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.

Health literacy of older adults with musculoskeletal problems: A systematic review.

INTRODUCTION: People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria. RESULTS: The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status. DISCUSSION: It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.

Associations between perceived discrimination over the life course, subjective social status, and health literacy: A racial/ethnic stratification analysis.

Objective: To analyze the relationship between perceived discrimination over the life course, social status, and limited health literacy (HL). Methods: 5040 adults who participated in the 2023 Survey of Racism and Public Health. We applied stratified multilevel models adjusted for sociodemographic characteristics. Results: The average age was 47 years, 48% identified as White, 20% as Latinx, and 17% as Black. In the overall sample, we observed associations of perceived discrimination (b = 0.05, 95% CI: 0.01, 0.09), subjective social status (b = -0.16, 95% CI: -0.23, -0.10), and their interaction (b = 0.02, 95% CI: 0.01, 0.03). More perceived discrimination was associated with lower HL in the White and Multiracial participants. Higher subjective social status was associated with higher HL in the White and Latinx participants. There was a statistically significant interaction between perceived discrimination and subjective social status on HL among the White, Latinx, and Multiracial participants. Conclusion: This analysis has implications for public health practice, indicating that multi-level interventions are needed to address limited HL. Innovation: Our findings provide novel insights for identifying key SDOH indicators to assess in clinical settings to provide health literate care.

Relationship between awareness of digital game addiction, health literacy, and sociodemographic characteristics of mothers: A structural equation modeling analysis.

AIM: Mothers' digital game addiction awareness and their health literacy levels are critical factors for addiction prevention strategies in children. Therefore, the present study is significant. This study examines the relationship between awareness of digital game addiction, health literacy, and the sociodemographic characteristics of mothers. METHOD: This cross-sectional study was conducted with 457 mothers of children aged 5-11 years in Turkey. The data were collected using a personal information questionnaire, the Awareness of Digital Game Addiction Scale, and the Health Literacy Scale between May and September 2021. RESULTS: This study revealed that mothers are highly aware of digital game addiction and have high health literacy. Furthermore, health literacy was determined to significantly and directly affect awareness of digital gaming addiction. Awareness of digital gaming addiction significantly and directly affects children owning their own technological devices and how much time mothers spend with their children. CONCLUSION: The study's results confirmed that mothers' health literacy had a positive and statistically significant effect on awareness of digital gaming addiction. As the health literacy levels of mothers increased, the internal and external awareness of digital gaming addiction increased. It is recommended to design intervention programs that increase mothers' awareness of digital game addiction. These programs should be planned according to the health literacy levels of mothers.

"I'm Gonna Hang on to These As Long As I Can": Examining the Perspectives and Knowledge of Oral Health Issues of Older Adults Living Independently.

PURPOSE: Advantages of fluoridated water, dental insurance, and greater awareness of preventive oral healthcare allow many adults in today's aging cohort to maintain their teeth into their advanced years. The purpose of this study was to describe attitudes, expectations, knowledge, and intentions related to oral health issues from the experiences of older adults living independently in a largely rural south central state. METHODS: A qualitative analysis guided by behavioral constructs of the Reasoned Action Approach was utilized to conduct semi-structured interviews of a purposeful sample of adults age 65 years and older living independently. RESULTS: Participant data (N = 26) revealed 5 themes: difficulties accessing dental care; active coping; taking care of your mouth as part of overall health; interactions affecting oral health-related quality of life; and supporting roles. Overall, the intention to attain dental care was affected by the perceived need to prioritize many health issues over oral care. An overarching expectation to have affordable basic services available pervaded. CONCLUSION: The perceptions of participants reflect socioeconomic determinants that could be influenced through improved health literacy education focused on establishing a greater understanding of the oral systemic link especially as it relates to diabetes.

The impact of public art education on college students' mental health literacy.

Introduction: This study aims to explore the impact of public art education on the mental health literacy of College Students. Methods: Conducted over a four-month period, the intervention involved freshmen from a Chinese college, comparing 1,334 students in the experimental group with 1,139 in the control group. Data were collected through a self-developed questionnaire and a standardized mental health literacy scale before and after the intervention. Results: Results showed that the experimental group's overall mental health literacy score significantly increased from 64.051 pre-intervention to 79.260 post-intervention, while the control group showed no significant changes during the same period. The experimental group demonstrated significant improvements in their ability to identify psychological disorders, belief in receiving professional help, attitudes towards seeking appropriate help, and knowledge in seeking mental health information. Furthermore, the frequency of classroom interaction was positively correlated with improvements in mental health literacy (regression coefficient = 2.261***), highlighting the critical role of active participation in public art education settings. Conclusion: This study underscores the importance and effectiveness of implementing public art education in higher education and provides empirical support for future educational policies and practices.

