Health Literacy in Kidney Disease: Associations with Quality of Life and Adherence

Stømer, Une Elisabeth; Wahl, Astrid Klopstad; Gøransson, Lasse Gunnar; Urstad, Kristin Hjorthaug

doi:10.1111/jorc.12314

Cited by 42 publications

(32 citation statements)

References 59 publications

(55 reference statements)

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“…We found that patients in the moderate HL group were more likely to be non-adherent with diet, but we did not confirm it in patients in the low HL group. This is in line with the research findings of Stømer et al [49] who focused on HL of CKD patients and its association with adherence to lifestyle recommendations and brought similar findings to ours, that patients with moderate HL reported worse adherence than patients with higher HL, but they did not find low HL group to be significantly different than moderate or high HL group. As end stage renal disease (ESRD) is a result of long-term health problems and occurred frequently in the elderly, patients with low HL may already depend their diet adherence on caregivers (spouse, family members), or simplify their diet regime to avoid non-adherence.…”

Section: Discussionsupporting

confidence: 93%

Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence?

Skoumalova

Gecková

Rosenberger

et al. 2020

IJERPH

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Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21–3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26–2.98) or anxiety (OR/95% CI: 1.81/1.22–2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients’ psychological distress to ensure adequate adherence with recommended diet.

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Section: Discussionsupporting

confidence: 93%

Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence?

Skoumalova

Gecková

Rosenberger

et al. 2020

IJERPH

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“…We found that patients with lower HL suffer from worse HRQoL than patients with moderate or higher HL. This confirms the findings of Dodson et al and Stømer et al [18,22], although they used a different measurement tools for assessing HRQoL and assessed less domains of HRQoL. The current study provided a better understanding of the impact of HL on different domains.…”

Section: Discussionsupporting

confidence: 91%

“…Patients with limited HL may fail to understand and apply health information for appropriate self-care activities, and limited HL may highly affect dialyzed patients, who have to adhere to strict recommendations regarding diet, medications and dialysis and must effectively cooperate with healthcare providers. These challenges may in turn negatively affect the quality of their physical health, mental health and social life [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…HL may affect HRQoL in dialyzed patients, but evidence on this is scarce. Previous research [ 18 , 22 ] showed that dialyzed patients with limited HL reported worse HRQoL than patients with better HL. In contrast Green et al [ 23 ], using a one-dimensional tool for assessing HL (REALM), did not find an association of HL and QoL in dialyzed patients.…”

Section: Introductionmentioning

confidence: 99%

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Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population

Skoumalova

Gecková

Rosenberger

et al. 2021

Int J Public Health

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Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL.Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test.Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001.Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.

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“…This is the first study investigating these associations. In the literature, higher HL scores were found to be associated with better adherence to therapies among people with chronic diseases [73][74][75][76]. Receiving COVID-19-related information online during the pandemic could be beneficial for various preventive behaviors [77].…”

Section: Principal Findingsmentioning

confidence: 99%

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

Binh¹,

Tran²,

Phan³

et al. 2020

J Med Internet Res

105

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Background The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. Objective The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. Methods We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. Results The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively. Conclusions The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.

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Health Literacy in Kidney Disease: Associations with Quality of Life and Adherence

Cited by 42 publications

References 59 publications

Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence?

Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence?

Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

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