Impact of Health Literacy on Time Spent Seeking Hand Care.
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ABSTRACT:
SUBMITTER: Alokozai A
PROVIDER: S-EPMC6109906 | biostudies-literature | 2018 Sep
REPOSITORIES: biostudies-literature
Publications
Impact of Health Literacy on Time Spent Seeking Hand Care.
Alokozai Aaron A Bernstein David N DN Sheikholeslami Nicole N Uhler Lauren L Ring David D Kamal Robin N RN
Hand (New York, N.Y.) 20170517 5
<h4>Background</h4>Patients with limited health literacy may have less knowledge and fewer resources for efficient access and navigation of the health care system. We tested the null hypothesis that there is no correlation between health literacy and total time spent seeking hand surgery care.<h4>Methods</h4>New patients visiting a hand surgery clinic at a suburban academic medical center were asked to complete a questionnaire to determine demographics, total time spent seeking hand surgery care ...[more]
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Project description:BACKGROUND:There has been a notable expansion in routine health care in sub-Saharan Africa. While heath care is nominally free in many contexts, the time required to access services reflects an opportunity cost that may be substantial and highly gendered, reflecting the gendered nature of health care guidelines and patterns of use. The time costs of health care use, however, have rarely been systematically assessed at the population-level. METHODS:Data come from the 2015 wave of a population-based cohort study of young adults in southern Malawi during which 1,453 women and 407 men between the ages of 21 and 31 were interviewed. We calculated the time spent seeking health care over a two-month period, disaggregating findings by men, recently-pregnant women, mothers with children under two years old, and "other women". We then extrapolated the time required for specific services to estimate the time that would be needed for each subpopulation to meet government recommendations for routine health services over the course of a year. RESULTS:Approximately 60% of women and 22% of men attended at least one health care visit during the preceding two months. Women spent six times as long seeking care as did men (t = -4.414, p<0.001), with an average 6.4 hours seeking care over a two-month period compared to 1 hour for men. In order to meet government recommendations for routine health services, HIV-negative women would need to spend between 19 and 63 hours annually seeking health care compared to only three hours for men. An additional 40 hours would be required of HIV-positive individuals initiating antiretroviral care. CONCLUSIONS:Women in Malawi spend a considerable amount of time seeking routine health care services, while men spend almost none. The substantial time women spend seeking health care exacerbates their time poverty and constrains opportunities for other meaningful activities. At the same time, few health care guidelines pertain to men who thus have little interaction with the health care system. Additional public health strategies such as integration of services for those services frequently used by women and specific guidelines and outreach for men are urgently needed.
| S-EPMC6303093 | biostudies-literature
Project description:BackgroundThe National Institutes of Health, American Medical Association, and US National Library of Medicine recommend that educational material for patients be written at a sixth-grade reading level. The purpose of this study is to assess the complexity of hand surgery information on academic plastic and orthopedic surgery websites.MethodsAn online search was performed for all hand surgery patient education materials provided by institutions with plastic and orthopedic surgery training programs. Readability analyses were conducted using the Flesch-Kincaid Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook Index, Gunning Fog Score, Automated Readability Index, and Coleman-Liau Index. A 2-tailed z test was used to compare means.ResultsSeventy-six institutions with both plastic and orthopedic surgery training programs were identified; 42 had educational material available online. The average readability for all hand-related information was at the 11.92 grade reading level. Information regarding de Quervain tenosynovitis had the highest grade level for all plastic surgery procedures (13.45). Hand arthritis had the highest grade level for all orthopedic surgery procedures (12.82). Ganglion cysts had the lowest grade level for both plastic and orthopedic surgery (10.15 and 11.01, respectively; P = .12). Carpal tunnel release was the most commonly described procedure overall. There were no differences in text complexity among geographic regions.ConclusionsOnline patient resources for common hand ailments are too complex for the average patient to understand. Efforts should be made to provide materials at the recommended sixth-grade reading level to improve patient education and improve the physician-patient relationship.
