Literacia em saúde da pessoa internada em serviço de cirurgia oncológica / Health literacy of patients admitted to a surgical oncology unit / Alfabetización en salud de las personas ingresadas en un servicio de cirugía oncológica

Resumo Enquadramento: A literacia em saúde (LS) é a capacidade da pessoa obter e traduzir informações a fim de manter e melhorar a saúde. Objetivo: Caracterizar o nível de LS da pessoa internada num hospital oncológico; avaliar a fiabilidade do instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodologia: Estudo transversal, quantitativo, descritivo e metodológico. Amostra de 188 pessoas internados num serviço de cirurgia oncológica entre maio e setembro de 2020, os dados foram colhidos através de formulário de caracterização sociodemográfica, de saúde e instrumento de avaliação da LS. Resultados: O HLS-EU-PT apresentou elevado nível de consistência interna. Todos os domínios e níveis de processamento do instrumento se correlacionam positivamente entre si. Os participantes apresentam em média um nível problemático de LS. Conclusão: Os resultados indiciam a necessidade de um maior investimento na capacitação da LS. São necessários mais estudos nesta e noutras populações e contextos de prestação de cuidados de saúde, de forma a direcionar a prática de cuidados na resposta eficaz aos problemas de saúde.

Abstract Background: Health literacy (HL) is the ability of an individual to obtain and translate information in order to maintain and improve their health. Objective: To characterize the level of HL of patients admitted to an oncology hospital and assess the reliability of the Portuguese version of the European Health Literacy Survey (HLS-EU-PT). Methodology: Cross-sectional, quantitative, descriptive, and methodological study. Sample of 188 patients admitted to a surgical oncology unit between May and September 2020. Data were collected through a sociodemographic and health characterization form and a HL assessment tool. Results: The HLS-EU-PT had a high level of internal consistency. All domains and information-processing levels correlated positively with each other. Participants had on average a problematic level of HL. Conclusion: The results indicate the need for greater investment in HL training. Further studies are needed in this population and in other populations and healthcare settings to provide an effective response to health problems.

Resumen Marco contextual: La alfabetización en salud (AS) es la capacidad de una persona para obtener y traducir información con el fin de mantener y mejorar su salud. Objetivo: Caracterizar el nivel de AS de las personas ingresadas en un hospital oncológico; evaluar la fiabilidad del instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodología: Estudio transversal, cuantitativo, descriptivo y metodológico. Muestra de 188 personas ingresadas en un servicio de cirugía oncológica entre mayo y septiembre de 2020, se recogieron datos mediante un formulario de caracterización sociodemográfica y de salud, y una herramienta de evaluación de AS. Resultados: El HLS-EU-PT mostró un alto nivel de consistencia interna. Todos los dominios y niveles de procesamiento del instrumento correlacionaron positivamente entre sí. Por término medio, los participantes tienen un nivel problemático de AS. Conclusión: Los resultados indican la necesidad de una mayor inversión en formación en AS. Son necesarios más estudios en esta y otras poblaciones, y en entornos sanitarios para orientar la práctica asistencial hacia una respuesta eficaz a los problemas de salud.

Competencias digitales en los ingresantes a la carrera de Licenciatura en Enfermería

Objetivo: Determinar las habilidades y conocimientos sobre las tecnologías de la información y la comunicación (TIC) de los ingresantes a la carrera de Licenciatura en Enfermería de una institución superior pública de Bahía Blanca, Provincia de Buenos Aires, Argentina. Metodología: Estudio observacional, descriptivo, transversal y cuantitativo. Se implementó un instrumento conformado por 59 preguntas con opciones de respuesta cerrada orientado a valorar las competencias digitales en los ingresantes a la carrera. Resultados: Participaron 386 ingresantes, mayormente de género femenino (85.49 %), del primer ciclo (74.35 %) y con 20 años o menos de edad (47.15 %). El 98.19 % tenía acceso a internet, el 79.27 % tiene computadora y más del 80 % tiene un amplio uso de redes sociales (WhatsApp, Instagram) y correo electrónico. Los ingresantes se autoevaluaron competentes en el programa MS Word, mientras que en MS Excel se declararon menos competentes. Hay desconocimiento y bajo desarrollo de habilidades para generar contenido, y un amplio despliegue de habilidades para buscar y descargar información de la web. La edad, el género, el tiempo diario de uso de internet y el ciclo de ingreso mostraron relación con el dominio de las herramientas digitales aplicadas a la educación. Conclusiones: Se identificó un desarrollo intermedio de competencias digitales aplicadas a la educación, lo que podría ameritar el diseño de programas que nivelen estas habilidades durante el proceso de ingreso o durante la formación.

