Letramento funcional em saúde em renais crônicos: um desafio na abordagem preventiva / Alfabetización funcional en salud en pacientes renales crónicos: un desafío en el enfoque preventivo / Functional health literacy in chronic kidney disease patients: a challenge in the preventive approach

Resumo Objetivo Identificar a prevalência de letramento funcional em saúde e analisar a associação entre os níveis de letramento funcional em saúde e as variáveis clínicas e sociodemográficas em pacientes renais crônicos não dialíticos. Métodos Estudo transversal realizado com 167 renais crônicos em acompanhamento no ambulatório de nefrologia de um município de grande porte do estado de Minas Gerais, Brasil. Para as entrevistas foram utilizados questionário sociodemográfico e clínico e a versão brasileira do Short Assessment of Health Literacy for Portuguese Speaking Adults - SAHLPA-18, para mensurar o letramento funcional em saúde. Realizado estatística descritiva para variáveis sociodemográficas e clínicas; testes de correlação e modelos de regressão lineares para associação com letramento funcional em saúde. Resultados A maior parte dos participantes era idosa com mediana de idade de 68 anos, 33,3% (56 pacientes) se encontravam no estágio 3B da doença renal crônica e 53,9% (90 pacientes) apresentaram letramento funcional em saúde inadequado. Não houve associação entre os níveis de letramento funcional em saúde e as variáveis clínicas. A maioria referiu não usar internet e o estágio mais avançado da doença renal crônica apresentou menores escores de letramento. Piores escores de letramento funcional em saúde também foi identificado naqueles com menor renda. Conclusão A maioria dos participantes apresentou letramento funcional em saúde inadequado. As variaveis clínicas não foram preditoras dos ecores de letramento. No entanto, escores mais baixos de letramento em saúde foram identificados naqueles em estágio mais avancado da doença renal, menor renda e menor uso da internet.

Resumen Objetivo Identificar la prevalencia de la alfabetización funcional en salud y analizar la asociación entre los niveles de alfabetización funcional en salud y las variables clínicas y sociodemográficas en pacientes renales crónicos no dializados. Métodos Estudio transversal realizado con 167 pacientes renales crónicos con seguimiento en consultorios externos de nefrología de un municipio de gran porte del estado de Minas Gerais, Brasil. Para las entrevistas se utilizó un cuestionario sociodemográfico y clínico y la versión brasileña del Short Assessment of Health Literacy for Portuguese Speaking Adults - SAHLPA-18, para medir la alfabetización funcional en salud. Se realizó estadística descriptiva para variables sociodemográficas y clínicas, pruebas de correlación y modelos de regresión lineales para asociación con alfabetización funcional en salud. Resultados La mayoría de los participantes eran personas mayores de 68 años de mediana de edad, el 33,3 % (56 pacientes) se encontraba en la etapa 3B de la enfermedad renal crónica y el 53,9 % (90 pacientes) presentó alfabetización funcional en salud inadecuada. No hubo asociación entre los niveles de alfabetización funcional en salud y las variables clínicas. La mayoría relató que no usaba internet y la etapa más avanzada de la enfermedad renal crónica presentó menor puntaje de alfabetización. Se identificaron peores puntajes de alfabetización funcional en salud en aquellos con menores ingresos. Conclusión La mayoría de los participantes presentó alfabetización funcional en salud inadecuada. Las variables clínicas no fueron predictoras de los puntajes de alfabetización. Sin embargo, se identificaron puntajes más bajos de alfabetización en salud en aquellos en etapa más avanzada de la enfermedad renal, con menores ingresos y menor uso de internet.

Abstract Objective To identify the prevalence of functional health literacy and analyze the association between functional health literacy levels and clinical and sociodemographic variables in non-dialysis chronic kidney disease patients. Methods This is a cross-sectional study carried out with 167 chronic kidney disease patients being monitored at the nephrology outpatient clinic of a large city in the state of Minas Gerais, Brazil. For the interviews, a sociodemographic and clinical questionnaire and the Brazilian version of the Short Assessment of Health Literacy for Portuguese Speaking Adults (SAHLPA-18) were used to measure functional health literacy. Descriptive statistics were performed for sociodemographic and clinical variables, and correlation tests and linear regression models for association with functional health literacy. Results Most participants were older adults with a median age of 68 years, 33.3% (56 patients) were in stage 3B of chronic kidney disease and 53.9% (90 patients) had inadequate functional health literacy. There was no association between functional health literacy levels and clinical variables. The majority reported not using the internet and the more advanced stage of chronic kidney disease had lower literacy scores. Worse functional health literacy scores were also identified in those with lower income. Conclusion Most participants had inadequate functional health literacy. Clinical variables were not predictors of literacy scores. However, lower health literacy scores were identified in those with more advanced stage kidney disease, lower income and less internet use.

