Health literacy levels of hypertensive patients, their views on the quality of health care and related factors in a province

Yıl 2020, Cilt: 18 Sayı: 1, 10 - 25, 30.04.2020

Emine Öncü Sümbüle Köksoy Vayısoğlu Yasemin Güven Gamze Aktaş Halil Ceyhan Esra Karakuş

https://doi.org/10.20518/tjph.555354

Öz

Objective: Health literacy and the quality of health services
are important factors affecting health results in patients with chronic
diseases. This study aimed to determine the level of health literacy of a group
of chronically-ill patients and evaluate their opinions about the quality of
health services and related factors. Method: This
cross-sectional study was carried out between November 2017 and April 2018 with
300 hypertensive patients in four central disricts at Mersin. Data was obtained
using the Health Literacy Scale (HLS), Patient Assessment of Chronic Illness
Care (PACIC) and blood pressure measurements were taken. Data was analyzed by a
computer program using T-test, Mann-Whitney U, ANOVA, Kruskal-Wallis,
Chi-square and correlation analysis. Results: The
participants’ age was 48.92±15.01, 54.5% were woman, 61.2% had high blood
pressure. HLS avarage was 29.1 (21.8-36.3), the lowest
scores belonged to “health promotion”’ and “health service”. Males and
employees had higher scores than the others. The patients’ income was related
to the their HLS. As the HLS decreased, applications to
physicians were increased. Low HL was associated with high blood
pressure (p<0.05). PACIC subdimensions score mean was 2.84±0.96
(min-max=1-5). PACIC
total score was negatively correlated with age, duration of illness, number of
physician visits and positively associated with income and Health Literacy.
According to the presence of hypertension, there were no differences in PACIC scores (p>0.05).   Conclusion: Patients with inadequate/ limited health literacy
have become more difficult to blood pressure control. Their satisfaction is
limited despite their more frequent use of health services. There is a need to
develop monitoring of hypertensive patients with low / limited health literacy.

Anahtar Kelimeler

Hypertension, health literacy, use of health service, blood pressure control.

Bir il örneğinde hipertansiyon hastalarının sağlık okuryazarlık düzeyi, sağlık hizmetlerinin niteliğine ilişkin değerlendirmeleri ve ilişkili faktörler

Öz

Amaç: Sağlık
okuryazarlığı ve sağlık hizmetleri kullanımı kronik hastalıklarda sağlık
sonuçlarını etkileyen faktörlerdendir. Yapılan çalışmada bir il
merkezinde HT hastalarının sağlık okuryazarlık düzeyi ve sağlık hizmetlerinin niteliğine
ilişkin değerlendirmeleri ile ilişkili özelliklerin belirlemesi amaçlanmıştır. Yöntem: Mersin’de 23.11.17-23.04.18’de
sahada yürütülen kesitsel çalışmaya 300 hipertansiyon hastası katılmıştır.
Veriler Sağlık Okuryazarlığı Ölçeği, Kronik Hastalık Bakım Değerlendirme Ölçeği
ve tansiyon ölçümleriyle elde edilmiş; bir bilgisayar programı ile tanıtıcı
istatistikler, T-testi, Mann-Whitney U, ANOVA, Kruskal-Wallis, Ki-kare ve
korelasyon analizleri kullanılarak değerlendirilmiştir. Bulgular: Katılımcıların yaş ortalaması 48.92±15.01
yıl, %54.5’i kadın, %61.2’sinin tansiyonu yüksektir. Sağlık okuryazarlığı puan
ortancası (%25-%75) 29.1’dir (21.8-36.3). En düşük
puanlar “sağlığın geliştirilmesi” ve “sağlık hizmeti” alt boyutlarındadır.
Erkeklerin, çalışanların ölçek puanları daha yüksektir (p<0.01).
Gelir ile sağlık okuryazarlığı ilişkilidir. Sağlık okuryazarlık düzeyi düştükçe
hekime başvuru sayısı artmaktadır. Düşük/ sınırlı sağlık okuryazarlığı, yüksek
kan basıncıyla ilişkilidir (p<0.05). Kronik Hastalık Bakım Değerlendirme Ölçeğinin
alt boyutlarına ait madde puan ortalaması 2.84±0.96’dır
(min-maks=1-5).