Objetivo: determinar habilidades e conhecimentos sobre as tecnologias da informação e comunicação (TIC) dos calouros no curso de bacharelado em enfermagem em uma instituição pública de ensino superior na cidade de Bahía Blanca, província de Buenos Aires, Argentina. Metodologia: estudo observacional, descritivo, transversal e quantitativo. Foi utilizado um instrumento composto por 59 perguntas com opções de resposta fechada para avaliar as competências digitais dos calouros do curso. Resultados: Participaram 386 estudantes, em sua maioria do gênero feminino (85,49 %), do primeiro ciclo estudantil (74,35 %) e com idade igual ou inferior a 20 anos (47,15 %). 98,19 % tinham acesso à internet, 79,27 % tinham computador e mais de 80 % usavam amplamente as redes sociais (WhatsApp, Instagram) e o e-mail. Os calouros se auto-avaliaram competentes no programa MS Word, enquanto no MS Excel se declararam menos competentes. Há desconhecimento e baixo desenvolvimento de habilidades para gerar conteúdo e uma ampla demonstração de habilidades para pesquisar e baixar informações da web. A idade, o gênero, o tempo diário de uso da Internet e o ciclo de ingresso estudantil mostraram relação com o domínio das ferramentas digitais aplicadas à educação. Conclusões: Foi identificado um desenvolvimento intermediário de competências digitais aplicadas à educação, o que poderia demandar a concepção de programas que nivelem essas competências durante o processo de admissão ou durante a formação.

Objective: To determine the skills and knowledge about information and communication technologies (ICT) of entrants to the Bachelor's Degree in Nursing at a public higher institution in Bahía Blanca, Province of Buenos Aires, Argentina. Methodology: Observational, descriptive, transversal and quantitative study. An instrument was implemented consisting of 59 questions with closed response options aimed at assessing digital competencies in those entering the career. Results: 386 entrants participated, mostly female (85.49 %), from the first cycle (74.35 %) and 20 years old or younger (47.15%). 98.19 % had access to the internet, 79.27 % have a computer and more than 80 % have extensive use of social networks (WhatsApp, Instagram) and email. The entrants evaluated themselves as competent in the MS Word program, while in MS Excel they declared themselves less competent. There is a lack of knowledge and low development of skills to generate content and a wide range of skills to search and download information from the web. Age, gender, daily time of Internet use and entry cycle showed a relationship with the mastery of digital tools applied to education. Conclusions: An intermediate development of digital competencies applied to education was identified, and a high one for the use of social networks. The variables age, gender, daily time of Internet use and entry cycle were related to the knowledge and skills for using ICT applied to education.

Validation of the Spanish version of the Health Literacy Survey (HLS19-Q12) in secondary care specialty consultations.

OBJECTIVES: This study sought to validate the HLS19-Q12 in Spain and in the Spanish language, as well as describe the sociodemographic profile and the general health literacy of the study population. STUDY DESIGN: Descriptive cross-sectional. METHODS: Factor analysis and Cronbach's alpha were used to validate the Spanish version of the HLS19-Q12. Health literacy scores and associated categories were calculated using the scale factsheet, and the patient population sociodemographic profile was determined using frequency analysis. RESULTS: The HLS19-Q12 used in Spain in the Spanish language was found to be both valid and reliable (Cronbach's alpha = 0.87). The sociodemographic profile was primarily male and aged, and the majority of patients were of Spanish origin and had diabetes. General patient health literacy was limited, with 60% of participants having general health literacy categorized as inadequate or problematic, and 40 % sufficient or excellent. CONCLUSIONS: This study validated the HLS19-Q12 in Spain, created a sociodemographic profile of the sample population, and calculated their health literacy scores. This contribution provides another valuable validated tool and associated data to the increasingly important field of health literacy.

Mental Health Literacy Interventions in Young People: a Narrative Review.

