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Open Access 25-04-2024 | Original Article

Patient activation and health literacy in Dutch patients with multiple involved specialties

Authors: Hidde Dijkstra, Liann I. Weil, Y. Vermeeren, M. Verhoeff, Barbara C. van Munster

Published in: Journal of Public Health

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Abstract

Aim

To examine the association between having a higher number of involved specialties, patient activation (PA), and health literacy (HL) in patients visiting a general hospital.

Subject and methods

Patients ≥ 18 years of age who had an appointment with the medical specialist or physician assistant were asked to participate in this study. Patients completed the Patient Activation Measure-13 (PAM) questionnaire and the European Health Literacy Survey Questionnaire (HLS-EU-Q). They were stratified into having < 3 or ≥ 3 involved medical specialties in the past 12 months. Two association models were built to examine the association.

Results

This study included 200 patients with 52% males (n = 104), a median age of 65 years, and low levels of education (67%). Patients with ≥ 3 involved medical specialties (58%) had lower total PAM scores (p = 0.03) and had lower HLS-EU-Q index scores (p = 0.23). The multivariable regression analysis showed that having ≥ 3 involved medical specialties was not associated with low PAM scores (OR = 1.59, p = 0.13) when adjusted for low education, low HLS-EU-Q scores, and higher age (> 65 years). In addition, having ≥ 3 involved medical specialties was not associated with low HLS-EU-Q scores (OR = 1.10, p = 0.76) when adjusted for low PAM scores and low education.