Normatização dos escores da escala eHealth Literacy Scale para avaliação do letramento digital em saúde / Standardization of eHealth Literacy Scale scores for assessing digital health literacy / Estandarización de las puntuaciones de la escala eHealth Literacy Scale para evaluar la alfabetización digital en salud

Objetivo: analisar os dados de normatização dos escores da versão brasileira do instrumento eHealth Literacy Scale (eHeals) para avaliação do letramento digital em saúde. Método: estudo transversal com 502 adultos brasileiros, realizado em 2019. Dados coletados pelo instrumento eHeals e questionário sociodemográfico. Foram aplicadas árvores de decisão e análise discriminante. Estudo aprovado pelo Comite de Ética em Pesquisa. Resultados: a análise discriminante determinou as faixas de classificação do eHeals a partir da distribuição dos escores. A árvore de decisão indicou que a escolaridade afetou de forma relevante os resultados da escala. Os indivíduos com escolaridade até o ensino fundamental II incompleto: baixo (até 10), médio (11 a 25), alto (27 a 40), e escolaridade acima: baixo (até 25), médio (25 a 32) e alto LDS (33 a 40). Conclusão: a classificação dos níveis de letramento digital em saúde de adultos pelo eHeals deve ser controlada pelos níveis de escolaridade dos participantes.

Objective: to analyze the normative data of the scores of the Brazilian version of the eHealth Literacy Scale (eHeals) instrument for assessing digital health literacy. Method: cross-sectional study with 502 Brazilian adults in 2019. Data collected using the eHeals instrument and sociodemographic questionnaire. Decision trees and discriminant analysis were applied. Study approved by the Research Ethics Committee. Results: Discriminant analysis determined the eHeals classification ranges based on the distribution of scores. The decision tree indicated that education significantly affected the scale results. Thus, individuals with incomplete elementary school education up to II: low (up to 10), medium (11 to 25), high (27 to 40), and higher education: low (up to 25), medium (25 to 32) and high LDS (33 to 40). Conclusion: the classification of digital health literacy levels using eHeals in adults should be controlled by the participants' education levels.

Objetivo: analizar los datos de estandarización de las puntuaciones de la versión brasileña del instrumento eHealth Literacy Scale (eHeals) para evaluar la alfabetización digital en salud. Método: estudio transversal con 502 adultos brasileños que tuvo lugar en 2019. La recolección de datos se hizo mediante el instrumento eHeals y un cuestionario sociodemográfico. Se aplicaron árboles de decisión y análisis discriminante. El Comité de Ética en Investigación aprobó el estudio. Resultados: El análisis discriminante determinó los rangos de clasificación de eHeals con base en la distribución de puntuaciones. El árbol de decisión indicó que la educación afectó significativamente los resultados de la escala. Individuos con educación primaria incompleta: baja (hasta 10), media (11 a 25), alta (27 a 40), y educación superior a esa mencionada: baja (hasta 25), media (25 a 32) y alto LDS (33 a 40). Conclusión: la clasificación de los niveles de alfabetización en salud digital en adultos con eHeals debe ser controlada por los niveles de educación de los participantes.

Health literacy and self-efficacy associations with non-adherence to dental treatment among young adults.

The aim of this study was to investigate associations of health literacy (HL), general self-efficacy (GSE), and sociodemographic variables with non-adherence to dental treatment among Brazilian young adults. This is a cross-sectional study based on a cohort study of 248 young adults aged 19 to 25 years followed up in an earlier study. The participants completed the perceived general self-efficacy scale (GSE), a questionnaire on socioeconomic and demographic variables and were examined for oral conditions. HL was measured using the Brazilian version of the health literacy questionnaire (HLQ-Br), which provides nine individual scores based on an average of the items within each of the nine scales. Dental treatment adherence was evaluated as the decision of young adults to seek a dentist to finish the recommended restorative treatment for dental caries. The effects of HL domains on the adherence to dental treatment were analyzed by logistic regression and the effect was adjusted for sex, age, family income, paternal and maternal education, type of housing, and self-efficacy. The results of the adjusted analysis showed associations among young adults who did not adhere to dental treatment with lower self-efficacy levels, living in non-owner-occupied homes, and lower HL levels in almost all of the HL domains (p < 0.05). Only the HLQ6 domain "Ability to actively engage with healthcare providers" was not associated with the outcome (p>0.05). Adherence to dental treatment in primary care among young adults was associated with their general self-efficacy levels, socioeconomic characteristics, and individual's lower HL aspects.

