Health literacy: a new piece of the puzzle in psoriasis care? A cross-sectional study.

BACKGROUND: Health literacy (HL) - the ability to seek, understand and utilize health information - is important for good health. Suboptimal HL has been associated with poorer health outcomes in other chronic conditions, although this has not previously been studied in patients with psoriasis. OBJECTIVES: To investigate the HL strengths and weaknesses of a cohort of patients with moderate-to-severe psoriasis. Another aim was to examine possible associations between patients' quality of life, their demographic, clinical and self-management characteristics, and dimensions of HL. METHODS: A cross-sectional study was conducted. Data were collected from a cohort of patients with psoriasis who had received climate helio therapy from 2011 to 2016 (n = 825). HL was assessed by the Health Literacy Questionnaire (HLQ). The association between HL domains, demographic, clinical and self-management variables were analysed using bivariate correlation and a four-step linear multiple regression model. RESULTS: The scores on all HLQ dimensions indicated lower health literacy than other populations. The linear regression models showed a significant association between HL, quality of life and self-management variables, with higher HL predicting higher quality of life, self-efficacy and psoriasis knowledge. Sex, educational attainment, age and disease severity had less influence on health literacy. CONCLUSIONS: Improving HL may be a useful strategy for reducing disparities in self-management skills for patients with psoriasis. Interventions that aim to reduce disease severity and increase psoriasis knowledge, self-efficacy and quality of life may positively increase HL.

Treatment of patients with postpolio syndrome in a warm climate.

PURPOSE: Treatment in warm climate of various patient groups including patients with postpolio syndrome is controversial. METHOD: Eighty-eight patients with postpolio syndrome (61 women) were recruited, stratified according to sex, age (above/below 60 years old) and use/not use of electrical wheelchair, and randomized to three groups. Group 1 (n=30) underwent treatment in a rehabilitation centre in Tenerife for four weeks in November/December 1999. Group 2 (n=29) were treated in two similar centres in Norway for the same period of time, while Group 3 (n=29), the control group, followed their ordinary health care programme. All patients were tested at the start of study, and 3 and 6 months later, including physical tests and several questionnaire and qualitative interviews. Patients in Group 1 and 2 were also tested after the rehabilitation period. RESULTS: Group 1 and 2 improved significantly both in physical tests and subjective ratings. The positive effects in Group 1 tended to exceed the positive effects in Group 2, and the effects lasted longer. Six minutes walking distance in the two groups was 347 m and 316 m, respectively, before the treatment period, 429 m and 362 m immediately after, and 431 m and 356 m 3 months later. Subjective rating of pain (VAS-scale) was 42 and 43, respectively, before treatment, 17 and 31 immediately after, and 28 and 44 3-months later. In the control group, only minor changes were found. CONCLUSIONS: The study seems to document a positive effect of treatment of patients with postpolio syndrome in warm climate.