Development and psychometric properties of a brief generic cancer knowledge scale for patients (BCKS-10).

PURPOSE: This study aims to introduce the development and psychometric properties of a brief generic cancer knowledge scale for patients (BCKS-10) that includes different elements of knowledge and skills (terminology, diagnosis, treatment, prevention, and numeracy). Although cancer knowledge is a central dimension of cancer literacy, most previous studies either investigated cancer knowledge among the general population, or among patients with a specific cancer diagnosis. METHODS: Qualitative interviews (n = 11) and a quantitative survey (n = 267) among peer support group leaders were conducted to further develop the BCKS-10 after literature screening. n = 500 patients with cancer were recruited across Germany between October 2020 and February 2021. Construct validity, item discrimination and reliability were tested. RESULTS: ANOVA revealed no significant differences of the knowledge score between various cancer sites, a significant positive association with education, and a negative association with migration background by trend supporting construct validity. In terms of item discrimination, the corrected item-total correlation of 8 out of 10 items were above the threshold of 0.3. Cronbach's alpha of about 0.68 revealed an acceptable internal consistency as the tool is brief and consists of different dimensions. CONCLUSION: Overall, the findings show that the BCKS-10 is a suitable tool to briefly assess cancer knowledge among patients independent of cancer site. However, further surveys have to be conducted to validate the psychometric properties and enhance the BCKS-10.

Prevalence and determinants of dental visits among older adults: findings of a nationally representative longitudinal study.

BACKGROUND: The first aim was to present descriptive data on the frequency of dental visits among older adults in Germany. The second aim was to identify the determinants of the number of dental visits using a longitudinal approach. METHODS: Longitudinal data were derived from the German Ageing Survey, which is a nationally representative sample of community-dwelling individuals ≥40 years in Germany. The frequency of dental visits in the past 12 months was recorded in the years 2002, 2008 and 2011. In order to control for time-constant unobserved heterogeneity, Poisson fixed effects regressions were used. RESULTS: While the mean number of dental visits was 2.3 (SD: 2.0) in 2002, it was 2.0 (SD: 1.7) in 2008 and 2.1 (SD: 1.7) in 2011. The frequency of dental visits declined with age (total sample and women), transitions from normal weight to overweight (total sample), changes from divorced/widowed/single/married, living separated from spouse to 'married, living together with spouse' in women and with a decrease in the number of physical illnesses (total sample and men). CONCLUSIONS: The frequency of dental visits declines with age in older adults. While some of the determinants of frequency are non-modifiable (e.g., ageing and worsening of general health), others are modifiable (e.g., change in weight category).

Self-assessments and determinants of HRQoL in a German MS population.

OBJECTIVES: The importance of health-related quality of life (HRQoL) in multiple sclerosis (MS) is widely acknowledged. In 2015, a multicenter study was launched to assess the HRQoL and coping styles of chronically ill persons in Germany. The aims of this paper were (i) to describe how persons affected by MS assess their HRQoL and (ii) find out sociodemographic and disease-specific determinants of HRQoL. MATERIALS AND METHODS: A quantitative survey (optionally per paper-pencil or online) was conducted between March and October 2015 in Germany. Recruitment ways were as follows: Associations of the German Multiple Sclerosis Society (DMSG), medical practices specialized in neurology/MS, hospitals, public events, social networks, and self-help clearinghouses. To measure HRQoL, the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire and the short form of the Fear of Progression Questionnaire (FoP-Q) were used. RESULTS: A total of 1220 individuals with MS participated in the study. Frequent problems reported were related to activities of daily living as well as sentimental and sexual life. Multiple regression analyses identified disease severity and comorbidity-in different directions (positive and negative)-as the strongest factors in predicting activities of daily living, symptoms, sentimental and sexual life, and reject. The demographic variables sex, age, education, and employment status also have different impact on the HRQoL. CONCLUSIONS: Using HRQoL measures can be feasible outcomes in addition to clinical assessments of MS and other chronic diseases and can help better managing the care. Some challenges have to be taken into account involving patients and the limitations of our empirical study.

[Diabetes-specific health literacy: what do Turkish immigrants with diabetes mellitus 2 know about their disease?]. / Diabetesspezifische Gesundheitskompetenz: Was wissen türkischstämmige Menschen mit Diabetes mellitus 2 über ihre Erkrankung?

AIM OF THE STUDY: Only few findings are available for the large group of type 2 diabetics whose origin is not German. This article investigates 1) the degree of diabetes-knowledge among diabetics of Turkish origin, and 2) factors that influence this knowledge and the competencies with handling the disease. METHODS: In cooperation with 15 medical practices 294 diabetics of Turkish origin were interviewed in person by Turkish-speaking interviewers. There is no established concept for this population to measure their health literacy, therefore we adopted some questions from other tests and added our own items. Besides diabetes knowledge tests with closed and open questions the interviewees had to undertake a reading test and a screening test on German language skills. Socio-demographics and the attendance at diabetes trainings were gathered as well, and analysed in principal component analyses and multiple regressions. RESULTS: On average, the respondents had lived in Germany for 32 years, but 40% of them do not speak German. 25% never went to school and 21% cannot read or write (Turkish). Even though 60% took part in a diabetes training course, it appears that knowledge about the disease is scarce: only 15% could sufficiently explain their diabetes disease with their own words. A dimensional analysis helps to differentiate "theoretical" and "behavioural relevant" knowledge about diabetes. Theoretical knowledge is strongly associated with education, German language skills and attending a training course, whereas competencies that are relevant to the behaviour only are associated with participation in diabetes training courses. The educational effects remain on a rather low level and cannot compensate the fact that theoretical knowledge about diabetes depends on education. Hence, the overall (too) low level of knowledge on health and diabetes is only marginally improved. CONCLUSIONS: Education, attending a diabetes training course and language skills are the main factors for explaining poor knowledge about diabetes. A tailor-made training course--considering people's educational background--for the large group of people of Turkish origin could lead to improvements. Moreover, the neglected potential of self-help groups should be developed, as only one person of the reviewed population reported to search for support here.