| S-EPMC6109909 | biostudies-literature
Project description:ObjectiveIn the United States, caregivers of children and youth with special health care needs (CYSHCN) must navigate complex, inefficient health care and insurance systems to access medical care. We assessed for sociodemographic inequities in time spent coordinating care for CYSHCN and examined the association between time spent coordinating care and forgone medical care.MethodsThis cross-sectional study used data from the 2018-2020 National Survey of Children's Health, which included 102,740 children across all 50 states. We described the time spent coordinating care for children with less complex special health care needs (SHCN) (managed through medications) and more complex SHCN (resulting in functional limitations or requiring specialized therapies). We examined race-, ethnicity-, income-, and insurance-based differences in time spent coordinating care among CYSHCN and used multivariable logistic regression to examine the association between time spent coordinating care and forgone medical care.ResultsOver 40% of caregivers of children with more complex SHCN reported spending time coordinating their children's care each week. CYSHCN whose caregivers spent ≥ 5 h/wk on care coordination were disproportionately Hispanic, low-income, and publicly insured or uninsured. Increased time spent coordinating care was associated with an increasing probability of forgone medical care: 6.7% for children whose caregivers spent no weekly time coordinating care versus 9.4% for< 1 hour; 11.4% for 1 to 4 hours; and 15.8% for ≥ 5 hours.ConclusionsReducing time spent coordinating care and providing additional support to low-income and minoritized caregivers may be beneficial for pediatric payers, policymakers, and health systems aiming to promote equitable access to health care for CYSHCN.
| S-EPMC10495536 | biostudies-literature
Project description:IntroductionFamily carers are cornerstones in the care of older people living with dementia. Family carers report extensive carer burden, reduced health-related quality of life (HRQoL), and extensive time spent on informal care (Time). Health literacy (HL) is a concept associated with people's ability to access health services, and navigate the healthcare system. This study's aim was to investigate HL among family carers, and investigate the associations between HL and carer burden, HRQoL, and Time spent on informal care.MethodWe designed a self-administered survey comprising validated instruments, including the Health Literacy Scale (HLS-N-Q12) to measure HL, Relative Stress Scale (RSS) to measure carer burden, the EQ-5D-5L instrument to measure HRQoL, and some modified questions from the Resource Utilization in Dementia (RUD) questionnaire to measure time spent on informal care (Time). Descriptive analysis in addition to bivariate and multiple linear regressions were undertaken. In multiple linear regression analysis, we used HL as the independent variable to predict the outcomes (carer burden, HRQoL, Time). Analyses were adjusted for the effects of explanatory independent variables: age, gender, education levels, urban residency, having worked as health personnel, caring for someone with severe/mild dementia, and being born abroad.FindingsIn a non-probability sample of 188 family carers from across Norway, most of them female and over the age of 60, we found high levels of HL. In the bivariate analysis, carer burden and HRQoL (EQvalue) showed significant associations with HL. In the multiple regression analyses, HL was statistically significantly associated with carer burden (B = -0.18 CI:-0.33,-0.02 p = 0.02), HRQoL (EQvalue: B = 0.003 with 95% CI: 0.001, 0.006 p = 0.04), and Time (B = -0.03 with 95% CI: -0.06, 0.000, p = 0.046), after adjusting for the effect of independent variables.ConclusionThis is one of the first studies to investigate the associations between HL and different outcomes for family carers of older people living with dementia. Additional research into the associations identified here is needed to further develop our understanding of how to support family carers in their roles. Targeted support that increases family carers' HL may have potential to enhance their ability to provide sustainable care over time.
| S-EPMC7678960 | biostudies-literature
Project description:ObjectivesThis study aims to examine a novel patient-centered metric of time spent engaging in left ventricular assist device (LVAD)-related clinical care outside the home.BackgroundAlthough LVAD implantation can improve survival and functional capacity in patients with advanced heart failure, this may occur at the expense of significant time spent engaging in LVAD-related health care activities.MethodsThe authors retrospectively assessed consecutive patients at a single center who received a continuous-flow LVAD between May 9, 2008, and December 31, 2019, and queried health care encounters after implantation, including all inpatient encounters and LVAD-related ambulatory encounters. Patient-level time metrics were determined, including the total number of days with any health care encounter, and the total estimated time spent receiving care. The primary outcome was the proportion (%) of days alive with an LVAD spent engaged in at least 1 health care encounter. The secondary outcome was the proportion (%) of total time alive with an LVAD spent receiving care.ResultsAmong 373 patients, the median number of days alive with LVAD was 390 (IQR: 158-840 days). Patients had a median number of 88 (IQR: 45-161) days with ≥1 health care encounter, accounting for 23.2% (IQR: 16.3%-32.4%) of their days alive with an LVAD. A median 6.0% (IQR: 2.1%-14.1%) and 15.0% (IQR: 10.7%-20.0%) of total days alive were spent in inpatient and ambulatory encounters, respectively. Patients spent a median of 592 (IQR: 197-1,257) hours receiving care, accounting for 5.6% (IQR: 2.2%-12.7%) of their total time alive with an LVAD.ConclusionsLVAD patients spent more than 1 of every 5 days engaging in health care. Our findings may inform strategies to improve efficiency of postdischarge care delivery and expectations for post-treatment care.
