ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Sabooteh   S. (1)
Shahnazi   H. (*1)
Mostafavi   F. (1)






(1) Health Education & Promotion Department, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence

Address: Health Faculty, Isfahan University of Medical Sciences, Hezarjerib Street, Isfahan, Iran. Postal Code:8144504500
Phone: +98 (31) 37923243
Fax: +98 (31) 36682509

Article History

Received:  August  27, 2018
Accepted:  November 10, 2018
ePublished:  March 19, 2019

BRIEF TEXT


Elderly people with low levels of health literacy, as one of the most at-risk groups, have some problems regarding the perception of information related to their health.

... [1-5]. Health literacy has been defined as the ability to access, understand and use information and health concepts that have a beneficial effect on the health of the individual [6]. ... [7-8]. In Tehrani et al. study, 56.6% of the subjects had inadequate health literacy and only 1.28% had a high level of health literacy [9]. ... [10-15]. In the study by Reisi et al., 6.79% of the elderly had inadequate health literacy, 6.11% had marginal, and only 8.8% had adequate health literacy [16]. The study of Izadi Rad & Zareban showed that only 32% of the participants had adequate health literacy, and it was dropped by aging [17]. ... [18, 19].

This study was conducted with the aim of determining health literacy status in elderly population of Dorood, Iran.

This research is a cross sectional descriptive-analytical study.

This study was conducted on 220 elderly referring to health centers in Dorood in 2017.

The stratified random sampling method was done and 222 elderly aged 60 years and older were enrolled in the study. Sample size according to the sample size formula in the cross-sectional studies (at least 197 people) and with a possible falling of 15% was estimated 232 people. Ten people were excluded from the study due to incomplete completion of the questionnaire and, as a result, 222 elderly studies. The inclusion criteria were reading and writing literacy to complete the questionnaire. Elderly with perception or psychological problems, or those unwillingness to participate in the study, were not included in the study.

Demographic data of the elderly, including age, sex, marital status, educational level and economic status were collected through a questionnaire. To assess health literacy, the Test of Functional Health Literacy in Adults (TOFHLA) was used [16], which is one of the most comprehensive and commonly used tools for measuring health literacy. The reliability of this questionnaire in Raeesi et al. study in the evaluation and understanding stages was confirmed by Cronbach's alpha coefficient of 0.79 and 0.88, respectively [16]. To perform the study, the questionnaire was completed by the elderly by referring to selected health centers. In cases where elderly people had difficulty reading and completing the questionnaire, interviewing method was used for data collection. At each stage of the completion of the questionnaire, a member of the research team attended the elderly to provide him with guidance as needed. Data were analyzed by SPSS 20 software using Pearson and Spearman correlation tests, independent T-test and one-way analysis of variance.

The mean age of participants was 66.29±7.57 years with the age range of 60 to 92 years. 51.4% of participants were female and most of them were married (76.1%). The highest level of education (81.1%) was below diploma. In terms of economic status, 74.4% of the elderly had an income below 800 thousand Tomans. There was no significant relationship between sex and marital status with health literacy (p>0.05), but there was a significant relationship between education and income levels with health literacy level (p<0.05; Table 1). The mean score of total health literacy in the subjects was 56.45±19.9 and the mean score of health literacy in the elderly in the evaluation and reading obtained 21.95±13.90 and 34.50 ± 10.30, respectively. 133 elderly (59.9%) had inadequate health literacy, 39 elderly (17.6%) had marginal and 50 subjects (22.5%) had adequate health literacy. There was a significant correlation between age and general health literacy and its dimensions, so that older cases showed more inadequate level of health literacy. There was a significant correlation between the level of health literacy with household income and education level; as the level of illiteracy was inadequate in people with lower education and lower income levels (Table 2). According to the source of health information and diseases, 51.4% of the elderly had their health information via radio and television, 28.4% through family and friends, 14% from health staff and 6.3% from newspaper and magazine. Thus, radio and television, and then family and friends were named as the most important sources of health information and disease in the elderly (Table 3).

