Health Literacy in Kidney Disease: Associations with Quality of Life and Adherence

• Published in: Journal of renal care Vol. 46; no. 2; pp. 85 - 94
• Main Authors: Elisabeth Stømer, Une, Klopstad Wahl, Astrid, Gunnar Gøransson, Lasse, Hjorthaug Urstad, Kristin
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-06-2020; European Dialysis and Transplant Nurses Associatio
• Edition: English ed.
• Subjects: Adherence to long‐term therapy; Chronic kidney disease; Female; Health education; Health literacy; Health Literacy - standards; Health Literacy - statistics & numerical data; Humans; Kidney diseases; Kidney Diseases - complications; Kidney Diseases - psychology; Male; Middle Aged; Nursing; Patient compliance; Patient‐reported outcome measures; Quality of life; Quality of Life - psychology; Surveys and Questionnaires; Treatment Adherence and Compliance - psychology; Norway; Health literacy; Chronic kidney disease; Adherence to long-term therapy; Patient-reported outcome measures; Quality of life
• ISSN: 1755-6678; 1755-6686
• DOI: 10.1111/jorc.12314

SUMMARY
Background
Health literacy (HL) is a multidimensional concept with significance for self‐management and health outcomes in patients with chronic kidney disease (CKD); however, research with a multidimensional perspective on HL is scarce.
Objectives
This study aimed to explore the relationship between multidimensional HL, quality of life (QoL) and adherence to long‐term therapy in CKD patients.
Design
A descriptive single‐centre cross‐sectional study.
Participants
Patients with CKD in stages 3–5 were recruited from the nephrology unit in a Norwegian hospital.
Measurements
The Health Literacy Questionnaire (HLQ) was used to assess HL, QoL was measured by the Short Form‐12 (SF‐12) and a Visual Analogue Scale (VAS‐QoL). Adherence to long‐term therapy was measured by the Medical Adherence Rating Scale 5 (MARS‐5), participants' prescription withdrawals from pharmacies, and a VAS (VAS‐adherence). Hierarchical cluster analysis was performed to group patients with similar HLQ scores, and multiple linear regression analysis was performed to identify the HL dimensions that were associated with QoL and adherence to long‐term therapy.
Results
A total of 187 patients were included, 65% were male, and the mean (SD) age was 67 (13) years. The high‐level HL group (N = 52) had significantly better QoL than patients in the mid‐level (N = 106) and low‐level (N = 27) HL groups. The HL dimensions “actively managing health,” “actively engage with healthcare providers,” “ability to find good health information” and “ability to understand health information” were predictive of QoL and adherence to long‐term therapy.
Conclusion
HL seems to be important for both QoL and adherence to long‐term therapy.