A Systematic Review of the Prevalence and Associations of Limited Health Literacy in CKD

Taylor, Dominic; Fraser, Simon; Bradley, J. Andrew; Bradley, Clare; Draper, Heather; Metcalfe, Wendy; Oniscu, Gabriel C.; Tomson, Charles; Ravanan, Rommel; Roderick, Paul

doi:10.2215/cjn.12921216

Cited by 149 publications

(140 citation statements)

References 62 publications

(131 reference statements)

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“…; Taylor et al . ). To address potential barriers to sensemaking and difficulties with the interpretation and application of the renal diet that may be due to inadequate health literacy, we recommend incorporating several rounds of teachback (Dinh et al .…”

Section: Discussionmentioning

confidence: 97%

“…In addition to the complexity of the diet, patients and carers in the current study described receiving renal diet information that was confusing and contradictory. Some of the difficulties experienced by patients when interpreting messages on diet sheets, could be attributed to the high level of cognitive impairment in patients with CKD (Lambert et al 2016); as well as low health literacy experienced among this patient population (Lambert et al 2015;Taylor et al 2017). To address potential barriers to sensemaking and difficulties with the interpretation and application of the renal diet that may be due to inadequate health literacy, we recommend incorporating several rounds of teachback (Dinh et al 2016) during education sessions to evaluate recall, and to ascertain understanding of important or complex concepts (Gibbs & Chapman-Novakofski 2012;Negarandeh et al 2013;Dantic 2014;Porter et al 2016;Gibbs 2017).…”

Section: Discussionmentioning

confidence: 99%

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How do patients and carers make sense of renal dietary advice? A qualitative exploration

Lambert

Mansfield

Mullan

2018

Journal of Renal Care

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SUMMARY Background Dietary modification is an integral part of chronic kidney disease (CKD) management. However, adherence to the renal diet is often suboptimal. Methods The aims of this study were to (i) describe the experiences of patients with CKD and their carers in their process of interpreting and implementing renal dietary advice; (ii) to explore strategies they used to make sense of and apply renal diet information and (iii) to develop recommendations for improved clinical practice. To achieve these aims, individual semi‐structured interviews with 26 patients and 10 carers were conducted, using interview questions guided by Sensemaking theory. Findings Six themes emerged from the data which did not differ according to CKD stage, geographic location or renal replacement therapy (RRT) type. The renal diet was perceived by patients and carers to be overwhelming, frustrating and emotionally demanding; as well as being complex and challenging. To help make sense of and apply renal dietary advice, participants highly valued the input of the dietitian; and patients believed that their carer support was important. Individual problem‐solving strategies were developed by participants to help them make sense of the renal diet, and many of them expressed a desire for additional resources and/or support. Conclusions This study highlights that learning to make sense of renal diet information is an emotionally challenging journey for patients and carers. In addition to utilising the expertise of dietitians, carer support was perceived to be integral to learning and using renal dietary advice. The study describes a number of important problem‐solving strategies utilised by patients and carers, as well as recommendations to help improve sensemaking and adherence to the renal diet.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

How do patients and carers make sense of renal dietary advice? A qualitative exploration

Lambert

Mansfield

Mullan

2018

Journal of Renal Care

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“…Even though the studies in this review touched on concepts related to health literacy, such as language and culture, they did not discuss low health literacy specifically as being a barrier to access in this population group. However, it is known from the literature that people from diverse cultural and linguistic backgrounds and those who are experiencing socioeconomic disadvantage are more likely to have low health literacy [28] and be less engaged with self-management [29]. Low health literacy in patients is associated with poorer patient health outcomes, poorer medication adherence and poorer knowledge and understanding of their own condition.…”

Section: Discussionmentioning

confidence: 99%

Access to appropriate health care for non-English speaking migrant families with a newborn/young child: a systematic scoping literature review