Anahtar Kelimeler

Hipertansiyon, sağlık okuryazarlığı, sağlık hizmetleri kullanımı, tansiyon kontrolü.

Kaynakça

• 1. A global brief on Hypertension. www.who.int. Geneva, Switzerland: WHO Press, Inc.; 2013-4. Available at: https://apps.who.int/iris/bitstream/handle/10665/79059/WHO_DCO_WHD_2013.2_eng.pdf;jsessionid Accessed October 25, 2018.
• 2. Mills KT, Bundy JD, Kelly TN, et al. Global Disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. HHS Public Access. 2017;134(6):441–50.
• 3. Türkiye Endokrinoloji ve Metabolizma Derneği. Türkiye Endokrinoloji ve Metabolizma Derneği Hipertansiyon Tanı ve Tedavi Kılavuzu. 1. Basım, Ankara, Miki Matbaacılık San. ve Tic. Ltd. Şti, 2018: 1-7.
• 4. Warren-Findlow J, Hutchison J, Patel P, Dulin M, Tapp H, Kuhn L. Assessing health literacy of hypertensive patients in a primary care setting using a self-administered questionnaire. J Health Care Poor Underserved. 2014;25(4):1833–43.
• 5. Shi D, Li J, Wang Y, et al. Association between health literacy and hypertension management in a Chinese community: A retrospective cohort study. Intern Emerg Med. 2017;12(6):765–76.
• 6. Human Development Report 2016 Team. Human Development Report 2016 Human Development for Everyone. Canada, by the Lowe-Martin Group, 2016: 230–4. Available at: http://hdr.undp.org/sites/default/files/2016_human_development_report.pdf. Accessed Novamber 8, 2018
• 7. Willens DE, Kripalani S, Schildcrout JS, et al. Association of brief health literacy screening and blood pressure in primary care. J Health Commun. 2013;18(SUPPL. 1):129–42.
• 8. Shibuya A, Inoue R, Ohkubo T, et al. The relation between health literacy, hypertension knowledge, and blood pressure among middle-aged Japanese adults. Blood Press Monit. 2011;16(5):224–30.
• 9. Yilmazel G, Çetinkaya F. Relation between health literacy levels, hypertension awareness and control among primary-secondary school teachers in Turkey. AIMS Public Health. 2017;4(4):314–25.
• 10. Chajaee F, Pirzadeh A, Hasanzadeh A, Mostafavi F. Relationship between health literacy and knowledge among patients with hypertension in Isfahan province, Iran. Electron Physician. 2018;10(3):6470–7.
• 11. Banerjee S, Mukherjee TK, Basu S. Prevalence, awareness, and control of hypertension in the slums of Kolkata. Indian Heart J. 2016;68(3):286–94.
• 12. Sabouhi F, Babaee S, Naji H, Zadeh AH. Knowledge, awareness, attitudes and practice about hypertension in hypertensive patients referring to public health care centers in Khoor & Biabanak. Iran J Nurs Midwifery Res. 2011;16(1):34–40.
• 13. Raji YR, Abiona T, Gureje O. Awareness of hypertension and its impact on blood pressure control among elderly nigerians: Report from the Ibadan study of aging. Pan Afr Med J. 2017;27(190):1–14.
• 14. Levinthal BR, Morrow DG, Tu W, Wu J, Murray MD. Cognition and health literacy in patients with hypertension. J Gen Intern Med. 2008;23(8):1172–6.
• 15. Hutchison J, Warren-Findlow J, Dulin M, Tapp H, Kuhn L. The association between health literacy and diet adherence among primary care patients with hypertension. Journal of Health Disparities Research and Practice. 2014;7(2):109–26.
