mean scores were 2.64 (2.43, 2.77), 2.45 (2.09, 2.72), 2.33 (2.17, 2.58), and 2.50 (2.25, 2.75) for the domains of accessing, understanding, appraising, and applying health-care-related information, respectively. Male patients had significantly higher HL indices and higher scores for accessing and appraising health information, while higher personal income was significantly associated with higher score for applying health knowledge. <b><i>Conclusion:</i></b> Patients with glomerulonephritis had lowest HL in the domain of appraising health information. Further research on targeted interventions to improve the HL in appraising treatment options and vaccinations in patients with glomerulonephritis is required.

A Descriptive Evaluation of Health Literacy and Determinants of COVID-19 Vaccine Acceptance among Patients with IgA Nephropathy with High Vaccine Uptake

“…The interviewer-administered questionnaire was conducted in English over the telephone by a single trained study member to minimize interviewer variability, while the self-administered survey (also in English) was offered in the clinic if the patient came for a routine nephrology consult. English was chosen since our pilot study noted that English was the most frequently used language in communicating with healthcare personnel and participants preferred the English version [ 14 ]. To reduce differences in the understanding of the questionnaire, patients had the opportunity to clarify any uncertainty about the survey, regardless of the modality.…”

“…The prerequisite for such shared decision-making is the ability to access, understand, evaluate, and apply healthcare-related information to make informed health decisions [ 13 ]. While data on health literacy among IgAN are scarce, our previous study of individuals with glomerulonephritides (conducted in mid-2020 before regulatory bodies approved the use of COVID-19 vaccines) noted that one of the areas with greatest perceived difficulty was related to appraising the need for vaccinations [ 14 ]. In particular, there is a real threat of misinformation about COVID-19 vaccines following an unprecedented manner of accelerated vaccine development and testing in 2020 then near-global exhortation to vaccinate immediately after vaccines became available [ 15 ].…”

Influenza vaccine awareness and acceptance in kidney disease during the corononavirus disease 2019 pandemic

“… 3 In 2020, we had noted that appraising the need for vaccinations was perceived as difficult among our patients with immune‐mediated kidney disease due to glomerulonephritis. 4 Since 2021, there has been a massive public education campaign to promote COVID‐19 vaccination. While vaccine advocates may hope for spillover effects on patients' acceptance of vaccinations in general, the pandemic may reduce opportunities for physicians to advocate influenza vaccination.…”