INTRODUCTION: Health literacy is defined as the "ability to obtain, process and understand basic health information and to access health services in order to make informed choices". The concept of Mental Health Literacy (MHL) has been introduced in recent years in order to promote mental health. MHL refers to knowledge and beliefs about mental disorders that facilitate their recognition, management, and prevention. A low level of MHL represents a fundamental barrier to seeking mental health care. METHODS: For this review we followed a narrative approach. Papers published between 2013 and 2024 were screened for inclusion. Only 24 articles met the inclusion criteria, all of them were included in the review. RESULTS: Among the 24 articles included, schools represented a particularly important context for interventions, as adolescents spend much of their time in school and school staff are often the point of reference for young people seeking help and advice. School-based interventions aimed at improving MHL and reducing stigma have the potential to prevent mental disorders and promote mental well-being, ultimately reducing their health, social, and economic burden. CONCLUSIONS: Schools are a key setting for mental health interventions, given the significant time adolescents spend there and their reliance on school staff for support. Enhancing MHL and reducing stigma through school-based programs can prevent mental disorders and promote well-being. Both live and digital interventions have shown effectiveness, though long-term impacts need more study.

Evaluation of health literacy level and personal factors in disease self-management of emergency department patients with chronic diseases.

BACKGROUND: Effective disease management in individuals with chronic illnesses can improve their health outcomes and reduce repeated visits to emergency departments. In this study, it was aimed to investigate the factors affecting the health literacy levels and disease self-management skills of emergency department patients with chronic diseases. METHOD: The data of the cross-sectional study was collected between July and December 2023. The study included 168 patients who applied to the emergency department of a university hospital. Data was collected using a Patient Description Form, Chronic Disease Self-Management Scale and Health Literacy Scale. Parametric and nonparametric tests, structural equation modelling and regression analysis were used to analyse the data. RESULTS: It was demonstrated that health literacy levels of the patients were an effectual factor on chronic disease self-management skills. Chronic Disease Self-Management levels of patients are affected by marital status, whom they are living with, chronic disease duration, educational status and health perception level. Personal factors affecting the Health Literacy levels of patients are age, chronic disease duration and educational status. CONCLUSION: Consequently, essential strategies such as patient education should be planned and implemented to support patients' health literacy and, indirectly, escalate their disease self-management skills.

The Relationship Between Nurses' Digital Health Literacy and Their Educational Levels, Professional Roles, and Digital Attitudes: A Cluster Analysis Based on a Cross-Sectional Study.

AIM: The current study aimed to identify digital health literacy levels among nurses with respect to their education, role and attitude towards digital technologies. DESIGN: Cross-sectional study. METHODS: Through convenience sampling, all Registered Nurses, managers/leaders and nurse researchers employed in Hospitals, University Hospitals and Districts were recruited and surveyed using an online questionnaire. The data collection tool assessed: (I) demographics, (II) Digital Health Literacy (DHL) with the Health Literacy Survey19 Digital (HLS19-DIGI) instrument including DHL dealing with digital health information (HL-DIGI), interaction with digital resources for health (HL-DIGI-INT) and use of digital devices for health (HL-DIGI-DD); (III) attitudes on the use of digital technologies in clinical practice. The multiple correspondence analysis was applied to identify three clusters for the education/professional role (A, B, C) and three for digital technologies' use (1, 2, 3). The one-way nonparametric analysis of variance (Kruskal-Wallis test) was applied to compare HL-DIGI, HL-DIGI-INT and the HL-DIGI-DD scores among clusters. RESULTS: Among 551 participants, the median scores of the HL-DIGI, the HL-DIGI-INT and the HL-DIGI-DD questionnaires were 70.2, 72 and 2.00, respectively. The distribution in the clusters 'educational/professional role' was A, (58.8%); B, (16.5%); and C, (24.7%). Nurses in a managerial or coordinator role and with a postgraduate degree used digital resources with greater frequency. The distribution in the clusters 'use of digital technologies' was: 1, (54.6%); 2, (12.2%); and 3, (33.2%). The HL-DIGI-DD and HL-DIGI scores of clusters 1, 2 and 3 differed significantly. CONCLUSION: DHL among nurses is strongly influenced by the education level, professional role, habits and attitude towards digital technologies. Nurses with coordinator roles used digital technologies with greater frequency and had a higher level of DHL. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were used for reporting. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. TRIAL REGISTRATION: Local Ethical Committee of the Polyclinic of Bari (code: DHL7454, date: 21/09/22).

Developing a foundation information and academic skills programme for potential Student Nursing Associates.