Improving Mental Health Literacy and Stigma Among the Hmong.

BACKGROUND: One in five adults in the United States suffers from mental illness. Negative social influences in the Hmong community stigmatize those who have mental health challenges and mental health outcomes are impacted by poor mental health literacy. Language barriers, conflicting traditional beliefs, and Western concepts of health contribute to low mental health literacy and willingness to seek professional mental health services among the Hmong. AIMS: The aim of this project was to successfully implement Mental Health First Aid (MHFA) to a group of 30 or more Hmong adult church leaders in a faith-based setting. METHODS: A pretest posttest project design was used. The project implementation process was guided by the Plan-Do-Study-Act (PDSA) model and took place from June 2023 to August 2023. Participants were recruited from three local Detroit Hmong churches. Indicator measures included the Mental Health Literacy Scale (MHLS) and Community Attitudes toward Mental Illness (CAMI) Scale before and immediately after training. One final survey was administered at 6 weeks post MHFA training to measure information retention, stigma, and utilization of MHFA skills. RESULTS: Results reflect the existing body of literature regarding MHFA and the positive impacts on mental health literacy, confidence level, mental health awareness, and decreasing stigma. CONCLUSION: MHFA continues to demonstrate successful implementation across many settings and populations, especially for this project among Hmong adult church leaders. More research is needed to expand on mental health and the Hmong.

Identifying the Health Educational Needs of Refugees: Empirical Evidence from a Delphi Study.

Refugees experience poorer health outcomes especially which can be exacerbated by or can be a result of low health literacy of refugee populations. To address poor health outcomes, health literacy, and health usage in refugee populations, it is essential to develop health educational interventions for refugees' healthcare integration. To do so, learning objectives must be identified based on refugees' health knowledge gaps. Therefore, the overall aim of this study is to identify these knowledge gaps. A modified Delphi method was employed for this study with three rounds of survey: the first to identify learning objectives, the second to prioritise learning objectives, and the third to categorise the learning objectives as not recommended, partially recommended, or highly recommended. An overarching theme of utilising the healthcare system and its various services effectively and efficiently was recognised to be an important learning objective for educational interventions to address refugees' health integration. Overall, learning objectives within the theme self-care and preventative health were ranked as most important.

Development of a health literacy scale for COVID-19 prevention among pregnant women in Thailand.

COVID-19 infection among pregnant women results in more severe symptoms and higher mortality rates. No comprehensive health literacy for protection against COVID-19 among pregnant women has been available for general use in Thailand. This cross-sectional study aimed to develop and examine an instrument for measuring health literacy of prevention COVID-19 infection among pregnant women (HLS-P). A total of 321 pregnant women aged older than 20 years were participated in this study, Selected through multistage cluster sampling, between September 2021 and January 2022. Data were collected using structured questions that included sociodemographic characteristics and the health literacy scale for protecting against COVID-19 (HLS-P) developed by the researchers. The content and construct validity of the health literacy scale were examined. Exploratory factor analysis performed with principal component analysis and Varimax rotation. Confirmatory factor analysis was conducted using IBM SPSS AMOS 26. The model fitting was evaluated using several indices namely root mean square error of approximation, normed fit index, comparative fit index, and goodness-of-fit index. The reliability of the scale was evaluated using Cronbach's alpha and item total correlation. As a results of exploratory factor analysis of the scale, 31 items were loaded which indicated a 6-factors for the scale that collectively explained 62.59% of total variance. Confirmatory factor analysis also indicated a good fit to the six latent structures with root mean square error of approximation 0.03, normed fit index 0.94, comparative fit index 0.97, and goodness-of-fit index 0.91. Internal consistency reliability was satisfactory with Cronbach's alpha coefficient of 0.94 and the item-total correlation between 0.34 and 0.86. The overall scale was sufficiently reliable. As a result, the HLS-P is a reliable and relevant measure for assessing health literacy in pregnant women. Thus, this scale is profoundly used as an evaluation tool for measuring health literacy among pregnant women, providing critical information for healthcare professionals and policymakers about the health literacy needs and capacity of service receivers.