... [20-34]. In this study, there was a significant correlation between the level of health literacy and income level, as those with higher income had higher health literacy. People with higher economic status are more likely to have higher education and access to health education. In this regards, the results of studies by Ghanbari et al. [12], Reisi et al. [16], Javadzade et al. [22], Mollakhalili et al. [29], Tavousi et al. [21] and Lee et al. [34] are consistent with the results of this study. However, there was no significant statistical relationship between the level of health literacy and the income level of the patients in the study of Mollakhalili et al. [29] and Seyedoshohadaei et al. [31]. ... [35].

It is suggested that similar studies be conducted in other cities of Iran so that the results of these studies and the factors affecting health literacy can be used to design effective interventions to improve the health literacy of the elderly.

Data collection in this study partly done by was self-report, which could be considered as a limitation of the present study.

The health literacy of elderlies is low in Dorood and the level of inadequate health literacy is less common in people with older ages, lower education, and lower income levels.

The authors are grateful to all who helped to perform this study.

None declared.

The present study is approved by the ethics committee of Isfahan University of Medical Sciences (Ethics code: IR.MUI.REC.1396.1.075).

This research project was sponsored by the Student Research Committee of Isfahan University of Medical Sciences.

TABLES and CHARTS

Show attach file


CITIATION LINKS

[1]Hojjati H, Koochaki G, Sanagoo A.The relationship between loneliness and life satisfaction of the elderly in Gorgan and Gonbad cities. J Res Dev Nurs Midwifery. 2012;9(1):61-8. [Persian]
[2]Aghamolaei T, Hasani L. Communication barriers among nurses and elderly patients. Hormozgan Med J. 2011;14(4):312-8. [Persian]
[3] Sanagoo A, Bazyar A, Chehrehgosha M, Gharanjic S, Noroozi M, Pakravanfar S, et al . People attitude toward elderly in Golestan province, 2009. J Res Dev Nurs Midwifery. 2012;8(2):24-9. [Persian]
[4]Adib Hajbagheri M, Akbari H. The severity of old age disability and its related factors. Feyz. 2009;13(3):225-34. [Persian]
[5]Tsai TI, Lee SY, Tsai YW, Kuo KN. Methodology and validation of health literacy scale development in Taiwan. J Health Commun. 2011;16(1):50-61.
[6]James BD, Boyle PA, Bennett JS, Bennett DA. The impact of health and financial literacy on decision making in community-based older adults. Gerontology. 2012;58(6):531-9.
[7]Sihota S, Lennard L. Health literacy being able to make the most of health. London: National Consumer Council; 2004.
[8] Panahi R, Ebrahimi Gh, Ahmadi A. Health literacy: a key component of controlling social determinants of health. J Educ Community Health. 2018;5(1):1-3. [Persian]
[9]Tehrani Banihashemi SA, Amirkhani MA, Haghdoost AA, Alavian SM, Asgharifard H, Baradaran H, et al . Health literacy and the influencing factors: a study in five provinces of Iran. Strides Dev Med Educ. 2007;4(1):1-9. [Persian]
[10]Kanj M, Mitic W. Promoting Health and Development: Closing the Implementation Gap. The 7th Global Conference on Health Promotion. Nairobi, Kenya: World Health Organization; 2009.
[11]Ferguson LA, Pawlak, R. Health literacy: the road to improved health outcomes. J Nurse Pract. 2011;7(2):123-9.
[12]Ghanbari Sh, Majlesi F, Ghaffari M, Mahmoodi Majdabadi M. Evaluation of health literacy of pregnant women in urban health centers of Shahid Beheshti Medical University. Daneshvar Med. 2012;19(97):1-12. [Persian]
[13]Scott TL, Gazmararian JA, Williams MV, Baker DW. Health literacy and preventive health care use among Medicare enrollees in a managed care organization. Med Care. 2002;40(5):395–404.
[14]Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: Longitudinal cohort study. Br Med J. 2012;344(3):2-10.