This article outlines the development of 'Prepare to Progress', a preapplication programme for potential Student Nursing Associate (SNA) applicants at Gloucestershire Hospitals NHS Foundation Trust. Created collaboratively by the Trust's Library and Knowledge Services and Professional Education teams, the programme aims to provide realistic course expectations, teach study skills and boost confidence in using library services. Evaluation results indicate increased understanding of the SNA course, improved application decision-making, and enhanced academic confidence among participants. The programme demonstrates the valuable role of library services in preparing healthcare support workers for further education and addressing library anxiety. The study suggests benefits for both participants and library services.

Adolescents' health literacy is directly associated with their physical activity but indirectly with their body composition and cardiorespiratory fitness: mediation analysis of the Slovak HBSC study data.

BACKGROUND: Health literacy is a core public health issue in relation to children and adolescents associated with multiple health behaviours and health outcomes. The aim of the study is to test the direct associations between health literacy, physical activity behaviour, health outcomes of body composition and cardiorespiratory fitness among Slovak adolescents and possible indirect effect of health literacy on health outcomes of body composition and cardiorespiratory fitness mediated by adolescents' physical activity behaviour. METHODS: Data from the Slovak Health Behaviour in School-aged Children (HBSC) study conducted in 2022 were used. For the purposes of this study, a subsample of the adolescents (n = 508; mean age = 14.50; SD = 0.82; 54.3% boys) which provided HBSC questionnaire data on health literacy, moderate-to-vigorous physical activity and vigorous physical activity and participated in body composition (InBody 230) and cardiorespiratory fitness (20-m shuttle run test) measurements. Data were analysed using linear regression analysis. RESULTS: The findings showed that higher health literacy of the adolescents was directly associated with higher frequency of physical activity represented by moderate-to-vigorous physical activity and vigorous physical activity and only with the visceral fat area in the crude model. Furthermore, there was an indirect effect of health literacy on cardiorespiratory fitness and most of the body composition variables (except the Body Mass Index) which was mediated by physical activity of the respondents. CONCLUSIONS: Health literacy is indirectly associated to body composition and cardiorespiratory fitness through higher frequency of physical activity. It seems that health literacy as cognitive and social competencies need behavioural components to be involved in the proposed causal pathway between health literacy and health outcomes. Our findings may contribute to the process of creating a framework for future health literacy interventions in adolescents.

The relationship between self-efficacy, health literacy, and quality of life in patients with chronic diseases: a cross-sectional study in China.

Background: Self-efficacy and health literacy are closely related to the quality of life in patients with chronic diseases; however, it remains unclear whether their combined effects on the quality of life (QoL) in these patients operate through mediation, interaction, or a combination of both. Methods: The research occurred in China between July 10 and September 15, 2021. A multi-stage random sampling technique was utilized to gather information on self-efficacy, health literacy, and QoL among individuals with chronic diseases. Linear regression models investigated the relationships between these patients' self-efficacy, health literacy, and QoL. Additionally, the four-way decomposition method was used to decompose the overall effects of self-efficacy and health literacy on the QoL in patients with chronic diseases. Results: Significant correlations were found between self-efficacy, health literacy, and QoL among individuals with chronic diseases (all p < 0.05). In the four-way decomposition results, the results of the European Quality of Life Five Dimension Five Level (EQ-5D-5L) displayed the interaction effects mediated by self-efficacy, and the reference interaction effects were not significant, with small effect sizes observed. The influence of health literacy levels on the QoL in these patients was primarily attributed to the controlled direct effect (CDE), accounting for approximately 86.12% [excess relative risk = 0.00415; 95% CI: 0.00326, 0.00504; p < 0.0001]. The proportion solely attributable to the pure indirect effect (PIE) of self-efficacy was 14.5% [excess relative risk = 0.0007; 95% CI: 0.00031, 0.00109; p < 0.0001]. In the EQ visual analog scale (EQ-VAS) results, the proportion of the controlled direct effect was 84.9% [excess relative risk = 0.62443; 95% CI: 0.52269, 0.72618; p < 0.0001], while the proportion solely attributable to the pure indirect effect of mediation was 14.8% [excess relative risk = 0.10876; 95% CI: 0.06409, 0.15344; p < 0.0001]. Conclusion: Self-efficacy and health literacy primarily influence QoL in patients with chronic diseases through controlled and pure indirect effects. Enhancing patients' health literacy and self-efficacy can contribute to improving their QoL.

Empowering patients: how accurate and readable are large language models in renal cancer education.