Signposting services for people with health and care needs: a rapid realist review.

Background: Signposting typically refers to an informal process that involves giving information to patients to enable them to access external services and support. It is perceived to reduce demand on primary care and other urgent care services. Methods: This focused realist review was conducted rapidly within time constraints. Searches to identify theory were undertaken on MEDLINE, Cumulative Index to Nursing and Allied Health Literature and Social Sciences Citation Index in June 2022 for research published in English from 2016. We selected 22 publications and extracted programme theories from these to develop three priority questions: Question 1: What do people with health and social care needs require from a signposting service to believe it is valuable? Question 2: What resources do providers require to confidently deliver an effective signposting service? Question 3: Under what circumstances should commissioners commission generic or specialist signposting services? Purposive searching was conducted to find a rich sample of studies. UK studies were prioritised to optimise the applicability of synthesis findings. Results: The review included 27 items, 4 reviews and 23 studies, a mix of qualitative, evaluations and case studies. Service users value a joined-up response that helps them to navigate the available resources. Key features include an understanding of their needs, suggestion of different options and a summary of recommended actions. Only a small number of service user needs are met by signposting services alone; people with complex health and social care needs often require extended input and time. Front-line providers of signposting services require appropriate training, ongoing support and supervision, good knowledge of relevant and available activities and an ability to match service users to appropriate resources. Front-line providers need to offer a flexible response targeted at user needs. Commissioned signposting services in England (no studies from Scotland, Wales and Northern Ireland) are highly diverse in terms of client groups, staff delivering the service, referral routes and role descriptions. A lack of service evaluation poses a potential barrier to effective commissioning. A shortage of available services in the voluntary and community sector may limit the effectiveness of signposting services. Commissioners should ensure that referrals target intensive support at patients most likely to benefit in the longer term. Conclusions: Signposting services need greater clarity of roles and service expectations to facilitate evaluation. Users with complex health and social care needs require intensive, repeat support from specialist services equipped with specific knowledge and situational understanding. A tension persists between efficient (transactional) service provision with brief referral and effective (relational) service provision, underpinned by competing narratives. Do signposting services represent 'diversion of unwanted demand from primary care/urgent care services' or 'improved quality of care through a joined-up response by health, social care and community/voluntary services'? Limitations: This realist review was conducted within a tight time frame with a potential impact on methodology; for example, the use of purposive searching may have resulted in omission of relevant evidence. Future work: Signposting services require service evaluation and consideration of the issue of diversity. Study registration: This study is registered as PROSPERO CRD42022348200. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130588) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 26. See the NIHR Funding and Awards website for further award information.

Signposting points people to information, help or advice that they should find useful. Signposting can be delivered face to face, by phone, or virtually, by technology. This review of research brings together what is already known. We have not collected any data ourselves. The review uses realist synthesis. This method tries to understand the whys and ways (the mechanisms and theories) of how things work (or do not work!). It goes beyond whether something works (is effective). It tries to explain why something might work for some people but not others. For example, why an approach may not be helpful for people with disabilities, why it might work in some places but not others and exactly what leads to what effects (what are the 'key ingredients'). The report answers the following three questions: What do people with health and social care needs require from a signposting service to enable them to believe it is a valuable and useful service? What resources do people providing signposting services require to ensure that they can confidently provide effective signposting services? How can commissioners/funders specify, monitor and evaluate signposting services (generic or specific) to optimise value for money and outcomes for service users? Specifically, do any factors favour funding general over specialist services and vice versa? The diversity of signposting services within health or across social and community services, including voluntary services, makes them difficult to evaluate and compare. Within each service, different people undertake signposting roles: from general practitioners, practice nurses or receptionist to a standalone signposting role, each for a different purpose and intensity. Only a small number of service users potentially benefit from signposting-only services. Many service users have complex health and social care needs and, therefore, need different support extended over a longer time.

Evaluation of a Digital Previsit Tool for Identifying Stroke-Related Health Problems Before a Follow-Up Visit (Part 1): Survey Study.

