Promoção da literacia em saúde no utente com patologia oncológica

Background:Wisconsin Literacy Incorporated is a statewide adult and family literacy coalition representing 75 community-based literacy organizations. This coalition focuses its work in four areas: (1) building capacity of its member agencies, (2) advocating for literacy, (3) preparing adults in worker readiness and career pathways, and (4) improving how health information is communicated through its division, Wisconsin Health Literacy (WHL).Brief Description of Activity:This article outlines how an adult basic education coalition successfully developed a statewide health literacy coalition that later transformed into a division of Wisconsin Literacy through a three-phase approach that included: (1) raising awareness and educating health care and literacy providers about health literacy, (2) implementing health literacy interventions through various grant funding, and (3) disseminating and sharing findings from such health literacy interventions to a broad audience.Implementation:Beginning its awareness work in 2003 with help from a physician champion, WHL implemented best practices within each of the three areas of approach. After being implemented, the initial volunteer-based health literacy coalition was transformed into a division of Wisconsin Literacy Incorporated.Results:The division now includes a full-time director, its own website, funding for community interventions, and a business plan for fee-for-service efforts with health care providers, public health agencies, and other stakeholders. Key relationships with Wisconsin health care organizations provided WHL venues to present about health literacy throughout the state and beyond. Wisconsin Literacy Incorporated helped secure a solid infrastructure by hosting two planning retreats and implementing both strategic and business plans for the newly formed division. Offering fee-for-service health literacy training to health care providers brought in new revenue to sustain the division and obtain buy-in from health care agencies on the importance of health literate organizations. Finally, participating in key partner coalitions and Communities of Practice allowed WHL to share experiences and best practices with a national audience.Lessons Learned:The importance of intentionally raising awareness in strategic health care settings across the state fostered many partnerships. Investing in a strategic planning retreat and a business plan guided the division's success. Delivering educational workshops in community-based literacy organizations and trusted settings where adults regularly go to learn was key to successful implementation. [HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S8–S14.]Plain Language Summary:Wisconsin Literacy Incorporated is an adult basic education coalition that built a health literacy division over several years. Using best practices such as raising awareness, implementing pilot projects, and broadly sharing its experience, the Wisconsin Health Literacy division advanced the understanding and commitment to health literacy in and beyond Wisconsin.

Supporting refugee and migrant health has become a critical focus of healthcare policy. Developing and designing health literacy interventions that meet the needs of refugees and migrants is core to achieving this objective. This literature review sought to identify antecedents and consequences of health literacy among refugees and migrants during the first two years of the COVID-19 pandemic. We systematically searched nine electronic databases and numerous grey literature sources to identify studies published between December 2019 and March 2022. The antecedents (societal and environmental determinants, situational determinants, and personal determinants) and consequences of health literacy among refugees and migrants were mapped to a validated integrated health literacy model. Social and environmental determinants (n = 35) were the most reported antecedent influencing health literacy among refugees and migrants during the first two years of COVID-19. Language (n = 26) and culture (n = 16) were these determinants' most frequently reported aspects. Situational determinants (n = 24) and personal determinants (n = 26) were less frequently identified factors influencing health literacy among refugees and migrants. Literacy (n = 11) and socioeconomic status (n = 8) were the most frequently reported aspects of personal determinants. Media use (n = 9) and family and peer influence (n = 7) were the most cited situational determinants reported. Refugees and migrants with higher levels of health literacy were more likely to use healthcare services, resulting in better health outcomes. The findings of this review reveal personal and situational factors that impacted health literacy among refugees and migrants during COVID-19 that require attention. However, the inadequate adaptation of health literacy interventions for linguistic and cultural diversity was a greater problem. Attention to this well-known aspect of public health preparedness and tailoring health literacy interventions to the needs of refugees and migrants during pandemics and other public health emergencies are paramount.

