Profiles of health literacy and digital health literacy in clusters of hospitalised patients: a single-centre, cross-sectional study.

OBJECTIVE: To investigate health literacy (HL) and digital health literacy (eHL) among patients hospitalised in surgical and medical wards using a cluster analysis approach. DESIGN: Cross-sectional study using Ward's hierarchical clustering method to measure cluster adequacy by evaluating distances between cluster centroids (a measure of cohesion). Different distances produced different cluster solutions. SETTING AND PARTICIPANTS: The study was conducted at a Norwegian university hospital. A total of 260 hospitalised patients were enrolled between 24 May and 6 June 2021. DATA COLLECTION: All data were collected by self-reported questionnaires. Data on HL and eHL were collected by the Health Literacy Questionnaire (HLQ) and the eHealth Literacy Questionnaire (eHLQ). We also collected data on background characteristics, health status and patient diagnosis. RESULTS: We found six HLQ clusters to be the best solution of the sample, identifying substantial diversity in HL strengths and challenges. Two clusters, representing 21% of the total sample, reported the lowest HLQ scores in eight of nine HLQ domains. Compared with the other clusters, these two contained the highest number of women, as well as the patients with the highest mean age, a low level of education and the lowest proportion of being employed. One of these clusters also represented patients with the lowest health status score. We identified six eHL clusters, two of which represented 31% of the total sample with the lowest eHLQ scores in five of seven eHLQ domains, with background characteristics comparable to patients in the low-scoring HLQ clusters. CONCLUSIONS: This study provides new, nuanced knowledge about HL and eHL profiles in different clusters of patients hospitalised in surgical and medical wards. With such data, healthcare professionals can take into account vulnerable patients' HL needs and tailor information and communication accordingly.

Effectiveness of a health communication intervention on health literacy in the first year following kidney transplantation - A randomized controlled study.

OBJECTIVE: This study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation. METHODS: We randomized 195 patients during 2020-2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©). RESULTS: Results showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the "ability to appraise health information" Domain 5, (p-value = 0.002) and the "ability to navigate the healthcare system" Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points. CONCLUSIONS: This study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients. PRACTICAL IMPLICATIONS: Current patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.

Patient experiences following liver transplantation due to liver metastases from colorectal cancer.

PURPOSE: Colorectal cancer is the second leading cause of cancer-related death in the western world. Little is known about patients undergoing liver transplantation (Ltx) due to liver metastases from colorectal cancer. This study aimed to explore individual patients' experiences having undergone this procedure as a treatment for liver metastases secondary to colorectal cancer. METHOD: Exploratory research methodology was used, whereby in-depth interviews with 9 patients were carried out 6 months after they had undergone liver transplantation. Median patient age was 56 years at the time of the surgery. The interviews were transcribed verbatim and qualitative content analysis was applied to the data. RESULTS: Three main themes emerged during the analysis phase. The first theme explored the informants' positive feelings about receiving experimental treatment that might prolong their life. The second theme related to the challenge presented by their feelings oscillating frequently between hope and despair. The final theme considered the strong wishes expressed by patients to live their lives as normally as possible thereafter. This last theme related in part to the patients' physical condition, side effects from medication and any relationships with loved ones. CONCLUSION: These findings offer new insight into the situation of patients undergoing liver transplantation due to liver metastases from colorectal cancer. In spite of the risks and side effects of major surgery and the transplant medication all participants expressed an overall view that having undergone liver transplantation was a very positive experience.