Journal of Health Literacy
Volume:8 Issue: 3, Autumn 2023

Health literacy is one of the factors that can influence tuberculosis medication adherence. Due to inadequate health literacy, patients had not fully used the information received related to tuberculosis in their daily behavior to support recovery. This research analyzes the association between domains of health literacy and medication adherence among pulmonary tuberculosis patients. This retrospective study analyzed the association between health literacy and medication adherence of 150 pulmonary tuberculosis patients in four primary healthcare units in Jember Regency. The participants were composed of; 1) adhere (had no history of interrupt medication > 1 month in 2021) and already recovered and 2) non-adhere (had a history of not taking medication for > 1 month in 2021). The prepared research assistants and health volunteers carried out the data collection. Descriptive statistics and the chi-square test were applied to analyze the data. Collection data held from October-November 2022. This study found that 128 participants adhered to and 22 did not adhere to tuberculosis medication. Forty-two percent of the participants (63 of 150) had a sufficient health literacy level. There was a significant association between health literacy level and medication adherence (p<.001).  All health literacy domains significantly associated with medication adherence with access (p=0.001), understand (p<0.001), appraise (p<0.001), and apply (p<0.001). Most participants had sufficient health literacy and good skills in accessing, understanding, appraising, and applying tuberculosis-related information. Health workers can improve tuberculosis patients’ ability to appraise and apply tuberculosis health information by providing continuous health counseling.

Over the last decade, there has been an increase in people undergoing haemodialysis for chronic kidney disease. This increase has led to many questions about the health literacy and quality of life of these patients. The main objective of this study is to assessing the association between health literacy level and quality of life of chronic kidney patients undergoing regular haemodialysis.  It is a cross-sectional study that took place from March 1, 2022, to April 30 of the same year. We assessed health literacy using the HHL-EU-PT assessment instrument and quality of life using the KDQOL-SF. The sample consisted of 268 patients aged between 25 and 90 years from 7 haemodialysis clinics in Portugal. Data analysis was conducted using SPSS version 26.0. The Kolmogorov-Smirnov test was used to evaluate the normality of variable distributions, and the T-test was used to compare the dimensions of the Health Literacy scale and KDQOL-SF with dichotomous categorical variables. The application of the KDQOL-SF, we found that the dimensions with the best scores were encouragement from dialysis staff (82.46) and social support (77.49). Overall, we found an association between the medium score of literacy and patients' quality of life: for each additional point in health literacy, the quality-of-life score increased by 0.78 points (p<0.001).  Therefore, improving the level of health literacy may be a possible strategy for improving quality of life for CKD patients.

Searching for health information online no longer attracts scientific attention, and eHealth literacy skills can influence health behaviors in the general population. This study aimed to assess the role of eHealth literacy on attitude towards Covid-19 Vaccine during the pandemic period. Between 1 April 2021 and 1 July 2021, a single-center descriptive cross-sectional study including 422 participants was conducted face-to-face in the vaccine clinics of a pandemic hospital in Istanbul. The eHealth Literacy Scale (eHEALS) was used to determine the health promotion skills of the participants and to use the resources to protect their health. Attitudes towards the Covid-19 vaccine scale score, approaches and biases towards the Covid-19 vaccine were evaluated. Data were analyzed with the NCSS 10 (2015 Kaysville, USA) program. The eHealth literacy level of participants aged 30.89±8.54 years was positively related to the attitude towards Covid-19 Vaccine (r=0.151, p=0.002). The averages of eHEALS and attitude toward Covid-19 Vaccine scale scores were 3.65±0.81 out of 5 (73.0%) and 2.99±0.82 points, respectively. An eHealth literacy of about twice as high as men was observed in women (OR: 1,663, 95% CI = 1,088-2,540; P=0.019). University graduation was observed to be 7.7 times more effective in providing a better level of eHealth literacy (OR: 7.736, 95% CI = 3.284-18.224; p<0.001). Participants with higher eHealth literacy demonstrated a 2.2-fold better attitude score towards the Covid-19 Vaccine (OR: 2,222, 95% CI = 1,270-3,887; p=0.005).  An increase in the level of an individual’s eHealth literacy translates to a more positive attitude toward vaccines.

Hemodialysis reduces patients’ ability to perform daily activities and makes them dependent on caregivers. Since the access to and understanding of health information by patients should be ensured by informal caregivers, caregivers' health literacy is of particular importance in treatment adherence. This study determined the relationship between caregivers' health literacy and hemodialysis patients’ treatment adherence. This descriptive correlational study was conducted on dyads of hemodialysis patients and their caregivers at all hemodialysis wards in Bushehr Province, Iran (2021) using the census method. Eligible patients and their caregivers were invited to participate (N=259). The data collection instruments were a demographic information form, the End-Stage Renal Disease Adherence Questionnaire, and the Health Literacy Instrument for Iranian Adults. The data were analyzed using SPSS19.0 via descriptive and analytical methods (univariate and multivariate linear regression). P<0.05 was considered statistically significant.  In total, 78 and 181 of the caregivers were male and female, respectively, with the mean ±SD age of 58.53±12.63 years. Among the patients, 153 were male and the rest were female with the mean ±SD age of 43.47±11.97 years. The mean ±SD of caregivers' health literacy and treatment adherence was 3.42±0.81 and 1063.61±142.11, respectively. There was no significant correlation between caregivers' health literacy and patients' treatment adherence (P<0.89). However, there was a direct correlation between treatment adherence and caregivers' age (P<0.01). Moreover, there was a negative correlation between the number of hours of caregiving per day and the patients' treatment adherence (P<0.04).  Since caregivers' health literacy was not associated with patients’ treatment adherence, if healthcare providers, provide appropriate information to informal caregivers even based on their health literacy, it may not be transferred well to their patients. Therefore, these results can be considered a warning for healthcare providers to pay attention to providing training in health promotion programs to both the patient and the caregiver.