The Multidimensionality of Low Health Literacy in Older Adults: A Scoping Review of International Studies.

This scoping review aims to map the dimensions encompassing the low health literacy (HL) of older adults, describing their respective causes and consequences. A three-step search strategy was conducted using 16 databases from nine portals and reference lists. Of the 4,259 identified studies, 2,845 were screened and 29 (1%) were included. Studies were published between 1999 and 2021, most of them in English (86.2%), from the American continent (48.3%) and with observational design (86.2%). Four dimensions encompassing the low HL of older adults were mapped: (1) patient dimension, (2) healthcare system dimension, (3) social/economic dimension, and (4) health condition dimension. This review highlights specific dimensions encompassing the low literacy in older adults with evidence about its causes and consequences. These results can guide future research and evidence-based practice involving HL of older adults.

Adaptação e validação do Kidney Transplant Understanding Tool para o contexto brasileiro / Adaptación y validación del Kidney Transplant Understanding Tool para el contexto brasileño / Adaptation and validation of the Kidney Transplant Understanding Tool for the Brazilian context

Resumo Objetivo Realizar a adaptação transcultural e validar o conteúdo do instrumento Kidney Transplant Understanding Tool para o cenário brasileiro. Métodos Estudo metodológico realizado na capital pernambucana, que executou cinco etapas de um protocolo canadense de adaptação transcultural. A versão pré-final do instrumento foi avaliada por 36 participantes em terapia renal substitutiva e sete especialistas em Nefrologia. Resultados Para cada item, atingiu-se o I-IVC ≥ 0,85; e 0,99 para a escala S-IVC/Ave em equivalência conceitual e de conteúdo. O teste binomial apresentou o p-valor ≥ 0,05 para todos os itens; e o Coeficiente de Concordância de Kappa foi de 0,90. Conclusão O instrumento adaptado foi considerado claro pelos participantes e o conteúdo foi validado pelos especialistas. O Kidney Transplant Understanding Tool (K-TUT-Br) foi validado para utilização no contexto do transplante renal no Brasil. A sua aplicação poderá instrumentalizar a enfermagem na implementação de mudanças estratégicas nas estruturas técnico-assistenciais em uso de práticas baseadas em evidências ressaltando o conhecimento e o Letramento em Saúde.

Resumen Objetivo Realizar la adaptación transcultural y validar el contenido del instrumento Kidney Transplant Understanding Tool para el escenario brasileño. Métodos Estudio metodológico realizado en la capital del estado de Pernambuco, donde se ejecutaron cinco etapas de un protocolo canadiense de adaptación transcultural. La versión preliminar del instrumento fue evaluada por 36 participantes en terapia de reemplazo renal y siete especialistas en Nefrología. Resultados En cada ítem se alcanzó el I-IVC ≥ 0,85; y 0,99 en la escala S-IVC/Ave en equivalencia conceptual y de contenido. La prueba binominal presentó el p-valor ≥ 0,05 en todos los ítems; y el coeficiente de concordancia de Kappa fue de 0,90. Conclusión El instrumento adaptado fue considerado claro por los participantes y el contenido fue validado por los especialistas. El Kidney Transplant Understanding Tool (K-TUT-Br) fue validado para su utilización en el contexto del trasplante renal en Brasil. Su aplicación podrá servir de instrumento para enfermeros en la implementación de cambios estratégicos en las estructuras técnico-asistenciales en uso de prácticas basadas en evidencia, destacando el conocimiento y la alfabetización en salud.

Abstract Objective To perform a cross-cultural adaptation and content validation of the Kidney Transplant Understanding Tool for the Brazilian context. Methods A methodological study conducted in the city of Pernambuco, Brazil, which performed the five steps of a Canadian cross-cultural adaptation protocol. The pre-final version of the instrument was evaluated by 36 participants in renal replacement therapy and seven specialists in nephrology Results For each item, the Item Content Validity Index - I-CVI ≥ 0.85 was achieved; and 0.99 for the mean Scale Content Validity Index - S-CVI/Ave in conceptual and content equivalence. The binomial test showed a p-value ≥ 0.05 for all items; and the Kappa Coefficient of Agreement was 0.9. Conclusion The adapted instrument was found to be clear by the participants, and the content was validated by the experts. The Kidney Transplant Understanding Tool (K-TUT-Br) was validated for use in the context of kidney transplantation in Brazil. Its application may enable nurses to implement of strategic changes in technical and care structures using evidence-based practices focusing on knowledge and health literacy.