BACKGROUND: Stroke may lead to various disabilities, and a structured follow-up visit is strongly recommended within a few months after an event. To facilitate this visit, the digital previsit tool "Strokehealth" was developed for patients to fill out in advance. The concept Strokehälsa (or Strokehealth) was initially developed in-house as a Windows application, later incorporated in 1177.se. OBJECTIVE: The study's primary objective was to use a patient satisfaction survey to evaluate the digital previsit tool Strokehealth when used before a follow-up visit, with a focus on feasibility and relevance from the perspective of people with stroke. Our secondary objective was to explore the extent to which the previsit tool identified stroke-related health problems. METHODS: Between November 2020 and June 2021, a web-based survey was sent to patients who were scheduled for a follow-up visit after discharge from a stroke unit and had recently filled in the previsit tool. The survey covered demographic characteristics, internet habits, and satisfaction rated using 5 response options. Descriptive statistics were used to present data from both the previsit tool and the survey. We also compared the characteristics of those who completed the previsit tool and those who did not, using nonparametric statistics. Free-text responses were thematically analyzed. RESULTS: All patients filling out the previsit tool (80/171; age: median 67, range 32-91 years) were community-dwelling. Most had experienced a mild stroke and reported a median of 2 stroke-related health problems (range 0-8), and they were significantly younger than nonresponders (P<.001). The survey evaluating the previsit tool was completed by 73% (58/80; 39 men). The majority (48/58, 83%) reported using the internet daily. Most respondents (56/58, 97%) were either satisfied (n=15) or very satisfied (n=41) with how well the previsit tool captured their health problems. The highest level of dissatisfaction was related to the response options in Strokehealth (n=5). Based on the free-text answers to the survey, we developed 4 themes. First, Strokehealth was perceived to provide a structure that ensured that issues would be emphasized and considered. Second, user-friendliness and accessibility were viewed as acceptable, although respondents suggested improvements. Third, participants raised awareness about being approached digitally for communication and highlighted the importance of how to be approached. Fourth, their experiences with Strokehealth were influenced by their perceptions of the explanatory texts, the response options, and the possibility of elaborating on their answers in free text. CONCLUSIONS: People with stroke considered the freely available previsit tool Strokehealth feasible for preparing in advance for a follow-up visit. Despite high satisfaction with how well the tool captured their health problems, participants indicated that additional free-text responses and revised information could enhance usability. Improvements need to be considered in parallel with qualitative data to ensure that the tool meets patient needs. TRIAL REGISTRATION: Researchweb 275135; https://www.researchweb.org/is/vgr/project/275135.

A cross-sectional quantitative analysis of the readability and quality of online resources regarding thumb carpometacarpal joint replacement surgery.

Background: Thumb carpometacarpal (CMC) joint osteoarthritis is a common degenerative condition that affects up to 15 â€‹% of the population older than 30 years. Poor readability of online health resources has been associated with misinformation, inappropriate care, incorrect self-treatment, worse health outcomes, and increased healthcare resource waste. This study aims to assess the readability and quality of online information regarding thumb carpometacarpal (CMC) joint replacement surgery. Methods: The terms "thumb joint replacement surgery", "thumb carpometacarpal joint replacement surgery", "thumb cmc joint replacement surgery", "thumb arthroplasty", "thumb carpometacarpal arthroplasty", and "thumb cmc arthroplasty" were searched in Google and Bing. Readability was determined using the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Reading Grade Level (FKGL). FRES >65 or a grade level score of sixth grade and under was considered acceptable. Quality was assessed using the Patient Education Materials Assessment Tool (PEMAT) and a modified DISCERN tool. PEMAT scores below 70 were considered poorly understandable and poorly actionable. Results: A total of 34 websites underwent qualitative analysis. The average FRES was 54.60 â€‹± â€‹7.91 (range 30.30-67.80). Only 3 (8.82 â€‹%) websites had a FRES score >65. The average FKGL score was 8.19 â€‹± â€‹1.80 (range 5.60-12.90). Only 3 (8.82 â€‹%) websites were written at or below a sixth-grade level. The average PEMAT percentage score for understandability and actionability was 76.82 â€‹± â€‹9.43 (range 61.54-93.75) and 36.18 â€‹± â€‹24.12 (range 0.00-60.00) respectively. Although 22 (64.71 â€‹%) of websites met the acceptable standard of 70 â€‹% for understandability, none of the websites met the acceptable standard of 70 â€‹% for actionability. The average total DISCERN score was 32.00 â€‹± â€‹4.29 (range 24.00-42.00). Conclusions: Most websites reviewed were written above recommended reading levels. Most showed acceptable understandability but none showed acceptable actionability. To avoid the negative outcomes of poor patient understanding of online resources, providers of these resources should optimise accessibility to the average reader by using simple words, avoiding jargon, and analysing texts with readability software before publishing the materials online. Websites should also utilise visual aids and provide clearer pre-operative and post-operative instructions.