The availability of health information through media has raised public awareness of health literacy (HL). HL is essential for medication adherence and self-management in individuals with chronic diseases, and for those without chronic conditions, HL is important for promoting health and engaging in preventive behaviors. This study examined the role of having a regular physician in improving HL among Korean adults, both with and without chronic diseases. We conducted a retrospective, cross-sectional analysis using data from 8,322 participants in the 2021 Korea Health Panel Study. HL was measured with the 16-item European Health Literacy Survey Questionnaire. To identify factors associated with HL categories and to calculate adjusted mean HL scores, we used multiple logistic regression and weighted linear regression. Among participants with chronic diseases (n=4,627), 56.6% reported having a regular physician, with the largest group (42.7%) showing inadequate HL. After adjustment, age 75 years or older and lower education were significantly linked to lower HL levels, regardless of chronic disease status. Having a regular physician was significantly associated with higher HL levels in participants with chronic diseases (adjusted odds ratio, 1.94; 95% confidence interval, 1.42-2.63), but not in those without chronic diseases. Participants with chronic diseases who had a regular physician showed higher mean HL scores across all HL competencies and domains. Although access to health information has increased, the risk of encountering conflicting or misleading content has grown. These findings emphasize the importance of regular physicians in guiding patients and improving HL, especially among individuals with chronic diseases.

OBJECTIVE To understand the relationship between health literacy and patient experience of outpatients in China, and to explore its mechanism. METHODS The conceptual framework was developed based on Andersen's behavioral model of health services use and health literacy skills framework. An online cross-sectional survey was conducted with snowball sampling method, while the health literacy was measured by self-designed patient health literacy scale, and the patient experience was measured by the Chinese patient experience questionnaire for ambulatory care developed by Peking Union Medical College. And a structural equation model was built to explore the relationship between them and test the mechanism of health literacy influencing patient experience. RESULTS A total of 2 773 subjects were investigated. The average score of health literacy was (90.72±12.90) points, accounting for 78.89% of the full score, and the dimension of seeking social support had the lowest score. The average score of overall rating of patient experience was (3.71±0.74) points, and the scores of each dimension of patient experience were between 3.56 and 3.80. The model fit indices of structural equation model for overall rating of patient experience among the outpatients were χ2/df=9.29 (χ2=4 107.27, df=442), root mean square error of approximation (RMSEA)=0.055 ( 0.90), Tucker-Lewis index (TLI)=0.918 (>0.90), standardized root mean square residual (SRMR)=0.061 (< 0.08), the model was acceptable. The variance in patient experience explained by the model was 0.108. The structural equation model analysis results showed that the overall rating of outpatient experience was directly affected by health literacy (β=0.263, P < 0.001), also indirectly affected by health literacy (β=0.012, P < 0.001). In other words, the overall rating increased by 0.275 units for each standard deviation increase of health literacy. Self-evaluated health status mediated the relationship between health literacy and the overall rating of outpatient experience. In terms of diffe-rent dimensions of patient experience, the standardized path coefficient of the total effect of health literacy on patient experience was as follows: Information guidance 0.337, humanistic care 0.319, communication with doctors 0.294, service efficiency 0.240, and hospital environment 0.173. CONCLUSION The patients with higher level of health literacy were more likely to have a better outpatient experience in China, and the information guidance experience and humanistic care experience were most affected by health literacy. And the communication and information utilization ability had the greatest influence on patient experience.

This study aimed to explore health literacy profiles in patients with heart failure and identify heterogeneous subgroups within the chronic heart failure population. Through investigating the health literacy of heart failure patients, we analyzed the factors influencing patients' health literacy levels, aiming to provide evidence-based guidance for improving health literacy in this patient population. This study used a cross-sectional design. A total of 220 patients with chronic heart failure hospitalized at a tertiary hospital in Shanxi Province were recruited via convenience sampling between January and June 2024. Participants were assessed using a general characteristics questionnaire, the Chinese Version of the Heart Failure Health Literacy Scale, and the Heart Failure Self-Care Behavior Scale. Data analysis included multinomial ordered logistic regression to identify factors influencing health literacy and latent profile analysis to explore potential classes of health literacy among the patients. The health literacy profiles were categorized into 3 potential profiles, including the low health literacy-resource-limited group (7.7%), the medium health literacy-communication barriers group (55.5%), and the high health literacy-high decision-making ability group (36.8%). The results of multicategorical ordered regression analysis showed that occupation, literacy, per capita monthly household income, type of health insurance, and self-care ability were the influential factors in potential profile categories of health literacy in heart failure patients (p < .05). Chronic heart failure patients have variable health literacy, with better self-care behaviors associated with higher health literacy.