Oral Health Literacy in Migrant and Ethnic Minority Populations: A Systematic Review.

Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs.

[Recruitment and activation of members in self-help organisations. Results of a survey of self-help organisations at the national level]. / Mitgliedergewinnung und -aktivierung in Selbsthilfeorganisationen. Ergebnisse einer Befragung von Selbsthilfeorganisationen auf Bundesebene.

The majority of the German population can envisage a membership in self-help groups or organisations when this should become relevant. As a matter of fact, only relatively few people are attending joint self-help activities. However, a significant number of members is important for self-help organisations (SHO) for self-organisation, lobbyism and (political) influence. Many SHOs in Germany are dissatisfied with their membership development and are therefore looking for better recruitment and activation strategies. The project "Activating Potentials for Joint Self-help Activities" (funded by the statutory health insurance fund BKK BV 10/2006-04/2009) is a participative collaboration between scientists, practitioners and SHO representatives to develop strategies and methods to promote access to joint self-help activities. In co-operation with the BAG SELBSTHILFE (a National HCPO Alliance) and the NAKOS (the National Clearing House for the Encouragement and Support of Self-Help Groups) 322 boards of national level SHOs were contacted in late 2007 and asked to complete a questionnaire on membership development, recruitment strategies and measures to activate members for voluntary commitment. 50% returned the questionnaire. The results were fed back in a transfer workshop in August 2008 and discussed with 60 representatives of SHOs. Their views are integrated in this paper. Despite all claimed stagnation or decline in membership development, the results show stability or increases over the last two years. Furthermore, the majority of SHOs was founded from the 1990 s until today, specifically in the areas of rare and chronic diseases. This development is based on a better socio-political recognition and promotion of self-help activities, self-help groups and SHOs as well as in better communication technologies. The views on the co-operation between SHOs and social service and health care providers are controversial: Positive and negative experience is more or less balanced. Then the openness and self-reflection of the workshop and survey participants is remarkable. In the context of a growing patient orientation in the health-care system participative co-operation in research and development will become more meaningful.

[Self-help friendliness as quality target in the SHI health care]. / Selbsthilfefreundlichkeit als Qualitätsziel in der vertragsärztlichen Versorgung1.

OBJECTIVES: The article discusses different possibilities to integrate a sustainable co-operation with self-help groups within the framework of the obligatory quality management in SHI-physicians' establishments. The results of a pilot study, which was conducted to develop a model project "self-help friendly doctor's offices", are presented and discussed. METHODS: Until now the subject has been being rarely discussed in the scientific literature. Therefore, we carried out an extensive internet research and document analysis of available quality management systems (QMS). Furthermore, the representatives of the QMS were asked to assess both the current status of integration and prospective chances of including "self-help friendliness" as a core element of quality. RESULTS: We could identify 2 generic and 5 specific QMS concerning ambulatory medical care which all offer the chance to integrate "self-help Friendliness" as a quality criterion. The concept of "self-help friendly doctor's offices" also found great acceptance with the representatives of the QMS. As a side effect of the QMS-expert-interviews, 3 of them announced that they would include this aspect in the current development of the quality objectives and criteria of their QMS. CONCLUSION: The criterion "self-help friendliness" is principally capable of being integrated in several QMS. However, the further development of the approach needs answers to different questions (e.g., hierarchy of quality criteria), and a test period with all parties involved. Parallel processes in the health-care system as well as the political regulation of quality management in health-care are of great importance for a successful implementation of "self-help friendliness".

[Health-related self-help of immigrants in Germany. Chances, barriers, potential]. / Gesundheitsbezogene Selbsthilfe bei Menschen mit Migrationshintergrund. Chancen, Barrieren, Potenziale.

Migrants in Germany participate in health-related self-help groups nearly as frequently as native-born Germans--as long as they have good German language skills and are widely integrated into the main society. However, the situation is different for those migrants who are not or only slightly integrated. Mother-tongue self-help groups of ethnic minorities would offer good chances for health-related self-management and coping; however, these groups are rare. This can partly be explained by the lack of knowledge of many migrants about support possibilities for self-help groups, also because the term "self-help" has no equivalent in many languages. On the other hand, there are many barriers for self-help activities: false shame attributed to certain health problems, fear of de-anonymization in ethnic communities, different concepts of health and illness, a lack of judging the potential of one's own competencies and self-efficacy, and particularly illiteracy. This article describes the relevance of self-help among migrants with special regard to self-organized migrant networks and outlines the current state of discussion within the self-help stakeholders. Finally, potential multipliers, networking examples and qualification measures for promotion of health-related self-help among migrants are presented.