Health Literacy and Kidney Disease: Toward a New Line of Research

Devraj, Radhika; Gordon, Elisa J.

doi:10.1053/j.ajkd.2008.12.028

Cited by 85 publications

(70 citation statements)

References 51 publications

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“…It is important to note that sensitivity was higher in our study with combinations of three or four questions compared to combinations of two questions, as we propose here. However, long combination questions may score less well with readability instruments due to their length and may be more difficult to answer among individuals with limited health literacy (26), which is common among patients with CKD (27)(28)(29). It is also important to note that compound questions have a tendency to yield less consistent answers than single questions, as they may cause misunderstanding among responders (30,31).…”

Section: Discussionmentioning

confidence: 99%

Variation in Patients’ Awareness of CKD according to How They Are Asked

Tuot

Zhu

Velásquez³

et al. 2016

CJASN

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Background and objectives Awareness of CKD is necessary for patient engagement and adherence to medical regimens. Having an accurate tool to assess awareness is important. Use of the National Health and Nutrition Examination Survey (NHANES) CKD awareness question "Have you ever been told by a doctor or other health professional that you had weak or failing kidneys (excluding kidney stones, bladder infections, or incontinence)?" produces surprisingly low measures of CKD awareness. We sought to compare the sensitivity and specificity of different questions ascertaining awareness of CKD and other health conditions.Design, setting, participants, & measurements Between August of 2011 and August of 2014, an in-person questionnaire was administered to 220 adults with CKD, diabetes, hypertension, or hyperlipidemia who received primary care in a public health care delivery system to ascertain awareness of each condition. CKD awareness was measured using the NHANES question, and other questions, asking if patients knew about their "kidney disease", "protein in the urine", "kidney problem", or "kidney damage." Demographic data were self-reported; health literacy was measured. The sensitivity and specificity of each question was calculated using the medical record as the gold standard.Results In this diverse population (9.6% white, 40.6% black, 36.5% Hispanic, 12.3% Asian), the mean age was 58 years, 30% had a non-English language preference, and 45% had low health literacy. Eighty percent of participants had CKD, with a mean eGFR of 47.2 ml/min per 1.73 m 2 . The sensitivities of each CKD awareness question were: 26.4% for "kidney damage", 27.7% for "kidney disease", 33.2% for "weak or failing kidneys", 39.8% for "protein in the urine", and 40.1% for "kidney problem." Specificities ranged from 82.2% to 97.6%. The best two-question combination yielded a sensitivity of 53.1% and a specificity of 83.3%. This was lower than awareness of hypertension (90.1%) or diabetes (91.8%).Conclusions CKD awareness is low compared with other chronic diseases regardless of how it is ascertained. Nevertheless, more sensitive questions to ascertain CKD awareness suggest current under-ascertainment.

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Section: Discussionmentioning

confidence: 99%

Variation in Patients’ Awareness of CKD according to How They Are Asked

Tuot

Zhu

Velásquez³

et al. 2016

CJASN

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“…39 Como pode ser observado na Figura 1, baseado em diversos autores, [39][40][41] os determinantes do LS podem ser agrupados em dois grandes compartimentos que interagem entre si: 1. Os inerentes ao indivíduo; e 2.…”

Section: Determinantes Do Letramento Em Saúdeunclassified

“…Intervenções que otimizem o LS favorecem, por exemplo: (1) nos estágios iniciais da doença: aderên-cia medicamentosa e consequente redução dos riscos associados às complicações decorrentes da doença e diminuição da velocidade de perda funcional renal; (2) na diálise: diminuição da ingesta hídrica e melhor controle do ganho de peso interdialítico; (3) no transplante renal: aderência à medicação imunossupressora; e (4) de maneira geral: melhores hábitos de vida por meio de dieta adequada e engajamento em atividades física 60 (Figura 2).…”

Section: Letramento Em Saúde Em Nefrologiaunclassified

Health Literacy: Importance of assessment in nephrology

Santos¹,

Mansur²,

Paiva³

et al. 2012

Jornal Brasileiro De Nefrologia

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“…There are few data characterizing numeracy skills in the CKD and end-stage renal disease (ESRD) populations (11). Yet, these patients regularly interact with the healthcare system due to their frequent coexisting comorbidities and the systemic manifestations of kidney disease.…”

mentioning

confidence: 99%

Numeracy Skills in CKD

Abdel-Kader

Dew²,

Bhatnagar

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Healthcare providers communicate the risks and benefits of treatments using frequencies, percentages, or proportions. However, many patients lack the numerical skills needed to interpret this information accurately to make informed choices.Design, setting, participants, and measurements: We assessed numeracy, the capacity to use and comprehend numbers, in a prospective cohort study of 187 patients with stage 4 to 5 chronic kidney disease or ESRD. Patients completed a three-item numeracy test and were assessed for global mental status, cognitive function, type of hemodialysis access, and kidney transplant use. We examined the association of numeracy with healthcare use and other cognitive and sociodemographic variables.Results: Over 50% of patients answered one or fewer numeracy questions correctly. Although African Americans (P ‫؍‬ 0.0001), women (P ‫؍‬ 0.05), and the unemployed (P ‫؍‬ 0.0004) demonstrated lower numeracy skills, numeracy deficits were prevalent in every subgroup. In analyses adjusted for demographics and length of follow-up, higher numeracy was significantly associated with receipt of a transplant or active waiting list status. Numeracy was not associated with dialysis modality or hemodialysis vascular access.Conclusion: Similar to prior findings in the general population, these findings indicate that poor numeracy skills are very common in patients with advanced chronic kidney disease and end-stage renal disease. Additional research is needed to further explore whether poor numeracy is a barrier to receipt of a kidney transplant. Clinicians caring for patients with kidney disease should consider using tools to enhance communication and overcome limited numeracy skills.

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Health Literacy and Kidney Disease: Toward a New Line of Research

Cited by 85 publications

References 51 publications

Variation in Patients’ Awareness of CKD according to How They Are Asked

Variation in Patients’ Awareness of CKD according to How They Are Asked

Health Literacy: Importance of assessment in nephrology

Numeracy Skills in CKD

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