[15] North Carolina Institute of Medicine. Just What Did the Doctor Order? Addressing Low Health Literacy in North Carolina [Internet]. Morrisville, North Carolina: North Carolina Institute of Medicine; 2007 [cited 2018 Nov 22]. Available from: http://nciom.org/what-did-the-doctor-order-addressing-low-health-literacy-in-north-carolina/
[16]Reisi M, Mostafavi F, Hasanzadeh A, Sharifi Rad Gh. The relationship between health literacy, health status and healthy behaviors among elderly in Isfahan. J Health Syst Res. 2011;7(4):469-80. [Persian]
[17] Izadi Rad H, Zareban I. The relationship of health literacy with health status, preventive behaviors and health services utilization in Baluchistan, Iran. J Educ Community Health. 2015;2(3):43-50. [Persian]
[18] Kooshyar H, Shoorvazi M, Dalir Z, Hosseini M. Health literacy and its relationship with medical adherence and health-related quality of life in diabetic community-residing elderly. J Mazandaran Univ Med Sci. 2014;23(1):134-43. [Persian]
[19] Mohseni M, Khanjani N, Iranpour A, Tabe R, Borhaninejad VR. The relationship between health literacy and health status among elderly people in Kerman. Salmand. 2015;10(2):146-55. [Persian]
[20] Headley AJ, Harrigan J. Using the pregnancy perception of risk questionnaire to assess health care literacy gaps in maternal perception of prenatal risk. J Natl Med Assoc. 2009;101(10):1041-5.
[21] Tavousi M, Haeri Mehrizi AA, Rafieifar Sh, Soleimanian A, Sarbandi F, Ardestani M, et al. Health literacy in Iran: findings from a national study. Payesh. 2016;15(1):95-102. [Persian]
[22] Javadzade H, Sharifi Rad Gh, Reisi M, Tavassoli E, Rajati F. Health literacy among adults of Isfahan, Iran. J Health Syst Res. 2013;9(5):540-9. [Persian]
[23]Asna Ashari F, Pirdehghan A, Rajabi F, Sayyarifard A, Ghadirian L, Rostami N, et al. The study of health literacy of staff about risk factors of chronic diseases in 2014. Avicenna J Clin Med. 2015;22(3):248-54. [Persian]
[24] Nekoei Moghadam M, Parva S, Amiresmaeili, Baneshi M. Health literacy and utilization of health services in Kerman urban area 2011. Toloo-e-behdasht. 2013;11(4):123-34. [Persian]
[25]Ramezankhani A, Ghaffari M, Rakhshani F, Ghanbari Sh, Azimi S. Comparison of health literacy between medical and non-medical students in Shahid Beheshti Universities in the academic. Pajoohandeh. 2015;20(2):78-85. [Persian]
[26]Kutner MA, National Center for Education Statistics. The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. Washington D.C.: Department of Education, National Center for Education Statistics; 2006.
[27]Heinrich C. Health literacy: the sixth vital sign. J Am Acad Nurse Pract. 2012;24(4):218-23.
[28]von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behavior in a national sample of British adults. J Epidemiol Community Health. 2007;61(12):1086-90.
[29]Mollakhalili H, Papi A, Sharifi Rad Gh, Zare Farashbandi Z, Hasanzadeh H. A survey on health literacy of inpatients educational hospitals of Isfahan University of Medical Sciences. Health Inf Manage. 2014;11(4):464-73. [Persian]
[30]Khosravi A, Ahmadzadeh Kh. Investigating health literacy Level of patients referred to Bushehr hospitals and recognizing its effective factors. Iran South Med J. 2016;18(6):1245-53. [Persian]
[31]Seyedoshohadaei M, Kaghanizadeh M, Nezami M, Hamedani B, Barasteh S. The relationship between health literacy and general health in patients with type 2 diabetes. Iran J Diabetes Metabol. 2016;15(5):312-9. [Persian]
[32] Sorlie V, Lopez RA. When language, health literacy, and miscommunication collide: tremors versus seizures. Fam Med. 2011;43(1):48-50.
[33]Muir KW, Lee PP. Health literacy and ophthalmic patient education. Surv Ophthalmol. 2010;55(5):454-9.
[34]Lee SY, Tsai TI, Tsai YW, Kuo KN. Health literacy, health status, and healthcare utilization of Taiwanese adults: results from a national survey. BMC Public Health. 2010;10:614.
[35]Ghanbari A, Rahmatpour P, Khalili M, Barari F. The association between health literacy and health status among the staff of Guilan University of Medical Sciences, Iran. J Health Syst Res. 2016;12(3):381-7. [Persian]