Validity and reliability of the translated Marathi version of the 14-item health literacy scale.

Introduction: Various tools for measuring health literacy are designed to assess reading comprehension and numeracy in English speakers. There is a need to develop a tool in the vernacular language and estimate health literacy levels in Indian settings. The present study was conducted with the objectives to develop a Marathi version of a 14-item health literacy scale (HLS-14) to test the reliability and validity of its Marathi version and to estimate the health literacy among patients attending the out-patient department at a tertiary care centre. Methodology: The present study was conducted among 50 adult patients attending the out-patient department of a tertiary hospital from July 2022 to December 2022. The 14-Item Health Literacy Scale available in English was translated into Marathi and back-translated to English, and the final version was developed. Bilingual study subjects were asked to fill the scales on day 0 and on day 7. Cronbach's alpha was calculated for internal validity, and the correlation coefficient was calculated for the reliability of the tool and health literacy was estimated. Results: When items of the Health Literacy Scale were analysed, all the items barring 2, 6, and 10 gave an r-value of more than 0.70, which shows good reliability of each translated item. The Cronbach's alpha value found for the current translated Marathi questionnaire is 0.66. Internal consistency is good. The mean total health literacy score was 51.16 ± 6.81. Conclusions: A translated Marathi version of HLS-14 is developed, which is valid and reliable. The health literacy among the study participants is marginal.

Promoting early-intervention for suicide prevention: The role of mental health literacy and attitudes towards suicide: A quantitative study in Ireland.

Suicide is a global public health issue which has far-reaching impacts on individuals, families, and wider communities. Early intervention is a core pillar of policy on the prevention of suicide related deaths. However, limited mental health literacy, and negative attitudes regarding mental illness amongst the public are a barrier to early intervention. Past research has not explored mental health literacy and attitudes regarding suicide specifically. The aim of the current study was to examine mental health literacy and attitudes towards suicide in adults. 590 adults in Ireland aged 18-80 years (M = 43.24, SD = 12.6) took part in this online cross-sectional study, completing the Mental Health Literacy Scale and The Attitudes Towards Suicide Scale. Experience of suicide deaths was common among participants. Independent t-tests indicated that males had significantly lower levels of mental health literacy and more stigmatising attitudes towards suicide than females. Young adults also had lower ability to recognise mental health difficulties than older adults. Hierarchical Multiple Regressions found that mental health literacy significantly accounted for varied attitudes towards suicide in adults, particularly willingness to communicate about suicide, and beliefs that suicide is preventable. Findings are discussed in the context of informing policy-makers who are promoting early-intervention for suicide prevention.

Measurement properties of the Mental Health Literacy Scale (MHLS): A systematic review.

BACKGROUND: Since its creation, the Mental Health Literacy Scale (MHLS) has been used worldwide in mental health literacy studies. OBJECTIVE: This study aimed to systematically evaluate, summarize, and compare the measurement properties of MHLS validation studies. METHODS: PsycINFO, CINAHL, ERIC, Scopus, Embase, MEDLINE, and PubMed databases were searched from May 30, 2015, to December 31, 2023. Peer-reviewed studies validating the MHLS and its measurement properties were included, irrespective of language, study population, and setting. Studies using the MHLS as an outcome measure, as a comparative instrument to validate another instrument, or using other MHL measures and grey literature was excluded. RESULTS: Of the 685 search results, 16 studies were deemed eligible. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) RoB criteria showed 15/15 studies exhibited 'Very Good' or 'Adequate' internal consistency, 3/6 reliability, 1/8 content validity, 14/14 structural validity, 6/7 hypothesis testing for convergent validity, 2/7 hypothesis testing for known-group validity, and 0/1 error measurement. The Cronbach's alpha ranged from 0.720 to 0.890, and the Intra-class Correlation Coefficient ranged from 0.741 to 0.99, while content validity was limited regarding the quality of evidence rating. The four-factor and unidimensional structures were 35.7 % and 28.6 %, respectively, the most common models. CONCLUSION: The MHLS exhibited strong evidence of construct validity and reliability, ensuring consistent and accurate evaluation of MHL and improving research credibility and generalizability. However, the low number of identical language versions of MHLS studies prohibited statistical pooling and quantitative summaries.

