Health literacy of caregivers of adult care recipients: A systematic scoping review

Caregivers play a vital role in providing support to adults with a chronic condition, or cognitive or physical impairment. Low health literacy in caregivers has the potential to impact adequate care provision, and consequently, care recipient health outcomes. The aim of the study was to systematically review literature related to health literacy of caregivers of adult care recipients, and examine its relationship with care recipient, and caregiver, health outcomes. Electronic databases were searched for relevant English‐language publications that assessed health literacy in caregivers. Included studies were abstracted into evidence tables and assessed using an eight‐item quality scale. The search identified 2717 new titles and abstracts, with 67 shortlisted for full review. Twelve papers from 2003 to 2015 met the inclusion criteria. The prevalence of limited health literacy in caregivers ranged from 0% to 52.5% depending on the measure and cut‐off criteria used. Associations were found between low caregiver health literacy and (i) poorer care recipient self‐management behaviours; (ii) increased care recipient use of health services; and (iii) increased caregiver burden. The quality of the studies ranged from fair to excellent. Low health literacy in caregivers differed depending on the measures and scoring criteria used. Evidence to support the relationship between caregiver health literacy and care recipient, and caregiver health outcomes was limited to single studies. Recommendations for further research include: the development of caregiver health literacy measures across different populations; examination of associations between caregiver health literacy and care recipient outcomes; and the development of interventions designed to improve caregiver health literacy.     

Disability training for health workers: A global evidence synthesis

BackgroundHealth worker training on disability is a recognized component of achieving high standards of health for people with disabilities, given that health worker’s lack of knowledge, stigma, and negative attitudes towards people with disabilities act as barriers to high quality health care.ObjectiveTo understand the published literature on training health workers about disability.MethodsWe searched five databases for relevant peer-reviewed articles published between January 2012 and January 2021. Studies that focused on training health care workers to improve knowledge, confidence, self-efficacy, and competence to support people with physical, sensory, or intellectual impairments were included. Data about the details of the intervention (setting, participants, format, impact assessments, etc.) and its effects were extracted.ResultsThere is an array of highly local tools to train health workers across stages of their training and careers (preservice, in-service, and continuing professional development). Studies involving people with disabilities in the training, community placements, simulations, or interactive sessions were found to be most effective in improving knowledge, confidence, competency, and self-efficacy.ConclusionsAs part of initiatives to build inclusive health systems and improve health outcomes for people with disabilities, health workers around the world need to receive appropriate and evidence-based training that combines multiple methods and involves people with disabilities. To monitor progress on the impact of training, there should also be a standardized measure of impact on core outcomes.     

Challenges for Japanese rural home care workers in interprofessional collaboration: a qualitative study

Among medical professionals, the role of home care workers is crucial in the care of patients in their homes. In Japan, however, research on the difficulties home care workers face while working in rural zones is limited. Using thematic analysis, a qualitative study was conducted with 57 home care workers in a rural area of Japan. Findings revealed the difficulties they experienced regarding the medical problems of their patients and in their relationships with other professionals. The old customs of rural medicine and the system of long-term care insurance strongly influence relationships among multiprofessionals, leading to conflict and hierarchy.     

Health literacy: addressing the health and education divide

Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.     

天门市居民健康素养现状与健康教育需求调查

目的 了解天门市居民健康素养和健康教育需求情况,为政府制定健康相关政策提供科学依据。方法 采用分层多阶段抽样法,在全市784个行政村和42个社区随机抽取15~69岁居民1 652人进行面对面调查。结果 2016年天门市居民健康素养水平为10.41%,其中男性11.16%,女性9.15%,男女性别差异无统计学意义。25~34岁年龄组、大专/本科及以上人群、城区居民素养水平较高,分别为18.00%、21.05%、21.94%。年龄不同、居住环境不同、受教育程度不同,表现在素养水平上差异有统计学意义。主要健康问题素养水平,最高为安全与急救素养(47.46%),最低为慢性病防治素养(5.57%)。调查对象首要的健教需求是慢性病防治知识(55.87%),其次为营养膳食(53.21)和科学就医(51.33%)。结论 天门市居民健康素养水平相对较低,应当提高健康教育与健康促进工作的针对性,加强对农村居民、文化程度较低人群的干预力度。开展经常性的健康教育需求调查,创新健康教育模式和方法。     