Background: The incorporation of Artificial Intelligence (AI) into healthcare sector has fundamentally transformed patient care paradigms, particularly through the creation of patient education materials (PEMs) tailored to individual needs. This Study aims to assess the precision and readability AI-generated information on kidney cancer using ChatGPT 4.0, Gemini AI, and Perplexity AI., comparing these outputs to PEMs provided by the American Urological Association (AUA) and the European Association of Urology (EAU). The objective is to guide physicians in directing patients to accurate and understandable resources. Methods: PEMs published by AUA and EAU were collected and categorized. kidney cancer-related queries, identified via Google Trends (GT), were input into CahtGPT-4.0, Gemini AI, and Perplexity AI. Four independent reviewers assessed the AI outputs for accuracy grounded on five distinct categories, employing a 5-point Likert scale. A readability evaluation was conducted utilizing established formulas, including Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and Flesch-Kincaid Grade Formula (FKGL). AI chatbots were then tasked with simplifying their outputs to achieve a sixth-grade reading level. Results: The PEM published by the AUA was the most readable with a mean readability score of 9.84 ± 1.2, in contrast to EAU (11.88 ± 1.11), ChatGPT-4.0 (11.03 ± 1.76), Perplexity AI (12.66 ± 1.83), and Gemini AI (10.83 ± 2.31). The Chatbots demonstrated the capability to simplify text lower grade levels upon request, with ChatGPT-4.0 achieving a readability grade level ranging from 5.76 to 9.19, Perplexity AI from 7.33 to 8.45, Gemini AI from 6.43 to 8.43. While official PEMS were considered accurate, the LLMs generated outputs exhibited an overall high level of accuracy with minor detail omission and some information inaccuracies. Information related to kidney cancer treatment was found to be the least accurate among the evaluated categories. Conclusion: Although the PEM published by AUA being the most readable, both authoritative PEMs and Large Language Models (LLMs) generated outputs exceeded the recommended readability threshold for general population. AI Chatbots can simplify their outputs when explicitly instructed. However, notwithstanding their accuracy, LLMs-generated outputs are susceptible to detail omission and inaccuracies. The variability in AI performance necessitates cautious use as an adjunctive tool in patient education.

Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication.

Background: This study aimed to assess medication adherence among Jordanian patients with dyslipidemia and evaluate the impact of health literacy, well-being, and doctor-patient communication on adherence in this population. Dyslipidemia is a prevalent condition that significantly increases the risk of cardiovascular diseases, and understanding the factors influencing medication adherence is crucial for improving patient outcomes. Methods: An observational cross-sectional study was conducted from March to July 2023. A convenience sample of adult Jordanians diagnosed with dyslipidemia was surveyed in a tertiary hospital using validated scales: the Lebanese Medication Adherence Scale-14 (LMAS-14), the Doctor-Patient Communication Scale (DPC), the WHO well-being index, and the health literacy scale. Bivariate analysis and linear regression models were employed to analyze associations. Results: Among 410 participants (mean age 58.62 ± 12.11 years), the mean scores were LMAS-14 (35.10), DPC (55.77), WHO well-being (47.53), and health literacy (38.96). Higher medication adherence was associated with older age (B = 0.093, p = 0.049), university education (B = 2.872, p = 0.017), prior surgery (B = 2.317, p = 0.021), medium income level (B = 3.605, p = 0.006), and better doctor-patient communication (B = 0.166, p = 0.003). Conversely, cigarette smoking (B = -3.854, p = 0.001) and health insurance (B = -2.146, p = 0.039) were linked to lower adherence. Conclusion: The findings underscore the substantial interplay of socio-demographic and clinical factors affecting medication adherence. Enhanced public health interventions focusing on improving health literacy, communication quality, and addressing socio-economic conditions are vital for better adherence and patient outcomes in Jordan.

e-Health literacy and online health information utilization among Jordanians: A population-based study.

Background: The internet has become an essential part of empowering people to access health-related information. Huge amounts of health-related information are available online, but few people have the skills to assess its validity and reliability. Accordingly, the concept of ehealth literacy competencies emerged to measure the skills necessary to validate such information. As a result, the purpose of this study was to assess Jordanian people's e-health literacy, online health information utilization, and associated factors. Methods: This population-based cross-sectional study was conducted from March to December 2023. Results: Results: The study found that participants rated their e-health literacy at 28.94 out of 40, indicating a sufficient level of health literacy, and their online health information utilization at 39.62, indicating a high level of engagement with online health resources. Furthermore, it is revealed that e-health literacy is associated with gender and geographic region, whereas online health information utilization is associated only with chronic disease. Conclusion: In Jordan, there is a balance between traditional and online health information use. While healthcare providers and primary health centers are the main sources of information, Jordanians show a sufficient level of e-health literacy, with females and the capital region exhibiting higher levels. Furthermore, Jordanians were more likely to use online health information. Nevertheless, it is crucial to work on improving internet platforms to enhance the quality of online health-related information.