Health literacy and self-efficacy associations with non-adherence to dental treatment among young adults

Abstract: The aim of this study was to investigate associations of health literacy (HL), general self-efficacy (GSE), and sociodemographic variables with non-adherence to dental treatment among Brazilian young adults. This is a cross-sectional study based on a cohort study of 248 young adults aged 19 to 25 years followed up in an earlier study. The participants completed the perceived general self-efficacy scale (GSE), a questionnaire on socioeconomic and demographic variables and were examined for oral conditions. HL was measured using the Brazilian version of the health literacy questionnaire (HLQ-Br), which provides nine individual scores based on an average of the items within each of the nine scales. Dental treatment adherence was evaluated as the decision of young adults to seek a dentist to finish the recommended restorative treatment for dental caries. The effects of HL domains on the adherence to dental treatment were analyzed by logistic regression and the effect was adjusted for sex, age, family income, paternal and maternal education, type of housing, and self-efficacy. The results of the adjusted analysis showed associations among young adults who did not adhere to dental treatment with lower self-efficacy levels, living in non-owner-occupied homes, and lower HL levels in almost all of the HL domains (p < 0.05). Only the HLQ6 domain "Ability to actively engage with healthcare providers" was not associated with the outcome (p>0.05). Adherence to dental treatment in primary care among young adults was associated with their general self-efficacy levels, socioeconomic characteristics, and individual's lower HL aspects.

Psychometric properties of the Brazilian version of the European Health Literacy Survey Questionnaire short form.

The aim of this study was to analyze the psychometric properties of the Portuguese Brazilian version of the instrument for measuring health literacy European Health Literacy Survey Questionnaire short form (HLS-EU-Q16). The study sample consisted of 783 Brazilian adults with a mean age of 38.6 years. The data were analyzed through an extensive and robust process of testing the properties with the combination of exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and item response theory (IRT) techniques, aiming to search for strong validation evidence in the internal structure and stability step for other sub-samples. The instrument's reliability was tested using Cronbach's alpha and McDonald's Omega. The analyses indicated the existence of only one dimension and good reliability values. The model tested with cross-validation indicated satisfactory, adequate, consistent and stable levels for EFA, IRT via item discrimination and CFA, both for primary indicators as factor loadings, communalities, item discrimination as well as for the model adequacy indicators. It is concluded that the Brazilian Portuguese version of the HLS-EU-Q16 proved to be a one-dimensional, consistent, accurate and stable model for measuring health literacy in Brazilian adults.

Health literacy (HL) is a field of scientific knowledge that has been related to the knowledge and skills of people to access, understand, evaluate and apply information in health. Among the currently existing instruments for measuring the HL construct in its broader aspects, involving multidimensional characteristics, there is the short version of European Health Literacy Survey Questionnaire (HLS-EU-Q16). The aim of this study was to investigate the psychometric properties of the Brazilian Portuguese version of the HL instrument European Health Literacy Survey Questionnaire in its short form, also known as HLS-EU-Q16. The instrument was applied to a sample of 783 Brazilian adults. Our results demonstrated that the Brazilian version of HLS-EU-Q16 presented good psychometric properties to measure HL in Brazilian adults.

Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy. / Reanimação cardiopulmonar para leigos: avaliação de vídeos sob a perspectiva do letramento digital em saúde.

OBJECTIVE: to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy. METHOD: a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed. RESULTS: of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation. CONCLUSION: no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.

Competencies of health personnel for the practice of health literacy in Brazil: A Delphi consensus survey.

OBJECTIVE: The aim of this study was to identify a set of competencies of health personnel for the practice of health literacy in Brazil. METHODS: Scoping review and online interviews with healthcare practitioners, followed by three rounds of the modified e-Delphi method with health literacy specialists from November/2020 to March/2021. During the rounds, the items were revised, new items added for review, and their importance was rated on a five-point Likert scale in an online form. Those items that achieved a mean Likert rating of 4+ (rated important to very important) and ≥ 90.0% agreement among the experts were maintained in each round. RESULTS: The initial competencies list contained 30 items from the literature scoping review and online interview with 46 Brazilian healthcare practitioners. 25 experts (health personnel with publications on health literacy) were invited to participate in the e-Delphi rounds. Of the total of 56 items evaluated, 28 reached consensus among the experts. The Brazilian competencies list differed from other consensuses by the emphasis on professional commitment to the literacy in health, autonomy and social context of the patient. CONCLUSION: For the Brazilian context, 28 competencies are relevant to the practice of health literacy in health care. This study is an initial step to develop the HL competences of Brazilian health professionals and an update of the skills evidenced in previous international studies.

Professional Responsiveness to Health Literacy: A Scoping Review.