构建“以健康为中心”的医疗卫生人才培养模式

随着医学模式的演变,我国的医疗卫生人才培养模式必须从“以治疗疾病为中心”转变为“以健康为中心”。文章阐述了“以健康为中心”的医疗卫生人才培养模式产生的背景,提出以“治未病与健康管理”博士项目为抓手,推进医学教育模式改革,加快医疗卫生人才培养机制的变革,以适应新时期我国医疗卫生事业发展的需要。     

Health and safety education for workers with low-literacy or limited-English skills.

Low literacy and limited English proficiency have become a growing concern for health and safety educators. With one-fifth of the workforce reading below an eighth-grade level and possibly another tenth having limited English skills, health and safety educators and unions have increasingly become aware that current training programs often surpass the language and literacy abilities of workers being trained. This article describes the dilemmas facing health and safety professionals in incorporating knowledge about language and literacy skill levels. It documents creative strategies and new programs, largely based on participatory and popular education approaches, to provide training that simultaneously matches worker needs and leads to worker empowerment.     

Risks to home care workers: Professional perspectives

Care at home is fundamental to community care policy, but the simultaneous growth of health and safety regulation has implications for home care services because of the duty of employers towards home care workers. This grounded theory study set in Northern Ireland used data from 19 focus groups and nine semi-structured interviews with a range of health and social services professionals and managers to explore perspectives on planning long term care for older people. Home care workers faced a wide range of hazards in the homes of clients, who themselves were faced with adapting their living habits due to their changing health and care needs and ‘risks.’ Creative approaches were used to ensure the health and safety of home care workers and simultaneously to meet the choices of clients. Staff experienced feelings of conflict when they judged it necessary to impose their way of providing home care and thus impose their values on clients to create a safe working environment. There was variation between and within organizations in terms of the staff focus on client needs or on their employer responsibility towards home care workers. The planning of home care services must take account of both the choices of clients and the hazards facing home care staff.     

北京市2460名医务人员心理健康调查分析

目的探讨北京市医务人员心理健康状况特征,发现可能存在的心理问题。方法应用症状自评量表（SCL-90）和人口学特征问卷,对北京市5所三级综合医院的2460名医务人员进行调查。结果三级综合医院医务人员心理健康状况除阳性项目数高于全国常模外,其他均低于全国常模;不同年龄、性别、文化程度、职称、工龄、工作形式、科室、专业、行政职务等人口学特征的医务人员在SCL-90上差异有统计学意义（P〈0．05）;中度以上心理问题检出率为17．6％,高于一般水平。结论三级综合医院医务人员心理问题比一般人群突出,应注重医务人员的压力管理。     

Health literacy weakly but consistently predicts primary care patient dissatisfaction.