| S-EPMC9908068 | biostudies-literature
Project description:ObjectiveWe examined the impact of language preference and health literacy on health information-seeking experiences in a multilingual, low-income cohort.MethodsWe administered a modified Health Information National Trends Survey in English, Spanish, and Chinese to a sample of San Francisco city/county residents. Using multivariable logistic regression analyses, we assessed how language and health literacy impact health information-seeking experiences (confidence, effort, frustration, quality concerns, and difficulty understanding information), adjusting for age, gender, race/ethnicity, education, usual place of care, health status, information-seeking behaviors, and smartphone ownership.ResultsOf 1000 participants (487 English-speaking, 256 Spanish-speaking, 257 Chinese-speaking), 820 (82%) reported at least one negative health information-seeking experience. Chinese-language was associated with frustration (aOR = 2.56; 1.12-5.86). Difficulty understanding information was more likely in Spanish-language respondents (aOR = 3.58; 1.25-10.24). Participants with limited health literacy reported more effort (aOR = 1.97; 1.22-3.17), frustration (aOR = 2.09; 1.28-3.43), concern about quality (aOR = 2.72; 1.60-4.61), and difficulty understanding information (aOR = 2.53; 1.58-4.05). Language and literacy impacted confidence only in the interaction term between Chinese-speakers and health literacy.ConclusionWe found that negative health information-seeking experiences were common in non-English speaking populations those with limited health literacy.Practice implicationsHealth communication efforts should consider both language preference and health literacy to ensure accessibility for all patients.
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Project description:ImportancePrimary care physicians (PCPs) spend the most time on the electronic health record (EHR) of any specialty. Thus, it is critical to understand what factors contribute to varying levels of PCP time spent on EHRs.ObjectiveTo characterize variation in EHR time across PCPs and primary care clinics, and to describe how specific PCP, patient panel, clinic, and team collaboration factors are associated with PCPs' time spent on EHRs.Design, setting, and participantsThis cross-sectional study included 307 PCPs practicing across 31 primary care clinics at Massachusetts General Hospital and Brigham and Women's Hospital during 2021. Data were analyzed from October 2022 to October 2023.Main outcomes and measuresTotal per-visit EHR time, total per-visit pajama time (ie, time spent on the EHR between 5:30 pm to 7:00 am and on weekends), and total per-visit time on the electronic inbox as measured by activity log data derived from an EHR database.ResultsThe sample included 307 PCPs (183 [59.6%] female). On a per-visit basis, PCPs spent a median (IQR) of 36.2 (28.9-45.7) total minutes on the EHR, 6.2 (3.1-11.5) minutes of pajama time, and 7.8 (5.5-10.7) minutes on the electronic inbox. When comparing PCP time expenditure by clinic, median (IQR) total EHR time, median (IQR) pajama time, and median (IQR) electronic inbox time ranged from 23.5 (20.7-53.1) to 47.9 (30.6-70.7) minutes per visit, 1.7 (0.7-10.5) to 13.1 (7.7-28.2) minutes per visit, and 4.7 (4.1-5.2) to 10.8 (8.9-15.2) minutes per visit, respectively. In a multivariable model with an outcome of total per-visit EHR time per visit, an above median percentage of teamwork on orders was associated with 3.81 (95% CI, 0.49-7.13) minutes per visit fewer and having a clinic pharmacy technician was associated with 7.87 (95% CI, 2.03-13.72) minutes per visit fewer. Practicing in a community health center was associated with fewer minutes of total EHR time per visit (5.40 [95% CI, 0.06-10.74] minutes).Conclusions and relevanceThere is substantial variation in EHR time among individual PCPs and PCPs within clinics. Organization-level factors, such as team collaboration on orders, support for medication refill functions, and practicing in a community health center, are associated with lower EHR time for PCPs. These findings highlight the importance of addressing EHR burden at a systems level.