Needed competence for registered nurses working at a patient-centred telehealth service aimed to engage and empower people living with COPD: A five-month participatory observational study.

BACKGROUND: The global population of older aged 65 and over is increasing, which means an increase in people living with long-term health conditions and multimorbidity. Implementing new digital health technologies enables increased patient empowerment and responsibility, and the ability to respond to changes in their condition themselves, with less involvement of healthcare professionals. Important parameters need to be addressed for this digitally enabled empowerment to be successful, these include increased individual and organizational health literacy, the establishment of joint decision-making activities among patients and healthcare professionals, and efforts that target the individual's ability to manage their condition, which include education to increase skills and providing technology for self-monitoring. OBJECTIVE: To identify needed competencies of digital healthcare professionals to be able to provide the needed services to service users with chronic obstructive pulmonary disease in a 24/7 digital healthcare service. METHOD: Five registered nurses' work was observed weekly for five months. In total 13 participatory observations were conducted. Data from the observations was transcribed and analysed through inductive content analysis. RESULTS: Five main categories were identified in the analysis; 1) tasks, 2) communication, 3) the relationships between the registered nurses, 4) service users, and 5) technology. These categories contain different competencies needed for registered nurses working in a digitalized healthcare system. CONCLUSIONS: Future digital healthcare professionals will require several competencies, to be able to deliver proper care in a digital health community that goes beyond traditional healthcare competencies, including social, technological, and communication skills.

Digital health literacy and its determinants among community dwelling elderly people in Taiwan.

Background: Digital Health Literacy (DHL) is crucial in navigating digital health environments, yet few studies focus on older adults. Objective: Explore the associations of digital health information and resource utilization, IT-related social support, and barriers/enhancers to digital health service usage with DHL among older adults. Methods: A cross-sectional study was conducted from January 2022 to April 2023, involving 417 individuals over the age of 60 who were interviewed using an instrument for collecting data on DHL, social support, barriers/enhancers influencing use of digital health resources and personal/demographic data. Multi-regression models were used to examine the associations. Results: Higher DHL scores were associated with daily use of digital interaction with healthcare (B = 0.28; 95% confidence interval [CI] = 0.07, 0.49; p = .01), daily use of other digital health resources (B = 0.22; 95% CI = 0.05, 0.40; p = .01), ease in finding assistance for online navigation (B = 0.27; 95% CI = 0.08, 0.45; p = .01), self-perceived digital proficiency ("usually very good at surfing the internet," B = 0.35; 95% CI = 0.18, 0.52; p = .01), assistance from relatives/others in internet browsing (B = 0.20; 95% CI = 0.02, 0.37; p = .02), and having access to a computer, tablet, or smartphone (B = 0.29; 95% CI = 0.11, 0.47, p = .01). Conversely, barriers like "no access to a computer, tablet, or phone at all times" (B = -0.19; 95% CI = -0.34, -0.04; p = .01), "difficulty understanding online content" (B = -0.22; 95% CI = -0.36, -0.07; p = .01), and "believing to be too old for online services" (B = -0.18; 95% CI = -0.32, -0.03; p = .02) were associated with lower DHL scores. Conclusions: Engagement with digital health platforms, including making online appointments and accessing personal health records, is associated with higher DHL levels. Support from relatives or others, a modifiable attribute, is also associated with elevated DHL among older adults.

Effect of mothers' health literacy on early childhood allergy prevention behaviours: results from the KUNO-Kids health study.

BACKGROUND: Parents can engage in several behaviours with regard to early childhood allergy prevention (ECAP). These can be related to diet of mother/child and the modification of the home environment; not all of them are justified by current evidence. Previous studies showed that parental health literacy (HL) is related to favourable health behaviours directed at the child. This study aimed to investigate the causal effect of mothers' HL on ECAP behaviours and to test different moderators of this effect. METHODS: One thousand six hundred sixty-two mothers participating in the KUNO-Kids health study in the area of Regensburg, Germany were surveyed on HL (assessed via the health care scale of the Health Literacy Survey-EU questionnaire, HLS-EU-Q47) and ECAP behaviours implemented during pregnancy and the child's first year of life. Patterns in ECAP behaviours were identified by latent class analysis. Multinomial regression modelling was performed with HL as exposure, ECAP as outcome variable, allergy risk, parental competence and bonding, anxiety and depression as moderators as well as potentially confounding variables. RESULTS: We identified three classes of ECAP behaviours (class 1: "breastfeeding " N = 871; class 2: "allergen-avoidance " N = 490; class 3: "mixed behaviours " N = 301). In univariable as well as fully adjusted regression models, compared to class 1, class 2 was negatively, and class 3 was not associated with HL. None of the tested moderating variables altered the association between HL and ECAP significantly. CONCLUSIONS: We found an effect of mothers' HL on ECAP behaviours: lower HL of mothers increased allergen-avoiding behaviour directed at their child, while decreasing the chance of exclusive breastfeeding. Improving HL could contribute to the implementation of recommended ECAP behaviours in families, especially to the reduction of allergen-avoiding behaviours.