BACKGROUND: Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the characteristics and interventions that make health care professionals responsive to the patient's health literacy. METHODS: Medline (PubMed), CINAHL (EBSCO), PsycInfo, ERIC (ProQuest), Lilacs (BVS) and EMBASE (Elsevier) were searched using a combination of controlled descriptors. The selected studies needed to address the concept or main focus of the study among health care professionals in the care or academic environment. KEY RESULTS: After reviewing 34 articles, 14 definitions and 10 subcategories of responsiveness were identified, and a broad characterization of health professional responsiveness to health literacy was proposed. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy, classified as (A) expository (n = 18; 94.7%), (B) interactive (n = 9; 47.4%), (C) practice with educational materials (n = 2; 10.5%), (D) practice with standardized patient or simulation (n = 8; 42.1%), and (E) practice with actual patients (n = 4; 21.1%). DISCUSSION: These characteristics and interventions provide a useful taxonomy for the development of curricula and professional education programs, and for the validation and use of measures to evaluate the health workforce. [HLRP: Health Literacy Research and Practice. 2022;6(2):e96-e103.] Plain Language Summary: We found 14 definitions and 10 categories of professional responsiveness to health literacy. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy.

Perfil de letramento em saúde de portadores de doença renal crônica em tratamento pré-dialítico / Perfil de alfabetización en salud de los pacientes con enfermedad renal crónica en prediálisis / Health literacy profile of patients with chronic kidney disease on pre-dialysis treatment

Objetivo: descrever as condições de letramento em saúde de portadores de doença renal crônica em tratamento pré-dialítico. Método: estudo transversal, realizado com 41 portadores de doença renal crônica em tratamento pré-dialítico em acompanhamento ambulatorial, nos meses de janeiro a julho de 2019. Nas entrevistas foi aplicada a versão brasileira do questionário Health Literacy Questionnaire e um questionário sociodemográfico e clínico. Estatística descritiva foi utilizada para análise dos dados. Resultados: os participantes tiveram menor desempenho nas escalas - informações suficientes para administrar minha saúde e capacidade de encontrar boas informações sobre saúde. E melhores desempenhos encontrados foram no apoio social e na capacidade de se envolver ativamente com os profissionais de saúde. Conclusão: o estudo fornece uma análise mais complexa dos pontos fortes e limitações relacionadas ao letramento em saúde de portadores de doença renal nos estágios iniciais, complemento importante para o campo do cuidado dessa população.(AU)

Objective: to describe the health literacy conditions of patients with chronic kidney disease undergoing pre-dialysis treatment. Method: a cross-sectional study, conducted with 41 patients with chronic kidney disease patients undergoing pre-dialysis treatment, under outpatient follow-up from January to July 2019. For the interviews was used the Brazilian version of the Health Literacy Questionnaire and a sociodemographic and clinical questionnaire. Descriptive statistics was used for data analysis. Results: patients had lower performance on the scales - enough information to manage my health and the ability to find good health information. The best performances were found in social support and the ability to actively engage with health professionals. Conclusion: the study provides an analysis of the strengths and limitations related to the health literacy of patients with kidney disease in the early stages, an important complement to the field of care for this population.(AU)

Objetivo: describir las condiciones de alfabetización en salud de pacientes con enfermedad renal crónica en tratamiento prediálisis. Método: estudio transversal, realizado con 41 pacientes con enfermedad renal crónica en tratamiento predialítico en seguimiento ambulatorio, de enero a julio de 2019. En las entrevistas, la versión brasileña del Health Literacy Questionnaire y un cuestionario sociodemográfico y clínico fueron aplicado. Se aplicó estática descriptiva a los datos. Resultados: los participantes se desempeñaron mal en las escalas: suficiente información para administrar mi salud y capacidad para encontrar buena información de salud. Y los mejores desempeños se encontraron en el apoyo social y la capacidad de involucrarse activamente con los profesionales de la salud. Conclusión: el estudio proporciona un análisis más complejo de las fortalezas y limitaciones relacionadas con la alfabetización en salud de los pacientes con enfermedad renal en tratamiento predialítico, un complemento importante al campo de atención de esta población.(AU)

Reanimação cardiopulmonar para leigos: avaliação de vídeos sob a perspectiva do letramento digital em saúde / Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy / Reanimación cardiopulmonar para legos: evaluación de videos desde la perspectiva de la alfabetización digital en salud