ObjectiveHealthy behaviours are important for people with polycystic ovary syndrome (PCOS). However, adopting and maintaining lifestyle changes involves a complex set of behavioural changes, which most patients fail to adhere...

BackgroundHealth literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia.MethodsA cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations.ResultDescriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains.ConclusionThe overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.

Introduction Burn injuries occur with a disproportionately higher frequency in vulnerable groups. Their health literacy (HL), defined as the way patients obtain, process, and understand health information, may be an important factor that influences access, care, and recovery after burns. This study aims to determine the current levels of health literacy and variables associated with poor health literacy for outpatients treated at two regional burn centres. Methods All eligible patients presenting to two tertiary outpatient burn centers were asked to participate. The Newest Vital Sign health literacy assessment tool and a sociodemographic survey were administered. The NVS scores were divided into poor (0-2), moderate (3-4), and adequate (5-6) health literacy. We first compared health literacy rates between sites using non-parametric Chi-squared test. We then developed a multivariable regression model using a stepwise construction with poor health literacy as our dependent variable. Included in the exploratory model were income, education level, working status, and age. Results Forty-nine patients with a mean age of 46.6 years (SD=17.4) were included; 57% (29/49) of patients identified as male. Most of the burn injuries (78%, 38/49) were less than 10% total body surface area. HL rates were poor, moderate, and adequate in 35% (17/49), 18% (9/29), and 47% (23/29), respectively. There were no differences in health literacy between the 2 sites. Age was the only independent predictor of poor health literacy in burn patients, with advanced age being associated with worse health literacy (95% CI: 1.001-1.119, p&amp;lt; 0.05). Income, education level and working status did not independently predict health literacy rates (Table 1). Conclusions More than half of patients treated at burn outpatient clinics have only poor or moderate health literacy. This study further suggests that older adults may be most at risk. This trend is consistent across two regional burn centres. This study highlights the importance of health literacy among patients with burn injury and stresses the importance of personalized and literacy-adjusted discussions surrounding care. Our next project will address the impact of health literacy on adherence to recommended therapies. Applicability of Research to Practice Poor health literacy is a barrier to obtaining burn care and is an important social determinant of health. We should identify factors associated with poor health literacy among patients with burn injury and improve the delivery of health information.

Failure to adhere to fluid restrictions negatively affects the quality of life and increases the risk of complications among hemodialysis patients. In chronic diseases, including chronic kidney disease, health literacy plays a crucial role in mitigating disease complications. The level of health literacy in chronic diseases such as chronic kidney disease can play a significant role in reducing the complications of the disease. This study aimed to assess the relationship between fluid control and health literacy in hemodialysis patients, representing the first such research in Turkey. This descriptive, cross-sectional, and correlational study was conducted in all dialysis centers in Bolu province, Turkey, from September 2022 to August 2023. The study included 144 hemodialysis outpatients meeting the inclusion criteria. Patient fluid control and health literacy were assessed using the "Fluid Restriction Scale in Patients Receiving Hemodialysis Treatment" and the "Turkey Health Literacy Scale-32". Statistical analysis was performed using SPSS version 25.0. The mean total score on the Health Literacy Scale was 22.6 ± 10.2, indicating a relatively low level of health literacy among the hemodialysis patients. 54.2% of patients receiving hemodialysis treatment exhibited inadequate health literacy. The mean score on the Fluid Restriction Scale was 50.4 ± 8.63, suggesting moderate fluid control adherence among the study population. 56.3% of hemodialysis patients had moderate levels of fluid control. A statistically significant moderate positive correlation was found between fluid control and health literacy levels (r = 0.456, p < 0.001). Health literacy scores accounted for 20.2% of the variance in fluid restriction scores (R 2 = 0.20), indicating a moderate contribution of health literacy to fluid control adherence. This study revealed a positive correlation between health literacy and fluid control adherence. Therefore, it is recommended that hemodialysis nurses concurrently assess patients' health literacy and fluid control and develop tailored educational programs based on these assessments.