OBJECTIVES: To study relationships between health literacy and multiple satisfaction domains. Health literacy is related to some domains of patient satisfaction such as communication and understanding, but little is known about relationships of health literacy with other satisfaction domains. Moreover, the importance of health literacy in predicting satisfaction compared with other patient sociodemographics is underexplored. DESIGN: Cross-sectional survey. SETTING: Primary care waiting areas with a Veterans Administration Medical Center and a university health system. PARTICIPANTS: One thousand five hundred and twenty-eight primary care patients. MAIN OUTCOME MEASURES: A brief demographics questionnaire, the Rapid Estimate of Adult Literacy in Medicine, the Veterans Affairs ambulatory care patient satisfaction survey, and an adaptation of the Charlson Comorbidity Index. RESULTS: In unadjusted regression analyses, lower health literacy level was a significant predictor of worse satisfaction in 7 of 10 domains (P < 0.01). When adjusting for patient sociodemographics, predicted relationships remained significant in six of the seven domains (P < 0.05), with each unit change in the 4-stage literacy classification associated with a 3-6 point decrease in dissatisfaction scores (0-100 scale). Health literacy did not predict overall dissatisfaction (P = 0.55). CONCLUSIONS: These results suggest that health literacy, as assessed through a pronunciation exercise that is closely related to more comprehensive measures of literacy, has a consistent, albeit weak relationship with patient satisfaction. Future work is needed to clarify if patients with lower literacy are really receiving different care than those with higher literacy and to pinpoint the sources of their more negative responses.     

Health literacy and knowledge of antenatal care among pregnant women

Health literacy has a direct impact on pregnancy from the perspectives of both the mother and the baby. This study aimed to determine the level of health literacy and assess the knowledge of antenatal care among pregnant women. From among all pregnant women who presented to the hospital's obstetric polyclinic during the study's timeline, the study group consisted of 460 women who agreed to take part (492 women were invited and a response rate of 93.5% was achieved). A questionnaire prepared based on the literature in line with the study's objectives was completed by the participants under supervision. The Turkish Health Literacy Scale (THLS-32) was used to assess health literacy. In order to determine the women's prenatal care knowledge levels, a total of 20 knowledge-testing statements prepared using the literature were applied, 14 of which were true and six of which were false. The internal consistency of antenatal information questions during pregnancy was made and the Cronbach alpha coefficient was calculated as 0.77. It was determined that 33.9% of the participants had a sufficient level of health literacy. Health literacy was sufficient in young married women (19 years and less) in their first pregnancy and those who had regular reading habits, participated in healthcare activities and received postpartum care at a family health clinic (p < 0.05 for each). While the most accurately evaluated statement about antenatal care was ‘It is normal to experience nausea/vomiting in the first trimester of pregnancy’, the least accurately evaluated statement was ‘Over 35% of women incorrectly believed it was normal to gain 20 kg of weight during pregnancy’. It was found that pregnant women with sufficient health literacy had higher levels of knowledge about antenatal care (p < 0.05). In this study, it was determined that approximately two-thirds of the participants had insufficient health literacy and the women with insufficient health literacy had low levels of knowledge about antenatal care.     

Impact of health literacy on health practices in the working life of young Japanese nurses and care workers

To continue to work healthily, health practices are necessary. This study assessed the impact of health literacy (HL) on health practices in the working life of young Japanese nurses and care workers, occupations with heavy physical and psychological burdens. A web-based survey was conducted with 500 women (330 nurses and 170 care workers) under the age of 30 in 2019. Data regarding their demographic characteristics, HL and health practices in their working life were collected. A significant association was found between high HL and better health practices, such as being likely to rest when tired, working at their own pace maintaining a good work-life balance and regularly performing self-check-ups, which were common to nurses and care workers. In addition, sub-analysis among the high-HL group revealed that the attendance of lectures regarding working life and health for new employees was effective for taking rest when needed, working when not overtired and a good work-life balance. The results of this study suggest that high HL relates to healthy practices in the working life of young Japanese nurses and care workers. Increasing HL or fundamentally enhancing attitudes towards their own health or both may, therefore, have some benefits for healthy working practices.     

Utilization of social workers in home care: An analysis of service use

ABSTRACT

Social workers are well positioned to address mental health complications impacting home care populations, yet social work has one of the lowest utilization rates of offered home care supports in Ontario. This study analyzed care plan data of frontline in-home social work services. Results identified adjustment to illness as the most common category and that seniors required significantly fewer visits and days on service than non-seniors. Most patients were able to accomplish their social work-based goals. Results highlight a need for further research and for capitalizing on the untapped potential value of social work home care services for patients.