Resumo Objetivo: analisar indicadores de qualidade e conteúdo técnico dos vídeos postados na plataforma YouTube, para leigos, sobre reanimação cardiopulmonar em adultos e sua produção audiovisual quanto aos princípios do letramento digital em saúde. Método: estudo descritivo, exploratório, que selecionou vídeos gravados entre dezembro de 2015 e abril de 2021. Foram analisados por indicadores da produção de material audiovisual, considerando as diretrizes da American Heart Association e os princípios do letramento digital em saúde. Foi realizada estatística descritiva e inferencial. Resultados: dos 121 vídeos analisados, 26 não atenderam qualquer indicador sobre ressuscitação cardiopulmonar; quatro atingiram 81% de conformidade; oito vídeos, 79%; nove vídeos, 69% e 74 vídeos de seis a 63%. De acordo com os princípios do letramento digital em saúde, um vídeo atendeu 85% dos indicadores; 81 vídeos atenderam de 50 a 80% e 39 vídeos, de 10 a 49%. Foi identificada correlação positiva entre letramento e ressuscitação cardiopulmonar. Conclusão: nenhum vídeo apresentou 100% de conformidade com as diretrizes da American Heart Association. A falta de mecanismos de fiscalização e controle sobre conteúdos relacionados à saúde permite a publicação de vídeos equivocados, que têm sido utilizados como aprendizado pelas pessoas e podem perder o maior objetivo que é salvar vidas.

Abstract Objective: to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy. Method: a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed. Results: of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation. Conclusion: no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.

Resumen Objetivo: analizar los indicadores de calidad y contenido técnico de los videos publicados en la plataforma YouTube, para legos, sobre reanimación cardiopulmonar en adultos y su producción audiovisual según los principios de la alfabetización digital en salud. Método: estudio descriptivo, exploratorio, que seleccionó videos grabados entre diciembre de 2015 y abril de 2021. Fueron analizados en función de los indicadores de producción de material audiovisual, considerando las directrices de la American Heart Association y los principios de la alfabetización digital en salud. Se realizó estadística descriptiva e inferencial. Resultados: de los 121 videos analizados, 26 no cumplieron con ninguno de los indicadores de reanimación cardiopulmonar; cuatro lograron un 81% de conformidad; ocho videos, 79%; nueve videos, 69% y 74 videos de seis a 63%. De acuerdo con los principios de la alfabetización digital en salud, un video cumplió con el 85% de los indicadores; 81 videos cumplieron del 50 al 80% y 39 videos del 10 al 49%. Se identificó una correlación positiva entre la alfabetización y la reanimación cardiopulmonar. Conclusión: ningún video cumplió el 100% de las directrices de la American Heart Association. La falta de mecanismos de supervisión y control sobre los contenidos relacionados con la salud permite la publicación de videos erróneos, que han sido utilizados como experiencia de aprendizaje por las personas y es probable que no cumplan con el principal objetivo, que es salvar vidas.

Evaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults / Evaluación de las propiedades psicométricas del instrumento eHealth Literacy Scale en adultos brasileños / Avaliação das propriedades psicométricas do instrumento eHealth Literacy Scale em adultos brasileiros

ABSTRACT Objective: To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version. Methods: The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach's alpha and McDonald's omega). Results: The eHealth Literacy Scale - Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%. Conclusions: The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.

RESUMEN Objetivo: Traducir y adaptar la eHealth Literacy Scale a realidad cultural Brasileña y evaluar sus propiedades psicométricas de la versión en portugués brasileño. Métodos: El instrumento fue traducido y adaptado al portugués brasileño y, en seguida, aplicado en una muestra de 502 individuos entre 18 y 80 años residentes en áreas cercas a seis Unidades de Salud de la Familia de un municipio del interior del estado de São Paulo, Brasil. Los datos fueron evaluados mediante análisis factorial exploratoria y confirmatoria, Teoría de Respuesta al Ítem y confiabilidad del instrumento (alfa de Cronbach y omega de McDonald). Resultados: El instrumento eHealth Literacy Scale - versión brasileña (eHEALS-Br) presentó excelente consistencia interna (α = 0,95 y ω = 0,95), apenas una dimensión y variancia explicada de 81,79%. Conclusiones: La versión brasileña del instrumento mostró excelentes propiedades psicométricas para contraste de los niveles de alfabetización digital en salud en adultos del nuestro país.

RESUMO Objetivo: Traduzir e adaptar a eHealth Literacy Scale para a realidade cultural do Brasil e avaliar suas propriedades psicométricas da versão em português brasileiro. Métodos: O instrumento foi traduzido e adaptado ao português brasileiro e, em seguida, aplicado em uma amostra de 502 indivíduos entre 18 e 80 anos residentes em áreas circunvizinhas a seis Unidades de Saúde da Família de um município do interior do estado de São Paulo, Brasil. Os dados foram avaliados mediante análises fatorial exploratória e confirmatória, Teoria de Resposta ao Item e confiabilidade do instrumento (alfa de Cronbach e ômega de McDonald). Resultados: O instrumento eHealth Literacy Scale - versão brasileira (eHEALS-Br) apresentou excelente consistência interna (α = 0,95 e ω = 0,95), apenas uma dimensão e variância explicada de 81,79%. Conclusões: A versão brasileira do instrumento mostrou excelentes propriedades psicométricas para aferição dos níveis de letramento digital em saúde em adultos do nosso país.

Evaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults.

OBJECTIVE: To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version. METHODS: The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach's alpha and McDonald's omega). RESULTS: The eHealth Literacy Scale - Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%. CONCLUSIONS: The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.

Quality of life of master's and doctoral students in health.

OBJECTIVES: to assess the quality of life of master's and doctoral students in health. METHODS: this is a cross-sectional study carried out with 503 master's and doctoral students from the Brazilian Center-West, using the WHOQOL-BREF to analyze their quality of life. Analysis included Cronbach's alpha coefficient, confirmatory factor analysis and bivariate and multivariate analyzes. RESULTS: older age and having a child were associated with higher average quality of life scores, while diagnosis of anxiety/depression, difficulty in managing academic and personal activities and thinking about dropping out of course were associated with lower average scores in quality of life domains (p <0.05). CONCLUSIONS: master's and doctoral students have reduced quality of life during the entire training period, mainly in psychological and physical health. The management of academic activities and dropping out of course are the main variables associated with decreased students' quality of life.

Psychometric properties of the adapted instrument European Health Literacy Survey Questionnaire short-short form.

OBJECTIVE: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. METHOD: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. RESULTS: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. CONCLUSION: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

Letramento em saúde de cuidadores domiciliares de uma capital brasileira / Alfabetización en salud de cuidadores domiciliarios de una capital brasileña / Health literacy of home caregivers in a Brazilian capital

Resumo Objetivo Analisar as condições de letramento em saúde dos cuidadores de usuários vinculados ao Serviço de Atenção Domiciliar de uma capital brasileira. Métodos Estudo transversal realizado com 90 cuidadores vinculados ao Serviço de Atenção Domiciliar, de município na região central do Brasil. Coleta realizada no domicílio dos usuários, usando questionário sociodemográfico e a versão brasileira do Health Literacy Questionnaire (HLQ-Br). Utilizada estatística descritiva para variáveis sociodemográficas, a média dos escores nas escalas do HLQ e testes não paramétricos para medidas de associação do letramento em saúde. Resultados A maioria dos entrevistados era mulher (90,0%), com companheiro (58,9%), vivia no mesmo local do usuário (75,6%), possuía renda pessoal até um salário mínimo (72,2%), não possuía o hábito de ler (57,8%), estudou nove anos ou mais (53,3%), era cuidador informal (91,1%) e tinha pais que não estudaram (42,2%). Limitações foram identificadas nas escalas "Cuidado ativo em saúde" e "Navegar no sistema de saúde". As condições de letramento em saúde foram influenciadas negativamente por não ter hábito de ler; escolaridade do cuidador e de seus pais; pelo fato de ser cuidador informal; pela renda e tempo cuidando dos pacientes. As potencialidades foram relacionadas ao acesso a quem entende e apoia o cuidador; à compreensão das informações sobre saúde e saber o que fazer, e a entenderem o que os profissionais de saúde lhes pedem. Conclusão Necessário incorporar os princípios do letramento em saúde no cotidiano dos cuidadores, profissionais e gestores para melhores desfechos e decisões em saúde no contexto da assistência no domicílio.

Resumen Objetivo Analizar las condiciones de alfabetización en salud de los cuidadores de usuarios vinculados al Servicio de Atención Domiciliaria de una capital brasileña. Métodos Estudio transversal realizado con 90 cuidadores vinculados al Servicio de Atención Domiciliaria de un municipio en la región central de Brasil. La recopilación fue realizada en el domicilio de los usuarios, mediante un cuestionario sociodemográfico y la versión brasileña del Health Literacy Questionnaire (HLQ-Br). Se utilizó la estadística descriptiva para variables sociodemográficas, el promedio de puntuaciones de las escalas del HLQ y pruebas no paramétricas para medidas de asociación de la alfabetización en salud. Resultados La mayoría de los entrevistados era mujer (90,0 %), con compañero (58,9 %), vivía en el mismo lugar que el usuario (75,6 %), tenía un ingreso personal de hasta un salario mínimo (72,2 %), no tenía el hábito de leer (57,8 %), estudió nueve años o más (53,3 %), era cuidador informal (91,1 %) y sus padres no estudiaron (42,2 %). Se identificaron limitaciones en las escalas "Cuidado activo de la salud" y "Navegar en el sistema de salud". Las condiciones de alfabetización en salud fueron influenciadas de forma negativa por no tener el hábito de leer, por la escolaridad del cuidador y de sus padres, por el hecho de ser cuidador informal y por los ingresos y tiempo cuidando a los pacientes. Las posibilidades se relacionaron con el acceso a quien entiende y apoya al cuidador, con la comprensión de la información sobre salud y saber qué hacer y entender lo que los profesionales de la salud les piden. Conclusión Es necesario incorporar los principios de la alfabetización en salud en la cotidianidad de los cuidadores, profesionales y administradores para obtener mejores resultados y tomar mejores decisiones respecto a la salud en el contexto de la atención domiciliaria.