• 16. Kaya Ç, Akturan S, Şimşek M, Uğuz K, İçen F, Akman M. Kronik hastalık bakımının hasta perspektifinden değerlendirilmesi. Turkish Fam Physician. 2013;4(3):1–9.
• 17. Darvishpour J, Omidi S, Farmanbar R. The relationship between health literacy and hypertension treatment control and follow-up. Casp J Heal Res. 2016;2(1):1–8.
• 18. Veghari G, Sedaghat M, Maghsodlo S, et al. Impact of literacy on the prevalence, awareness, treatment and control of hypertension in adults in Golestan Province (northern Iran). Casp J Intern Med. 2013;4(1):580–4.
• 19. Powers BJ, Olsen MK, Oddone EZ, Thorpe CT, Bosworth HB. Literacy and blood pressure - Do healthcare systems influence this relationship? A cross-sectional study. BMC Health Serv Res. 2008;8:1–9.
• 20. İncirkuş K, Nahcivan N. Kronik Hastalık Bakımını Değerlendirme Ölçeği-Hasta Formu’nun Türkçe Versiyonu’nun geçerlik ve güvenirliği. DEUHYO ED. 2011;4(1):102–9.
• 21. Dede B, Sarı M, Gürsul A, et al. Kronik hastalığı nedeniyle ayaktan izlenen hastaların aldıkları sağlık hizmetlerinin niteliğini etkileyen değişkenler. TAF Prev Med Bull. 2016;15(3):238–47.
• 22. Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. Development and validation of the patient assessment of chronic ıllness care (PACIC). Med Care. 2005;43(5):436–44.
• 23. Öncü E, Köksoy Vayısoğlu S, Önen E. Bir il örneğinde sağlıkta dönüşüm sonrası I. basamak sağlık hizmetleri kullanımı ve ilişkili faktörler. J Hum Sci. 2017;14(4):4546–59.
• 24. Aboumatar HJ, Carson KA, Beach MC, Roter DL, Cooper LA. The impact of health literacy on desire for participation in healthcare, medical visit communication, and patient reported outcomes among patients with hypertension. J Gen Intern Med. 2013;28(11):1469-76.
• 25. Okyay P, Abacıgil F. Türki̇ye Sağlık Okuryazarlığı Ölçekleri̇ Güveni̇li̇rli̇k ve Geçerli̇li̇k Çalışması. 1. Basım, Ankara, Anıl Reklam Matbaa Ltd. Şti, 2016: 3-104.
• 26. Tanrıöver M, Yıldırım H, Ready N, Çakır B, Akalın E. Türki̇ye Sağlık Okuryazarlığı Araştırması. 1. Basım, Ankara, Sağlık_Sen Yayınları, 2014: 17-54.
• 27. Naimi AJ, Naderiravesh N, Bayat ZS, Shakeri N, Matbouei M. Correlation between health literacy and health-related quality of life in patients with hypertension, in Tehran, Iran, 2015-2016. Electron Physician. 2017;9(11):5712–20.
• 28. Joyner-Grantham J, Mount D, McCorkle O, Simmons D, Ferrario C, Cline D. Self-reported influences of hopelessness, health literacy, lifestyle action, and patient inertia on blood pressure control in a hypertensive emergency department population. Am J Med Sci. 2009;338(5):368–72.
• 29. Glasgow RE, Whitesides H, Nelson CC, King DK. Use of the patient assessment of chronic illness care (PACIC) with diabetic patients: Relationship to patient characteristics, receipt of care, and self-management. Diabetes Care. 2005;28(11):2655–61.
• 30. Akbolat M, Kahraman G, Eriguc G, Saglam H. Does patient-physician relationship affect health literacy?: A research in Sakarya Province. TAF Prev Med Bull. 2016;15(4):354.
• 31. Safeer RS, Keenan J. Health literacy: The gap between physicians and patients. Am Fam Physician. 2005;72(3):463–8.