Abstract:The rural area residents suffered more from low functional health literacy, compared with their urban counterparts. Health literacy as a determinant of health and social welfare should be focused on with more detail by health decision-makers.
“…Fourth, convenience sampling in our study may not be representative of the elderly population. Hence, we introduced stratified sampling by population density, which has been reported to be a determinant of health literacy to reduce selection bias (Golboni, Nadrian, Najafi, Shirzadi, & Mahmoodi, ). Nevertheless, this pilot study is the first comprehensive study to elucidate the association between hospice care and health literacy.…”
The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community‐dwelling elderly participants. This cross‐sectional study enrolled 990 community‐dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer‐administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.
“…Fourth, convenience sampling in our study may not be representative of the elderly population. Hence, we introduced stratified sampling by population density, which has been reported to be a determinant of health literacy to reduce selection bias (Golboni, Nadrian, Najafi, Shirzadi, & Mahmoodi, ). Nevertheless, this pilot study is the first comprehensive study to elucidate the association between hospice care and health literacy.…”
The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community‐dwelling elderly participants. This cross‐sectional study enrolled 990 community‐dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer‐administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.
“…In places where Malay is the only medium of communication, it is imperative that healthcare providers use the language of the people. This is especially the case in rural areas, where underprivileged and low literacy populations are in dire need of health education [26][27][28].…”
Background: Health-promoting behaviour is an important concept for health education. Unfortunately, there is a dearth of validated instruments to measure levels of health-promoting behaviour in the Malaysian context. The purpose of this study was to validate a Malay-language version of the Health-Promoting Lifestyle Profile II (HPLP-II) using a confirmatory approach. Methods: Participants were 997 university undergraduate students, with a mean age of 21 years (SD = 1.58). The majority of the participants (80.4%) were female. Health-promoting behaviour was assessed using the 52-item HPLP-II, which measures six components of health-promoting behaviour outcomes. HPLP-II was translated into the Malay language using standard forward and backward translation procedures. Participants then completed the HPLP-II Malay version (HPLP-II-M). Confirmatory factor analysis (CFA) was conducted using Mplus 8.0 software on the six domains of HPLP-II-M model. Results: The CFA result based on the hypothesised measurement model of six factors was aligned with the original HPLP-II, except for two low loading items which were subsequently removed from the CFA analysis. The final CFA measurement model with 50 items resulted in a good fit to the data based on RMSEA and SRMR fit indices (RMSEA = 0.046, 90%CI = 0.045, 0.048, SRMR = 0.062). The construct reliabilities for the HPLP-II-M subscales were acceptable, ranging from 0.737 to 0.878. Conclusion: The HPLP-II-M with six components of health-promoting behaviour outcomes and 50 items was considered valid and reliable for the present Malaysian sample.
“…2,3 Lower health literacy and lower socio-economic status among older rural residents might also cause poor health outcomes. 4,5 Universal health coverage is one of the most important issues promoted by the World Health Organization (WHO) and a key aspect of the United Nations' Sustainable Development Goals (SDGs). 6 Thus, the promotion of health among older adults residing in rural areas is essential.…”
Background: Studies have shown that rural residents face disadvantages concerning medical access and socioeconomic conditions. However, the social determinants of health among older people in rural areas are still unclear. The Neuron to Environmental Impact across Generations (NEIGE) study investigated the social determinants of health among older rural adults. Methods: A survey was conducted among the older residents of Tokamachi City, Japan. We randomly selected study participants (N = 1,346) from four stratified groups by age (65-74 and 75-84 years) and residential area (Tokamachi center [downtown] and Matsunoyama [mountain]). The survey collected data on socioeconomic status, lifestyle, health, and neighborhood environment. Blood and urine sampling were also conducted, and physical activity was assessed. Magnetic resonance brain imaging (MRI) and Apo-E gene were also examined in the analysis. Results: In total, 527 people participated in the NEIGE study (participation rate: 39.2%). The average age of the participants was 73.5 (standard deviation, 5.6) years, and 47.3% were male. No differences in demographics were found between downtown and mountain residents, except for educational attainment, which was lower among mountain residents. Lifestyles were similar, except for the higher percentage of everyday drinkers (33.3-35.3%) in the mountain area. Concerning physical health, muscle mass, grip strength, and measured physical activity were significantly higher among mountain residents. However, gait speed and balance were better among downtown residents. Conclusion: The findings of the NEIGE study will help elucidate the social determinants of health in older rural adults in Japan, and emphasize the different outcomes between downtown and mountain areas.
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