Abstract Objective To analyze the health literacy conditions of caregivers of Brazilian Home Care Program users. Methods Cross-sectional study conducted with 90 caregivers of the Brazilian Home Care Program in a municipality in central Brazil. Data collection was performed at users' homes using a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Descriptive statistics were used for sociodemographic variables, the mean scores of the HLQ scales and non-parametric tests for measures of association of health literacy. Results Most respondents were women (90.0%), with a partner (58.9%), lived in the same location as the user (75.6%), had a personal income of up to one minimum wage (72.2%), did not have the habit of reading (57.8%), studied nine years or more (53.3%), were informal caregivers (91.1%) and had parents who did not study (42.2%). Health literacy limitations were identified in the scales "Actively managing my health" and "Navigating the healthcare system". Health literacy conditions were negatively influenced by the infrequent reading habit; schooling of caregivers and their parents; the fact of being an informal caregiver; by the low income and less time as a caregiver. The strengths of caregivers were related to the access to those who understand and support the caregiver; understanding health information and knowing what to do, and understanding health professionals' requests. Conclusion It is necessary to incorporate the principles of health literacy in the routine of caregivers, professionals and managers for better health outcomes and decisions in the home care context.

Psychometric properties of the adapted instrument European Health Literacy Survey Questionnaire short-short form / Propriedades psicométricas do instrumento adaptado European Health Literacy Survey Questionnaire short-short form / Propiedades psicométricas del instrumento adaptado European Health Literacy Survey Questionnaire short-short form

Objective: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. Method: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. Results: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. Conclusion: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

Objetivo: investigar as propriedades psicométricas da versão adaptada ao português do Brasil do questionário de letramento em saúde European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) em adultos brasileiros. Método: o instrumento foi traduzido e pré-testado em uma amostra de 50 indivíduos. Em seguida, ele foi aplicado em uma amostra com 783 indivíduos adultos. Os dados passaram por um processo adequado de testagem das propriedades, com a combinação de técnicas da Análise Fatorial Exploratória, Análise Fatorial Confirmatória e Teoria de Resposta ao Item. Para a avaliação da confiabilidade, foram utilizados os indicadores de alfa de Cronbach e o Ômega de McDonald. Foi aplicada a validação cruzada com análise integral dos dados. Resultados: a maioria dos participantes era do sexo feminino (68,1%), com idade média de 38,6 (dp=14,5) anos e 33,5% estudaram até o ensino fundamental. Os resultados indicaram um modelo unidimensional com variância explicada de 71,23%, níveis de cargas fatoriais, comunalidades e discriminação do item adequados, bem como estabilidade e a replicabilidade do instrumento para outras populações. Conclusão: a versão brasileira do HLS-EU-Q6 indicou que o instrumento está adequado para aplicação de forma indiscriminada na população a que se destina para aferir os níveis de letramento em saúde.

Objetivo: investigar las propiedades psicométricas de la versión en portugués brasileño del cuestionario de alfabetización en salud European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) en adultos brasileños. Método: el instrumento fue traducido y probado primero en una muestra de 50 individuos. Luego, se aplicó a una muestra de 783 individuos adultos. Los datos pasaron por un proceso adecuado de prueba de las propiedades, con la combinación de técnicas de Análisis Factorial Exploratorio, Análisis Factorial Confirmatorio y Teoría de Respuesta al Ítem. Para evaluar la confiabilidad se utilizaron los indicadores alfa de Cronbach y Omega de McDonald's. Se aplicó validación cruzada con análisis de datos completo. Resultados: la mayoría de los participantes era de sexo femenino (68,1%), con una edad media de 38,6 (dt = 14,5) años y el 33,5% cursó hasta la educación primaria. Los resultados indicaron un modelo unidimensional con una varianza explicada de 71,23%, niveles adecuados de carga factorial, comunalidades y discriminación de ítems, así como estabilidad y replicabilidad del instrumento a otras poblaciones. Conclusión: la versión brasileña de HLS-EU-Q6 indicó que el instrumento es apto para su aplicación indiscriminada en la población a la que se destina para evaluar los niveles de alfabetización en salud.