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      Improving Self-Care Management in Patients with Breast Cancer through Health Literacy Promotion

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          Abstract

          Background

          Self-care is one of the most important principles of life and the successful treatment of patients diagnosed with cancer. Also, the first step and the most effective factor for self-care is health literacy. Thus, the aim of this study is to evaluate the relationship between level of health literacy and self-care ability in patients diagnosed with breast cancer.

          Method

          Using an analytical-descriptive approach, the present study was conducted using a random access method among 120 patients diagnosed with breast cancer referring to Imam Reza Hospital of Tabriz University of Medical Sciences, during 2019. The data was gathered using two standard self-care questionnaires in patients diagnosed with breast cancer (SCHFIV6.2) and Health Literacy for Iranian Adults (HELIA). Data analysis was conducted using SPSS v22, through Pearson correlation tests and linear regression analysis.

          Results

          The results indicate a positive and significant relationship among dimensions of health literacy including access, reading, appraisal, decision, and understanding, and dimensions of self-care including self-care maintenance, self-care management, and self-care confidence. Other findings show that reading, access and decisions have a direct and significant effect on self-care ability (P-value ≤0.01).

          Conclusion

          With regard to the direct and significant relationship of health literacy and self-care dimensions in patients diagnosed with breast cancer, enhancing their health literacy can result in improved self-care among them. In addition, due to the increasingly high prevalence of this disease among women, improving their health literacy can be effective in the treatment of this disease or in enhancing their quality of life.

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          An update on the self-care of heart failure index.

          Barbara Riegel, Christopher S D Lee, Victoria Vaughan Dickson … (2015)
          The Self-care of Heart Failure Index (SCHFI) is a measure of self-care defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiological stability (maintenance) and the response to symptoms when they occur (management). In the 5 years since the SCHFI was published, we have added items, refined the response format of the maintenance scale and the SCHFI scoring procedure, and modified our advice about how to use the scores. The objective of this article was to update users on these changes. In this article, we address 8 specific questions about reliability, item difficulty, frequency of administration, learning effects, social desirability, validity, judgments of self-care adequacy, clinically relevant change, and comparability of the various versions. The addition of items to the self-care maintenance scale did not significantly change the coefficient alpha, providing evidence that the structure of the instrument is more powerful than the individual items. No learning effect is associated with repeated administration. Social desirability is minimal. More evidence is provided of the validity of the SCHFI. A score of 70 or greater can be used as the cut-point to judge self-care adequacy, although evidence is provided that benefit occurs at even lower levels of self-care. A change in a scale score more than one-half of an SD is considered clinically relevant. Because of the standardized scores, results obtained with prior versions can be compared with those from later versions. The SCHFI v.6 is ready to be used by investigators. By publication in this format, we are putting the instrument in the public domain; permission is not required to use the SCHFI.
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            Association of health literacy with diabetes outcomes.

            Dean Schillinger, Kevin Grumbach, John D. Piette … (2015)
            Health literacy is a measure of patients' ability to read, comprehend, and act on medical instructions. Poor health literacy is common among racial and ethnic minorities, elderly persons, and patients with chronic conditions, particularly in public-sector settings. Little is known about the extent to which health literacy affects clinical health outcomes. To examine the association between health literacy and diabetes outcomes among patients with type 2 diabetes. Cross-sectional observational study of 408 English- and Spanish-speaking patients who were older than 30 years and had type 2 diabetes identified from the clinical database of 2 primary care clinics of a university-affiliated public hospital in San Francisco, Calif. Participants were enrolled and completed questionnaires between June and December 2000. We assessed patients' health literacy by using the short-form Test of Functional Health Literacy in Adults (s-TOFHLA) in English or Spanish. Most recent hemoglobin A(1c) (HbA(1c)) level. Patients were classified as having tight glycemic control if their HbA(1c) was in the lowest quartile and poor control if it was in the highest quartile. We also measured the presence of self-reported diabetes complications. After adjusting for patients' sociodemographic characteristics, depressive symptoms, social support, treatment regimen, and years with diabetes, for each 1-point decrement in s-TOFHLA score, the HbA(1c) value increased by 0.02 (P =.02). Patients with inadequate health literacy were less likely than patients with adequate health literacy to achieve tight glycemic control (HbA(1c) or = 9.5%; adjusted OR, 2.03; 95% CI, 1.11-3.73; P =.02) and to report having retinopathy (adjusted OR, 2.33; 95% CI, 1.19-4.57; P =.01). Among primary care patients with type 2 diabetes, inadequate health literacy is independently associated with worse glycemic control and higher rates of retinopathy. Inadequate health literacy may contribute to the disproportionate burden of diabetes-related problems among disadvantaged populations. Efforts should focus on developing and evaluating interventions to improve diabetes outcomes among patients with inadequate health literacy.
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              Patients' shame and attitudes toward discussing the results of literacy screening.