A Pilot Study of BRAIN BOOTCAMP, a Low-Intensity Intervention on Diet, Exercise, Cognitive Activity, and Social Interaction to Improve Older Adults' Dementia Risk Scores.

BACKGROUND: Little is known about the impact of short, low-intensity multidomain dementia risk reduction interventions in older adults. OBJECTIVES: To examine the effectiveness and feasibility of a low-intensity multidomain lifestyle intervention on dementia risk and dementia literacy in Australian older adults. DESIGN: Single-group pre-post design. SETTING: Community-dwelling. PARTICIPANTS: A total of 853 older Australians (Mean age=73.3 years, SD=6.1) recruited from the community. INTERVENTION: A 3-month dementia risk reduction program, BRAIN BOOTCAMP, including education, personalised risk information, physical cues for healthier choices and goal setting and planning to target four modifiable risk factors of diet, exercise, cognitive activity and social interaction in older adults. MEASUREMENTS: The 'LIfestyle for BRAin health' (LIBRA) index was used to assess participants' modifiable dementia risk based on 12 factors, with higher scores indicating greater risk. Dementia literacy was measured using a modified questionnaire derived from Dutch and British surveys, encompassing knowledge, risk reduction, and awareness aspects. Paired t-tests were used to compare dementia risk scores and dementia literacy before and after the program. Multivariate regressions were performed to identify sociodemographic and psychological factors associated with change in the LIBRA index. RESULTS: Program attrition was high (58.3%). Participants who completed the program had decreased dementia risk scores (Cohen's d=0.59, p<0.001), increased dementia literacy and awareness (Cohen's d=0.64, p<0.001) and increased motivation to change lifestyle behaviors (Cohen's d=0.25-0.52, p<0.016). Participants with higher motivational beliefs had greater dementia risk reduction. CONCLUSIONS: Improving older adults' motivation and knowledge may help modify lifestyle behaviors to reduce dementia risk. However, program attrition remains a challenge, suggesting the need for strategies to enhance participant engagement and retention in such interventions.

Health Literacy Levels of Women Attending a Perinatology Outpatient Clinic for High-Risk Pregnancy Follow-Up.

BACKGROUND: Health literacy, defined as the ability to obtain, understand, evaluate, and apply health information with knowledge, motivation, and skills, is crucial for maintaining and improving quality of life. Despite the availability of health information, limited health literacy is linked to health disparities, inadequate self-management of chronic diseases, and poorer health outcomes. OBJECTIVE: The purpose of this study is to assess the health literacy of pregnant women who visit the Perinatology Outpatient Clinic for follow-up care. It seeks to identify gaps in knowledge and understanding that may impede effective healthcare delivery and inform targeted health education and public awareness programs to enhance health literacy. METHODS: This prospective survey study included 210 pregnant women aged 18 to 40 years attending the Perinatology Outpatient Clinic at Giresun Obstetrics and Gynecology Training and Research Hospital, Turkey. Participants completed a questionnaire on health literacy, sociodemographics, and basic health status via Google Forms (Google Inc., Mountain View, CA, USA). Statistical analysis was performed using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA), employing tests such as Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, Student's t-test, ANOVA, Spearman, and Pearson correlation, and multivariate linear regression analysis. RESULTS: The mean age of participants was 29.97±5.44 years, with a mean health literacy score of 29.89±7.05. Education level and living place significantly influenced health literacy scores, with higher scores among those with higher education and urban living (p = 0.014 and p = 0.038, respectively). Economic status also significantly impacted health literacy, with lower scores among those with poor economic status (p<0.001). Health literacy scores were higher among those receiving health information from healthcare professionals (p = 0.006) and lower among those finding medical information from doctors insufficient (p = 0.008). CONCLUSION: Health literacy is significantly influenced by education level, living place, and economic status. The study emphasizes the necessity of focused health education initiatives, especially for individuals with lower educational attainment and those residing in rural regions. Improving health literacy via efficient communication from medical professionals can benefit expectant mothers and their unborn children by lowering medical expenses and improving health outcomes.

