Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly

Abstract

Objective To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge.Methods A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control.Results We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency.Conclusion This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills.

Health literacy of adults with and without arterial hypertension

“…In Brazil, there is not a research of national amplitude showing the HL level of the population (4) ; however, there are studies that validated measurement instruments of this construct for the Portuguese language (12) and classified levels of health literacy of people with specific health problems (5,11,14) .…”

“…We observed that the studies conducted in Brazil have assessed the HL of individuals in specific populations, such as adults and seniors (1,(11)(12) , people with distinct health aggravations, such as diabetes (5,13) , cardiovascular diseases (14) and chronic kidney disease (15) , or in individuals in continuous use of medicines (16) , but only few studies assessed the HL of adults with hypertension (15) , in particular those who are treated in the Primary Health Care (PHC).…”

“…The professionals of BA shall focus on the user's participation in the treatment, involving him/her in the definition and implementation of strategies to control high blood pressure (17) . Given this context, the HL of users contributes greatly to text reading and comprehension of the written and oral information provided by doctors, nurses and other health professionals to make decisions, use medicines properly and/or perform self-care (14) .…”

Health Literacy Levels among Outpatients at a Tertiary Hospital in Delhi, India

“…13 Moreover, poor health literacy is found to be associated with worse glycemic control and a higher risk of complications. 14 Among patients with hypertension, significant differences were present depending on the education status of subjects. Similarly, unemployed patients also had lesser understanding of the information provided by clinicians.…”

Application of Multidisciplinary Intervention Model in Nursing of Older patients with Diabetes

“…The care programs of a multidisciplinary collaborative care model for hospitalized diabetic elders were established by centralized consultation, reducing the repeated nursing consultation time of older diabetic patients with multiple diseases and thus effectively shortening the hospital stay [24,25]. In the multidisciplinary team teamwork model, all nursing staffs have a new and improved understanding in the care theory of older patients with diabetes through business study, pathological discussion, bedside rounds, and head nurse on-site management [7,[26][27][28]. Through the multipronged cooperation, the overall level of disease management around patients has been raised.…”