Health literacy in type 2 diabetes patients: a systematic review of systematic reviews

Abstract

Aim To summarize, critically review, and interpret the evidence related to the systematic reviews on health literacy (HL) amongst type 2 diabetes mellitus (T2DM). Methods The methodology for this study consisted of a systematic review of systematic reviews, using the PRISMA statement and flowchart to select studies, and searching on PubMed, CINAHL, Scopus, and Cochrane. The search covered the period between January 2006 and June 2016. Results From the 115 identified record by the queries, only six systematic reviews were included, following a quality evaluation using AMSTAR. The included systematic reviews content was analyzed by the independent work of two authors, using a narrative synthesis approach. The findings of this study (i.e., main themes) are areas of consensus and gaps in knowledge. Areas of consensus are HL definition, HL measurement tools, and the relationship between T2DM patient knowledge (or literacy) and his/her HL. The gaps in knowledge were the assessment of the relations between HL and health outcomes and self-efficacy, the gender differences, the effectiveness of interventions to improve HL, the cost-effectiveness study of interventions to improve HL, and the understanding of the influence of organizational environment on HL. Conclusion This review provides a current state of knowledge to address clinical practice and research proposals. HL could be useful to personalize patients' follow-up and it should be routinely assessed in its three dimensions (i.e. functional, interactive and critical) to enhance patients' ability to cope with clinical recommendations. Future research should be mainly aimed to test the effectiveness of evidence-based interventions to improve HL amongst T2DM patients.

The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis

“…In a similar fashion, we found that health literacy was positively related to diabetes knowledge, echoing findings from systematic reviews on the two concepts. 10 Again, the relationship was stronger when performance-based tests were used exclusively or in addition to other measures, as compared to measures based on (self-)perception. This is an important finding as research has previously shown that diabetes knowledge is related with successful self-management and health outcomes.…”

“…4 These functional skills have been studied in the context of chronic diseases since the term health literacy first appeared in 1974, 5 and their relations to health outcomes, use of healthcare services, and costs have been repeatedly documented. 6 Concerning diabetes, a large body of empirical research assessing the relation between health literacy and diabetes-related knowledge, management, and outcomes has been summarized in numerous systematic and narrative reviews with heterogeneous results (e.g., [5][6][7][8][9] ) For example, Caruso and colleagues, 10 in their systematic review of six systematic reviews, concluded that, while the link between health literacy and diabetes knowledge is well-established, inconsistent findings exist for the relationships between health literacy and diabetes-related outcomes. To the best of our knowledge, only one metaanalysis on eight studies 11 investigated the role of health literacy in diabetes outcomes, focusing on health-literacy-sensitive interventions.…”

Determinants of health-related quality of life: a cross-sectional investigation in physician-managed anticoagulated patients using vitamin K antagonists

“…Specifically, beliefs are defined as patients' concerns for treatment, and their understanding of the necessity of being treated with OAC [23]. Lastly, health literacy was defined as an individual's capacity to obtain, understand, and function the basic information and services to best manage his or her health, and engage in proper decision-making [24]. Previous research reported that anticoagulated patients with low health literacy were less adherent to OAC, exhibiting an increased risk of complication and disease-related mortality [25].…”

Treating a non‐healing postoperative sternal wound in a woman with type 2 diabetes mellitus: A case report

“…This case report shows a complex case of non‐healing sternal wound management in a patient with type 2 diabetes mellitus. Several factors could have affected the healing process over the course of the treatments, such as lifestyle and patient compliance, so it can be difficult to define which clinical change could be associated with the wound healing . However, the timing of consultation with the wound care specialist appears to reflect the traditional modus operandi in managing sternal wounds after cardiac surgeries.…”

“…Several factors could have affected the healing process over the course of the treatments, such as lifestyle and patient compliance, so it can be difficult to define which clinical change could be associated with the wound healing. [8][9][10] However, the timing of consultation with the wound care specialist appears to reflect the traditional modus operandi in managing sternal wounds after cardiac surgeries. In fact, the wound care specialist, unlike other wounds (eg, pressure ulcers), did not initially assess the sternal wound because its treatment was initially managed without wound specialist consultation.…”