Who should be screened for colorectal cancer and how can it be prevented more effectively?

In this editorial, we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol (2024; 30: 1368-1376). We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer (CRC) screening as a public health strategy to diminish disease burden. Individuals exposed to risk factors for CRC, those with comorbid conditions, and those with limited health literacy should undergo screening. However, we believe that more regular screenings should be accompanied by a greater focus on primary prevention (PP) of CRC. CRC remains a significant global health challenge, and its incidence is strongly linked to age, lifestyle, and socioeconomic factors. It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease, and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC, which significantly impacts the prognosis and imposes a substantial economic burden. This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways. Remarkably, early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings. This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods, health care systems can create a more comprehensive safety net for individuals at risk of CRC. However, before maximizing the health benefits of screening programs, it is essential to make additional efforts prior to screening, such as raising awareness via public education, risk assessment, and personalized recommendations, enhancing the knowledge and skills of health care professionals, optimizing the accessibility and convenience of screening processes, ensuring the quality and safety of screening services, strengthening follow-up and support systems, and providing policy support and financial investment. The establishment of a comprehensive screening system often requires substantial investment in human, material, and financial resources, which can be challenging to achieve in regions with limited health care resources. Strengthening PP strategies can reduce the disease burden by targeting the cause, representing a more cost-effective and impactful approach. Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP, individualized malignant tumor risk assessment, and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies.

Eating disorders and health literacy in Germany: results from two representative samples of adolescents and adults.

Introduction: Eating disorders are associated with substantial burden for the affected individuals including negative health outcomes and increased mortality. So far, prevention programs for eating disorders have yielded mixed results concerning their efficacy. Therefore, more targeted prevention programs need to be developed. Health literacy has been identified as a potential influencing factor of eating disorders. This study aimed at exploring the relationship between likely cases of eating disorders and health literacy, alongside additional sociodemographic factors. Materials and methods: Two large samples of adults (N = 3,011) and adolescents (N = 1,021) representative of the German-speaking population in Germany were recruited. Likely cases of eating disorders were identified using the SCOFF questionnaire. Health literacy was assessed with the HLS-EU-Q16 questionnaire. Sociodemographic information, including age, gender, social status and level of education, and subjective body image were obtained. χ2-tests of independence were calculated to determine the association between the investigated constructs. Results: Suspected eating disorders were more likely in female than male adolescents but were not related to gender in adults. Rates of suspected eating disorders increased with increasing age in adolescents and decreased with increasing age in adults. While levels of education were unrelated to suspected eating disorders, low social status was associated with higher rates of suspected eating disorders in adults but not adolescents. Inadequate or problematic health literacy and negative body image were associated with higher rates of suspected eating disorders compared to adequate health literacy and more positive body image. Discussion: Likely cases of eating disorders are related to health literacy and body image as well as sociodemographic factors. These constructs should therefore be addressed in future research to improve prevention programs.

Preventive health behaviour differences across racial groups during the early stages of COVID-19.

Background: Throughout the COVID-19 pandemic, the practice of preventative health behaviours had been used disparately across different racial groups. This study seeks to identify any differences in preventative health behaviours across racial groups, controlling for other socio-demographic factors. Methods: A US national survey study was electronically conducted from July through November 2020, to measure racial/ethnic differences in health preventive behaviours about COVID-19. We performed 2-part regression models to assess whether preventive health behaviours differed by race and ethnicity. Specifically, we employed generalized logistic regressions for investigating the predictors of the use of complementary or alternative medicine (CAM), or stay-at-home strategy, then performed ordinal logistic regression to examine the predictors of social distancing, face mask wearing, and hand hygiene strategy practice. Results: The results show that non-White respondents were more likely to practice social distancing, mask wearing, and hand hygiene strategy to prevent COVID-19, compared to their White counterparts. Additionally, the findings indicate that individuals who experienced COVID-19-related racial abuse or depression had a higher likelihood of practicing preventive health behaviours. Discussion: We found ethnicity can be a predictor of health preventive behaviours, in accordance with previous research. The causes of these disparities will require further investigation in order to be addressed.

The role of health literacy in the association between social support and self-rated health: a Danish population-based study in 10,787 individuals with a long-term condition.