Influence of information anxiety on core competency of registered nurses: mediating effect of digital health literacy.

BACKGROUND: In the information age of health care, nurses often face information overload, leading to negative emotions, e.g., anxiety that may impede the adoption of evidence-based practice and clinical decision-making process. Nurses with higher digital health literacy can effectively process and manage information. Despite this, no research has explored the relationship between information anxiety, digital health literacy, and core competency among nurses. Therefore, this study aims to investigate the mediating effects of digital health literacy on information anxiety and core competency among nurses. METHODS: From July to October 2023, the data for this cross-sectional study were collected. The study surveyed a total of 608 nurses from three tertiary hospitals in Fujian Province, and the survey instruments included a sociodemographic information questionnaire, Chinese revision version of the Digital Health Literacy Instrument (CR-DHLI), Information Anxiety Scale (IAS), and Competency Inventory for Registered Nurses (CIRN). Descriptive statistics and Pearson correlation analysis were conducted using SPSS 29.0, and the mediating effect of digital health literacy was examined using Mplus. RESULTS: The mean score of nurses' information anxiety, digital health literacy, and core competency was 3.03 ± 0.91, 2.46 ± 0.56, 2.72 ± 0.88, respectively. And the mediation model of information anxiety on core competency for nurses showed a good model fit index (χ²/df = 2.207, CFI = 0.985, TLI = 0.982, RMSEA = 0.045, SRMR = 0.035). Digital health literacy was positively correlated with nurses' core competency but negatively correlated with information anxiety. The results of path analysis revealed that information anxiety had negative and significant direct effects on NCC (ß = -0.119, P = 0.004) and DHL (ß = -0.297, P < 0.001). DHL had a positive effect on NCC (ß = 0.306, P < 0.001). Digital health literacy played a partial mediating role, accounting for 43.54% of the relationship between information anxiety and nurses' core competency. CONCLUSIONS: Information anxiety among nurses was at relatively high levels, which had a negative impact on the core competency of nurses. This issue requires attention from nursing managers. The mediating role of digital health literacy in the relationship between information anxiety and core competency among nurses has been established. Nursing managers should strengthen the evaluation of nurses' DHL and devise effective support strategies to enhance DHL, thus improving the core competence of nurses in information age.

A scoping review of health literacy in rare disorders: key issues and research directions.

BACKGROUND: The ability to find, understand, appraise and utilise health information is crucial among individuals living with rare disorders. The aim of this study was to give a comprehensive overview of the literature on health literacy in adult persons with rare disorders. METHODS: We applied a scoping review methodology and performed a systematic search in 2021 in bibliographic databases. Searches were conducted in Medline (Ovid), Embase (Ovid), PsycInfo (Ovid), CINAHL (ebsco), and ERIC (Ovid). References were sorted and evaluated for inclusion using EndNote and Covidence. This review was guided by the question "What are the characteristics of research on health literacy in rare disorders?" RESULTS: The database searches yielded 75 eligible reports. A total of 6223 individuals with rare disorders were represented alongside 1707 caregivers. The reports in this review have included study participants representing a total of 80 different rare disorders with unique ORPHA and ICD-10 codes. The results revealed that persons with rare disorders often exhibit gaps in health literacy through a lack of knowledge and access to information related to self-management, their own diagnosis and health, as well as daily coping and social rights. In addition, the importance of aid and information from healthcare personnel and the significance of getting social support from others in the same situation were accentuated. CONCLUSION: This review emphasizes the importance of reinforcing health literacy among persons with rare disorders through peer support and education. This is the first review to give a comprehensive and state-of-the-art overview of literature investigating health literacy among persons with rare disorders and offers a basis for further research.