This study aimed to evaluate health literacy in patients (n=395) with systemic autoimmune diseases (SAD) and analyze their relationships with health-related quality of life (HRQoL), attitudes and beliefs about Covid-19 and vaccination, and perceptions of changes in medical care during the pandemic. This study was cross-sectional and the majority (81%) of particpants resided in Spain. An anonymous online survey was distributed to an online SAD association. Health literacy was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the SF-36 tool was used to assess HRQoL. More than half of patients (57.7%) have inadequate health literacy and the mean health literacy level was 9.63(5.66). Patients with inadequate health literacy levels presented the lowest HRQoL scores in all SF-36 domains (p < .001). Health literacy scores were positively correlated with all SF-36 domains (p < .001). The reservations to get vaccinated against Covid-19 were linked to health literacy level (p = 0.024). There are high levels of inadequate health literacy among patients with SAD and it is associated with worse HRQoL and risk attitudes about Covid-19 vaccination and medical care during the pandemic.

To investigate the structural relationships among perceived stress (PS), positive psychological capital (PsyCap) and health literacy (HL) in patients with multiple chronic conditions (MCC) and construct a model to explore the relationships of PS and PsyCap on HL. HL is critical in the rehabilitation and management of patients with MCC. Extensive understanding of the relationships between research variables can help nursing staff to implement effective programmes that improve the level of HL of patients. However, currently there is no research that has evaluated the structural relationships among these variables using a single model. This study adhered to the STROBE guidelines for reporting cross-sectional studies. The Health Literacy Scale for Chronic Patients, Chinese Perceived Stress Scale (CPSS) and Positive Psychological Capital Questionnaire were used to assess HL, PS and PsyCap, respectively. Questionnaires were distributed to 317 patients with MCC attending a tertiary general care hospital in China from February to May 2023, using convenience sampling approach. Structural equation modelling was used to validate the proposed model. The findings showed that PS has a negative relationship with HL and PsyCap. PS was indirectly associated with HL through PsyCap. The results indicated that PsyCap was positively associated with HL. The PS and PsyCap explained 64% of the variance in HL. The findings showed that the proposed model had high validity and structural relationships between chosen variables were observed for MCC patients. These results may help nursing staff develop strategies to improve the HL of patients with MCC, which should focus on reducing PS and enhancing PsyCap to improve HL. Nursing staff can provide targeted psychological counselling and health guidance for patients to alleviate negative emotions and further promote their HL. Participate in research and fill out questionnaires.

This quality improvement project was designed to close a gap in capturing health literacy in adult patients with heart failure discharged from a hospital system. An opportunity existed to investigate if health literacy levels contribute to individuals' social factors and overall health. A priority focus was evident across healthcare organizations to address the social determinants of health (SDOH) for the populations served. Throughout the literature, limited health literacy is associated with higher hospital readmission rates. Pre-implementation data included 2023 heart failure readmission rate (19.02%) and baseline SDOH screenings (9,500) which noted housing, food insecurities, and transportation as greatest needs. There was no prior data analysis of how social factors may have impacted readmissions. Patients with recent hospitalization in Acute Care Hospitals with a known heart failure diagnosis; received health literacy screenings by the Registered Nurse (RN) Transitional Care Managers (TCMs) during their post-hospital discharge follow-up calls. Pre-implementation period began in August 2024. Project launched in November 2024 with RN TCMs conducting assessments using the BRIEF (Health Literacy Screening Tool) during post-hospital discharge calls. Additional follow-up calls were required as the intervention for patients with limited literacy during their 30-day post-hospitalization transition period. Data collection occurred from November 2024 through June 2025. The 8-month period included 1,543 high-risk hospital discharges, among them 580 patients with heart failure screened for health literacy; 517 patients had adequate health literacy, 44 had marginal health literacy, and 19 had limited health literacy. The intervention of additional follow-up calls for patients with limited health literacy achieved statistical significance in reducing readmissions. By implementing the BRIEF screening tool within an existing RN TCM workflow, it allowed for RN TCMs to interview patients with important questions during a vulnerable time for patients - transitioning from hospital to home. Expansion of health literacy assessments is vital for patients with any chronic condition, not just heart failure. RN TCMs identify the necessary interventions needed to support their patients and develop care plans. It is especially important to understand the needs specifically for patients with limited health literacy. Care management plays a pivotal role in patient advocacy by providing education and coordinating directly with providers to support patients' journey to better health.