BACKGROUND: Managing a long-term condition requires higher health literacy. Social networks may play a crucial role for self-management. However, the pathway is not entirely understood. This study aimed to examine whether the association between social support and self-rated health is mediated by health literacy among individuals with a long-term condition. METHODS: This cross-sectional study used data from the "How are you?" 2021 survey in Central Denmark Region. Social support was assessed using a single question, health literacy with two dimensions from the Health Literacy Questionnaire (HLQ): 'Understanding health information' and 'Engaging with healthcare providers', and self-rated health with a single question from SF-36. Multiple logistic regression analyses were used to examine the associations, and multiple mediation analyses were performed using the Karlson-Holm-Breen method. RESULTS: A total of 10,787 individuals with a long-term condition were included in the study, whereas 6% (n = 595) reported a low level of social support. Both health literacy scales mediated the association between social support and self-rated health, particularly the ability to engage with healthcare providers, accounting for 25% of the variance. After adjustment for sociodemographic factors, individuals with a low level of social support had significantly higher odds of reporting difficulties in understanding health information (OR 2.53 (95% CI: 1.84-3.48)) and engaging with healthcare providers (OR 3.77 (95% CI: 2.96-4.79)). CONCLUSIONS: Health literacy, particularly the ability to engage with healthcare providers, was a mediator between social support and self-rated health. Additionally, a low level of social support was associated with higher odds of reporting lower health literacy. These findings suggest that strategies to enhance health literacy, improve health outcomes, and reduce health inequities may benefit from strengthening individuals' social network, particularly focusing on those with limited support.

Improve disaster literacy in nurses: a qualitative descriptive study.

BACKGROUND: The enhancement of nurses' disaster literacy is crucial for effective disaster emergency management, especially for clinical nurses with no prior experience in disaster rescue. This study aims to explore the perspectives of nurses who have been involved in disaster rescue operations on strategies to advance nurses' disaster literacy. METHODS: A qualitative descriptive study, which follows unified qualitative study reporting guidelines. Thirty disaster rescue nurses were recruited to participate in this study, who came from 30 third-class hospitals in China. From October to December 2021, information was acquired by conducting semi-structured telephone interviews with participants. Qualitative content analysis was used to examine the data. RESULTS: Six categories and eleven subcategories were created. Strengthening disaster education and training was the main focus, and its subcategories included continuing education, nursing curriculum development, and disaster rescue experience guide. The second focus, which included scene simulation, actual combat/military simulation, and virtual reality simulation, was strengthening disaster simulation and drill. The third focus was on providing psychosocial support, which included improving self-psychological adjustment, developing resilience, and engaging in active coping. The fourth category was to strengthen nurse/hospital managers roles and leadership, which included enhancing professional identity and policies/leadership support. The fifth category was disaster preparedness, and the sixth was enhancing knowledge transformation. CONCLUSIONS: Government agencies or healthcare organizations should actively promote the formation of nurses' disaster literacy from multiple viewpoints. Disaster education and training, simulation exercises, and psychosocial support should be prioritized.

Psychometric properties of the Spanish version of the media health literacy questionnaire (MeHLit-SV).

Introduction: Media health literacy emerges as a response to the vast array of informational disorders prevalent in media communications. Given the absence of a measurement tool for this type of literacy in Spanish-speaking communities, the aim of the present study is to conduct a cross-cultural adaptation of the Media Health Literacy (MeHLit) questionnaire into Spanish and to analyze its psychometric properties in a sample of nursing students. Methods: The Spanish version of the MeHLit questionnaire (MeHLit-SV) was obtained through a process involving translation, back-translation, evaluation of the proposed items by a group of 22 experts, and a pilot study with 80 Spanish nursing students. Content validity was assessed using each item's content validity index (CVI) and Aiken's V (VdA), while internal consistency was evaluated through Cronbach's Alpha. Results: Following the translation and adaptation process, the final version of the MeHLit-SV comprised 21 items organized into five dimensions. The CVI values exceeded 0.82 for all items, and the overall content validity index (S-CVI) was 0.9. Furthermore, the results of Aiken's V surpassed the threshold considered acceptable (0.70). After piloting, the questionnaire demonstrated high internal consistency with a Cronbach's alpha value of 0.936. Conclusion: The findings of this research support the reliability and validity of the MeHLit-SV for use among nursing students to measure their level of media health literacy. This questionnaire, with satisfactory psychometric properties and ease of administration, is an useful tool for assessing whether individuals possess the necessary skills to accurately analyze health information they encounter on a daily basis.