              Michael Wolf, Shital Parikh, Donna Parker … (2007)
              We investigated patients' willingness to have their reading ability documented in their medical records and the degree of shame and embarrassment associated with such disclosure. Structured interviews were conducted among a consecutive sample of 283 primary care patients at an urban public hospital. Patients' literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Self-report of degree of shame and embarrassment related to literacy skills was measured using an orally administered questionnaire. Fifty-one percent of patients had low literacy skills (< or =sixth grade) and 27.9% were assessed as having marginal literacy (seventh-eighth grade). Half (47.6%) of patients reading at or below the third-grade level admitted feeling ashamed or embarrassed about their difficulties reading, compared with 19.2% of those reading at the fourth-sixth-grade level and 6.5% of those reading at the seventh-eighth-grade level (p < 0.001). More than 90% of patients with low or marginal literacy reported it would be helpful for the doctor or nurse to know they did not understand some medical words. Patients with limited literacy were more likely to report feelings of shame as a result of disclosure (p < 0.05). Health care providers must recognize the potential shame patients might experience as a result of literacy screening.
              Article 0 comments Cited 42 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ethiop J Health Sci
                Journal ID (iso-abbrev): Ethiop J Health Sci
                Title: Ethiopian Journal of Health Sciences
                Publisher: Research and Publications Office of Jimma University (Jimma, Ethiopia )
                ISSN (Print): 1029-1857
                ISSN (Electronic): 2413-7170
                Publication date (Print): January 2021
                Volume: 31
                Issue: 1
                Pages: 85-90
                Affiliations
                [1 ] School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
                [2 ] Department of Medical Library and Information Sciences, Iranian Center of Excellence in Health Management (IceHM), School of Health Management and Medical Informatics, Tabriz University of Medical sciences, Tabriz, Iran
                [3 ] Hematology and Oncology Research Center, Tabriz University of medical sciences. Tabriz, Iran
                [4 ] Student Research Committee of Tabriz University of Medical Sciences, Faculty of Management and Information, Tabriz University of Medical Sciences, Tabriz, Iran
                Author notes

                Funding: Tabriz University of Medical Sciences

                Competing Interests: The authors declare that this manuscript was approved by all authors in its form and that no competing interest exists.

                Article
                Publisher ID: jEJHS.v31.i1.pg85
                DOI: 10.4314/ejhs.v31i1.10
                PMC ID: 8188109
                PubMed ID: 34158755
                SO-VID: 5bed37e4-bb9a-4c2c-a246-34aa533dcfbf
                Copyright © © 2021 Ahmadzadeh Isa. et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 25 July 2020
                Date accepted : 2 August 2020
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: health literacy,self-care,breast cancer,breast neoplasms,self-care maintenance,self-care management,self-care confidence
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: health literacy, self-care, breast cancer, breast neoplasms, self-care maintenance, self-care management, self-care confidence

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