Dougherty

Lloyd

Harris

et al. 2020

BMC Health Serv Res

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Background: Recently arrived culturally and linguistically diverse migrant mothers in Western Industrialised Nations are less likely to access health care and are more likely to report negative healthcare experiences than more established migrant or non-migrant populations. This is particularly an issue in Australia where nearly half of all Australians were born overseas or have at least one parent born overseas. Methods: A systematic scoping review was conducted to identify a) the main enablers and barriers to accessing appropriate health care for migrant families with a new baby/young child who speak a language other than English, and b) the effectiveness of interventions that have been tested to improve access to appropriate health care for this group. Three academic databases (CINAHL, Medline and ProQuest) were searched, with additional publications identified through expert knowledge and networks. Data was extracted and analysed according to the Access framework, which conceptualises access to health care as being generated by the interaction of dimensions of accessibility of services (supply side) and abilities of potential users (demand side).Results: A total of 1964 records were screened for eligibility, with nine of these included in the review. Seven studies only described barriers and enablers to health care access, one study reported on an evaluation of an intervention and one study described the barriers and enablers and the evaluation of an intervention. This review identified that the most significant barriers occurred on the supply side, within the 'appropriateness' domain. Overall, the most frequently cited barrier was a lack of cultural sensitivity/understanding of different cultural practices (five studies). The most significant enablers also occurred on the supply side, but within the 'acceptability' domain. The most frequently cited enabler was cultural sensitivity and understanding. (Continued on next page)Conclusions: There is a dearth of evaluated interventions in the peer reviewed literature to improve appropriate access to postnatal care for migrant families who speak a language other than English. The literature focuses on identifying barriers and enablers to access to healthcare for this population group. Interventions which aim to address barriers within the 'appropriateness' dimension may have the greatest impact on access.

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“…Indeed, prior studies have shown that limited health literacy is common among patients with CKD and is associated with inferior outcomes including decreased likelihood of undergoing kidney transplantation. [18][19][20] Alternatively, it may be reflective of the residual role of peritransplant financial hardship as a barrier to receiving the long-term benefits of transplantation for some patients. [21][22][23] Regardless, this group-level heterogeneity in participant responses demonstrates that the development of effective, comprehensive informational materials requires the input of all segments of the diverse CKD/ESRD population (including, perhaps, those who were denied the opportunity to be transplanted).…”

Section: More Than 19 000 Patients Receive Kidney Transplants In the mentioning

confidence: 99%

Patients prioritize waitlist over posttransplant outcomes when evaluating kidney transplant centers

Husain

Brennan

Michelson

et al. 2018

American Journal of Transplantation

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Factors that patients value when choosing a transplant center have not been well studied. In order to guide the improvement of patient-facing materials, we conducted an anonymous electronic survey of patients that assessed the relative importance of patient experience, practical considerations, transplant center reputation, center experience, and waitlist when selecting a transplant center. A total of 409 respondents completed the survey, of whom 68% were kidney transplant recipients and 32% had chronic kidney disease or were on dialysis. Participants had mean age 56 ± 12 years and were predominantly female (61%), white (79%), and had an associate's degree or higher (68%). Participants most often prioritized waitlist when evaluating transplant centers (transplanted 26%, chronic kidney disease 40%), and waitlist was almost twice as likely as outcomes to be ranked most important (30% vs 17%). Education level and transplant status were significantly associated with factors used for center prioritization. Waitlisted respondents most commonly (48%) relied on physicians for information when selecting a center, while a minority cited transplant-specific organizations. In order to improve shared decision-making, materials outlining center-specific waitlist features should be prioritized. Novel patient-oriented metrics for measuring transplant center quality that align with patient priorities must be explored.

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A Systematic Review of the Prevalence and Associations of Limited Health Literacy in CKD

Cited by 149 publications

References 62 publications

How do patients and carers make sense of renal dietary advice? A qualitative exploration

How do patients and carers make sense of renal dietary advice? A qualitative exploration

Access to appropriate health care for non-English speaking migrant families with a newborn/young child: a systematic scoping literature review

Patients prioritize waitlist over posttransplant outcomes when evaluating kidney transplant centers

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