Today’s society exposes children to vast amounts of health-related information, presenting significant challenges in navigating this content. European health literacy (HL) research underscores the primary school’s role in educating children’s HL. Several HL interventions have been developed for a school setting and few have used co-design with adolescents. However less is known about co-designing HL activities with children. Therefore, this study aims to identify barriers and facilitators for co-designing HL activities with 9 to 12-year-old children in school settings. We use 4 phases of design-based research for the process of co-designing learning activities with multiple teams of 6-8 children in school settings. First, children Reflect on HL and empathize and define skills they want to design activities for. They Design activities through ideation and prototyping. We use a variety of creative methods for the sessions and analyses, such as body mapping and affinity mapping. The evaluation of the effectiveness regarding HL and learning outcomes will be performed in Test and Evaluate phases. Our preliminary results show that children need short and clear assignments for the sessions to reach the goals. Children are enthusiastic to participate and like the methods used in the session, although the concept of HL is sometimes difficult to comprehend. It is challenging for children to come up with creative and appropriate elements for activities without correct health information. We are awaiting results from Test and Evaluate phase on the effect on HL levels and learning outcomes. Children are able to co-design HL activities together with HL and health promotion researchers. By giving children a voice and hands-on experience in the design process, we are able to create activities that are suitable for the target population. This co-design process will be evaluated and adapted to an intervention for the “healthy school” program in the Netherlands. Key messages • By co-designing HL activities children actively learn about health literacy. • Children are important and capable co-designers for HL activities when working together with HL researchers.

Background:A significant proportion of new parents in high-income countries have lower health literacy, but few health literacy interventions exist for this group.Objective:This study investigated the feasibility of delivering health literacy content within existing postnatal parenting groups.Methods:Multicenter feasibility study using a seven-group pre-test post-test design. Parents older than age 16 years with children between age 4 and 26 weeks with sufficient English fluency were invited to participate in a 4-week health literacy program (four 2-hour sessions) delivered by trained facilitators (e.g., child and family health nurses). Mixed-methods evaluation was used, with quantitative data analyzed descriptively and qualitative data (e.g., focus groups, observations, interviews) analyzed using the Framework approach.Key Results:Our health literacy program was successfully delivered at six sites in New South Wales, Australia, in 2018. Our recruitment strategy was successful in reaching diverse learners (N = 73), many who were born in a country other than Australia. However, few had limited health literacy as assessed by a subjective, single-item measure, and only half completed the follow-up questionnaires. High baseline knowledge, skills, and confidence among participants limited the potential for change in these quantitative outcomes but shed light on the utility of different measurement instruments in this context. Qualitative analyses suggested that the health literacy program aligned well with the institutional objectives of child and family health services and was acceptable to learners from diverse cultural backgrounds. However, in its current form, it may be perceived as too simple for learners with higher levels of education and literacy.Conclusions:Our study has offered practical insights into the feasibility of embedding a health literacy intervention into established postnatal parenting groups and shown how program resources and facilitator training could be adapted to make the program more suitable for a range of learners and better support facilitators. [HLRP: Health Literacy Research and Practice. 2020;4(1):e67–e78.]Plain Language Summary:This study looked at the feasibility of delivering a 4-week health literacy program to new parents using existing postnatal parenting groups in New South Wales, Australia. Although the program was generally acceptable to learners and facilitators, this study offers several strategies to further improve the program so that it better supports facilitators and suits a wider range of learners.

The Italian Health Literacy Project: Insights from the assessment of health literacy skills in Italy