| S-EPMC10665969 | biostudies-literature
Project description:BackgroundPrevious research suggests that it would be useful to view health literacy as a set of 'distributed competencies', which can be found dispersed through the individual's social network, rather than an exclusively individual attribute. However, to date there is no focused exploration of how distributed health literacy has been defined, conceptualized or assessed in the peer-reviewed literature.AimsThis systematic review aimed to explore: (1) definitions and conceptual models of distributed health literacy that are available from the peer-reviewed literature; and (2) how distributed health literacy has been measured in empirical research.MethodsWe searched MEDLINE, Embase, CINAHL, PsycInfo, Scopus, ERIC and Web of Science using truncated versions of the keywords 'literacy' and 'distributed' (within five words' distance). We collated the definitions and conceptual models of distributed health literacy, and report on how health literacy has been measured in empirical research studies. Findings related to distributed health literacy from included manuscripts were synthesized using thematic synthesis.ResultsOf the 642 studies screened, 10 were included in this systematic review. The majority were empirical manuscripts reporting on qualitative research in one of five countries, with two reviews, one conceptual analysis and one quantitative study. Edwards' definition of distributed health literacy, which emphasizes the health literacy abilities, skills and practices of others that contribute to an individual's level of health literacy was widely applied in a variety of clinical and geographical settings. However, we did not identify any quantitative instruments which directly measured distributed health literacy. There was significant variability in questions used to explore the concept qualitatively, and discrepancies across studies in regard to (a) what constitutes distributed health literacy and what does not (e.g., general social support), and (b) the relationship between distributed health literacy and other constructs (e.g., public health literacy).ConclusionAlthough there is a widely applied definition of distributed health literacy, our review revealed that the research space would benefit from the development of the concept, both theoretically for example via conceptual distinctions between distributed health literacy and other types of social support, and empirically for example through the development of a quantitative measurement instrument.Patient or public contributionThis paper is a systematic review and did not involve patients or the public.
| S-EPMC9122402 | biostudies-literature
Project description:Health literacy has been reported to have effects on health behavior change and health-related outcomes, but few studies have explored the association between health literacy and frailty. The aim of our study is to investigate the relationships between health literacy and frailty among community-dwelling seniors. This cross-sectional study enrolled 603 community-dwelling older adults (307 women) in residential areas, with a mean age of 70.9 ± 5.82 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Physical frailty was defined by Fried frailty phenotype. Logistic regression was carried out to determine potential risk factors of frailty. In the multivariate logistic regression model, physical activity (Odds Ratio [OR] 1.47, 95% Confidence Interval [CI] 1.06⁻2.03) and health literacy (sufficient vs. excellent: OR 2.51, 95% CI 1.32⁻4.77) were associated with prefrailty and frailty. In subgroup analysis, pre-frailty and frailty were also negatively associated with health literacy in individuals with 'insufficiently active' (inadequate vs. excellent: OR 5.44, 95% CI 1.6⁻18.45) and 'sufficiently/highly active' physical activity levels (sufficient vs. excellent: OR 2.41, 95% CI 1.07⁻5.42). Therefore, in these community-dwelling elderly adults, health literacy was associated with pre-frailty and frailty regardless of age, gender, socio-economic status, and education level.
| S-EPMC6307088 | biostudies-other
Project description:Mental health literacy (MHL) is recognised as a major factor in whether athletes seek help when they experience mental health difficulties. Therefore, the current study aimed to provide a systematic review of the effectiveness of MHL training programmes in improving mental health knowledge and help-seeking and reducing stigma among athletes. To identify intervention studies of MHL programmes, five electronic databases were systematically searched for articles published before May 2020. The selection procedure was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All kinds of study designs were included. Effect sizes were calculated for mental health knowledge, stigma reduction and help-seeking attitudes, intentions and behaviours. Risk of bias was assessed for each study using the Cochrane tool and the Newcastle-Ottawa quality assessment scale. Five studies (1239 participants in total) were selected for review. Overall, either small or medium effects were found for mental health knowledge, stigma reduction, help-seeking attitudes, and intentions for post- and follow-up interventions, whereas a null effect was found in help-seeking behaviours for both post- and follow-up interventions. Furthermore, three studies had a low risk of bias, and two had a high risk of bias. MHL interventions can enhance help-seeking attitudes and intentions and mental health knowledge and reduce stigma but do not increase help-seeking behaviours for now. Further studies should evaluate interventions to enhance help-seeking behaviours. Furthermore, the methodological quality of studies, including randomized controlled trials and other designs, should be improved in future research.
| S-EPMC7579198 | biostudies-literature