Antibiotics self-medication is a global concern, and more common especially in low-income countries, and cause problems such as antibiotic resistance and drug toxicity. This study examined the levels of health literacy (HL) and their association with the knowledge of antibiotics and its self-inflected use among women in Zahedan. The present study was an analytic –descriptive study conducted on 400 women living in Zahedan from October 1 to November 25, 2021. The data collection method was self-explanatory. Antibiotics self-medication and the Health Literacy for Iranian Adults (HELIA) questionnaires were used to collect data. Chi-square and two-variable logistic regression test were applied using SPSS software version 19, (p= 0.05). Education had a higher correlation with the correct antibiotics consumption compared to the only knowledge (OR=2.812), and the higher levels of health literacy were related to correct antibiotics consumption (OR=0.480). Education level also had a significant relationship with the knowledge level regarding correct antibiotics consumption (OR=6.845). Furthermore, the domains of understanding (OR=1.035) and evaluation (OR=1.022) had a significant relationship with having a good knowledge. The findings showed that at all levels of health literacy, the optimal level of knowledge and correct antibiotics consumption were low, and the level of health literacy supports proper knowledge about the correct antibiotics consumption, so it is suggested that the level of health literacy and knowledge be improved to increase the rational use of antibiotics presenting understandable content in educational programs of the national media.

Health literacy provides us not only with motivation and knowledge, but also with the opportunity to seek, comprehend, assess, and apply information for making right decision in critical situations. Pregnancy and postpartum are considered to be unique and significant periods in a woman's life. Health literacy and its determinants can play an important role in protecting and improving the health of women. The aim of this study was to assess health literacy and its associated factors among postpartum women referring to Farsan comprehensive health centers. This descriptive–analytical study was conducted on 300 postpartum women referring to Farsan comprehensive health centers in 2021. Quota-convenience Sampling was used to select the participants. Data were collected by demographic information and Iranian health literacy standard questionnaires. Descriptive statistics, Independent t-test and Pearson correlation test, kruskal-wallis and Mann-whitney tests were used to analyze the data.  The total mean score of health literacy was 61.62±17.02. Among the dimensions of health literacy, the highest score belonged to understanding, followed by reading, accessibility, evaluation and decision making. 63 (21%) of the participants had inadequate health literacy, 96 (32%) had not quite adequate, 128 (42.7%) had adequate, and 13 (34.3%) had high health literacy. Health literacy was significantly correlated with age (r=0.342, p<0.001), education (Χ2= 17.734, p<.001), occupational status (t=-2.843, p=.005) and spouse' age (r=.264, p<.001).  Health literacy score in more than half of women in our study was inadequate, especially in the young women with young husbands, low education level and housewives. The dimensions of evaluation and decision-making should be given more attention and effective interventions should be designed in this regard.

Patient compliance plays an important role in the relationship between the patient and the physicians. The purpose of this systematic review and meta-analysis was to determine the impact of internet health information on patient compliance.

Comprehensive searches of the databases were used to identify potentially eligible studies. No year range was set in this study. PRISMA guidelines have carried out this systematic view and meta-analysis. The two authors reviewed the studies based on inclusion criteria for systematic review. Statistical analysis was performed using CMA, version 2.0.

The results of this meta-analysis showed that the satisfaction and quality of Internet health information can have a positive effect on patient compliance with treatment.

Internet health information is widely available and interpreted in different ways, so it can positively or negatively affect patients' decision and performance to compliance to treatment. Therefore, physicians need to identify credible and understandable and the quality of health information websites, so that patients have access to quality information.

Measuring concepts such as health literacy, either generally or specifically, in different populations requires the use of existing standard instruments or the development of new ones by the researcher. The study was conducted to critical review of common methodologies for instrument development in the health literacy. 

 This review article examines health literacy measurement tools with two

1) methodological review of tool design 2) review of the items used in each tool by posing this question (validity review) "Do the items measure what is intended in relation to the concept of health literacy and its dimensions?”. In order to access the health literacy tools, first was referred to the site "Health Literacy Tool Shed".10% of the available tools (20 item) were randomly included in the study for a deep and detailed review. 

Finding showed, researchers employed three different approaches to the development of measurement instruments; 1) Review of literature or used the already existing instruments, 2) The qualitative approach to explain a concept and embrace it from different dimensions as well as construct the items and 3) Mix-method approach (a mixture the previous two approaches). Two mistakes include 1) interpretation error (error of qualitative content analysis, creation of categories and sub-categories from codes and meaning units) and 2) program error (error of exploiting subcategories and categories in designing and generating items and different parts of tools) reported. 

Paying attention and considering what was indicated regarding different approaches and paths as well as processes and methods can preserve researches to a large extent from the main problem that is the collection of inaccurate data due to instruments with low validity and reliability.