Conclusion

Patients with ≥ 3 involved medical specialties visiting the internal medicine department of a general (non-academic) hospital had variable levels of PA and HL. Moreover, having ≥ 3 involved medical specialties was not significantly associated with lower PA and HL. Importantly, the number of involved specialties may not be a proxy for recognizing low PA and HL. Organizations aiming to improve PA and HL could measure these constructs directly.
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Literature
go back to reference Altin SV, Stock S (2015) Impact of health literacy, accessibility and coordination of care on patient’s satisfaction with primary care in Germany. BMC Fam Pract BMC Family Practice 16(1):1–7 Altin SV, Stock S (2015) Impact of health literacy, accessibility and coordination of care on patient’s satisfaction with primary care in Germany. BMC Fam Pract BMC Family Practice 16(1):1–7
go back to reference Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155(2):97–107CrossRefPubMed Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155(2):97–107CrossRefPubMed
go back to reference Deen D, Lu WH, Rothstein D, Santana L, Gold MR (2011) Asking questions: the effect of a brief intervention in community health centers on patient activation. Patient Educ Couns Elsevier Ireland Ltd 84(2):257–260CrossRef Deen D, Lu WH, Rothstein D, Santana L, Gold MR (2011) Asking questions: the effect of a brief intervention in community health centers on patient activation. Patient Educ Couns Elsevier Ireland Ltd 84(2):257–260CrossRef
go back to reference Fowles JB, Terry P, Xi M, Hibbard J, Bloom CT, Harvey L (2009) Measuring self-management of patients’ and employees’ health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics. Patient Educ Couns 77(1):116–122CrossRefPubMed Fowles JB, Terry P, Xi M, Hibbard J, Bloom CT, Harvey L (2009) Measuring self-management of patients’ and employees’ health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics. Patient Educ Couns 77(1):116–122CrossRefPubMed
go back to reference Frandsen B, Joynt Maddox K, Rebitzer J, Jha A (2015) Care fragmentation, quality, and costs among chronically Ill patients. Am J Manag Care 21:355–362PubMed Frandsen B, Joynt Maddox K, Rebitzer J, Jha A (2015) Care fragmentation, quality, and costs among chronically Ill patients. Am J Manag Care 21:355–362PubMed
go back to reference Hawley ST, Janz NK, Lillie SE, Friese CR, Jennifer J, Graff JJ, Hamilton AS, Jain S, Katz SJ (2011) Perceptions of care coordination in a population-based sample of diverse breast cancer patients. Patient Educ Couns (1):1–16 Hawley ST, Janz NK, Lillie SE, Friese CR, Jennifer J, Graff JJ, Hamilton AS, Jain S, Katz SJ (2011) Perceptions of care coordination in a population-based sample of diverse breast cancer patients. Patient Educ Couns (1):1–16
go back to reference Hibbard JH, Cunningham PJ (2008) How engaged are consumers in their health and health care, and why does it matter? Res Brief 8:1–9 Hibbard JH, Cunningham PJ (2008) How engaged are consumers in their health and health care, and why does it matter? Res Brief 8:1–9
go back to reference Hibbard JH, Greene J (2013) What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff 32(2):207–214CrossRef Hibbard JH, Greene J (2013) What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff 32(2):207–214CrossRef
go back to reference Hibbard JH, Greene J, Overton V (2013) Patients with lower activation associated with higher costs; delivery systems should know their patients’ “scores”. Health Aff 32(2):216–222CrossRef Hibbard JH, Greene J, Overton V (2013) Patients with lower activation associated with higher costs; delivery systems should know their patients’ “scores”. Health Aff 32(2):216–222CrossRef
go back to reference Hibbard JH, Mahoney ER, Stockard J, Tusler M (2005) Development and testing of a short form of the patient activation measure. Health Serv Res 40(6 I):1918–30 Hibbard JH, Mahoney ER, Stockard J, Tusler M (2005) Development and testing of a short form of the patient activation measure. Health Serv Res 40(6 I):1918–30
go back to reference Hosseinzadeh H, Downie S, Shnaigat M (2022) Effectiveness of health literacy- and patient activation-targeted interventions on chronic disease self-management outcomes in outpatient settings: a systematic review. Aust J Prim Health 28(2):83–96CrossRefPubMed Hosseinzadeh H, Downie S, Shnaigat M (2022) Effectiveness of health literacy- and patient activation-targeted interventions on chronic disease self-management outcomes in outpatient settings: a systematic review. Aust J Prim Health 28(2):83–96CrossRefPubMed
go back to reference Huang LY, Lin YP, Glass GF, Chan EY (2021) Health literacy and patient activation among adults with chronic diseases in Singapore: a cross-sectional study. Nurs Open 8(5):2857–2865CrossRefPubMedPubMedCentral Huang LY, Lin YP, Glass GF, Chan EY (2021) Health literacy and patient activation among adults with chronic diseases in Singapore: a cross-sectional study. Nurs Open 8(5):2857–2865CrossRefPubMedPubMedCentral
go back to reference Kern LM, Seirup JK, Casalino LP, Safford MM (2017) Healthcare fragmentation and the frequency of radiology and other diagnostic tests: a cross-sectional study. J Gen Intern Med 32(2):175–181CrossRefPubMed Kern LM, Seirup JK, Casalino LP, Safford MM (2017) Healthcare fragmentation and the frequency of radiology and other diagnostic tests: a cross-sectional study. J Gen Intern Med 32(2):175–181CrossRefPubMed
go back to reference Maeng DD, Martsolf GR, Scanlon DP, Christianson JB (2012) Care coordination for the chronically ill: understanding the patient’s perspective. Health Serv Res 47(5):1960–1979CrossRefPubMedPubMedCentral Maeng DD, Martsolf GR, Scanlon DP, Christianson JB (2012) Care coordination for the chronically ill: understanding the patient’s perspective. Health Serv Res 47(5):1960–1979CrossRefPubMedPubMedCentral
go back to reference Magnezi R, Glasser S, Shalev H, Sheiber A, Reuveni H (2014) Patient activation, depression and quality of life. Patient Educ Couns Elsevier Ireland Ltd 94(3):432–437CrossRef Magnezi R, Glasser S, Shalev H, Sheiber A, Reuveni H (2014) Patient activation, depression and quality of life. Patient Educ Couns Elsevier Ireland Ltd 94(3):432–437CrossRef
go back to reference Newland P, Lorenz R, Oliver BJ (2021) Patient activation in adults with chronic conditions: a systematic review. J Health Psychol 26(1):103–114CrossRefPubMed Newland P, Lorenz R, Oliver BJ (2021) Patient activation in adults with chronic conditions: a systematic review. J Health Psychol 26(1):103–114CrossRefPubMed
go back to reference Nyweide D, Bynum J (2017) Relationship between continuity of ambulatory care and risk of emergency department episodes among older adults. Ann Emerg Med 69(4):407–415CrossRefPubMed Nyweide D, Bynum J (2017) Relationship between continuity of ambulatory care and risk of emergency department episodes among older adults. Ann Emerg Med 69(4):407–415CrossRefPubMed
go back to reference O’Malley AS, Cunningham PJ (2009) Patient experiences with coordination of care: the benefit of continuity and primary care physician as referral source. J Gen Intern Med 24(2):170–177CrossRefPubMed O’Malley AS, Cunningham PJ (2009) Patient experiences with coordination of care: the benefit of continuity and primary care physician as referral source. J Gen Intern Med 24(2):170–177CrossRefPubMed
go back to reference Paasche-Orlow MK, Wolf MS (2007) The causal pathways linking health literacy to health outcomes. Am J Health Behav 31(SUPPL. 1):S19–S26CrossRefPubMed Paasche-Orlow MK, Wolf MS (2007) The causal pathways linking health literacy to health outcomes. Am J Health Behav 31(SUPPL. 1):S19–S26CrossRefPubMed
go back to reference Paukkonen L, Oikarinen A, Kähkönen O, Kaakinen P (2022) Patient activation for self-management among adult patients with multimorbidity in primary healthcare settings. Heal Sci Reports 5(4):1–17 Paukkonen L, Oikarinen A, Kähkönen O, Kaakinen P (2022) Patient activation for self-management among adult patients with multimorbidity in primary healthcare settings. Heal Sci Reports 5(4):1–17
go back to reference Pedersen SE, Aaby A, Friis K, Maindal HT (2023) Multimorbidity and health literacy: a population-based survey among 28,627 Danish adults. Scand J Public Health 51(2):165–172CrossRefPubMed Pedersen SE, Aaby A, Friis K, Maindal HT (2023) Multimorbidity and health literacy: a population-based survey among 28,627 Danish adults. Scand J Public Health 51(2):165–172CrossRefPubMed
go back to reference Rijken M, Close J, Menting J, Lette M, Stoop A, Zonneveld N, de Bruin SR, Lloyd H, Heijmans M (2022) Assessing the experience of person-centred coordinated care of people with chronic conditions in the Netherlands: validation of the Dutch P3CEQ. Heal Expect 25(3):1069–1080CrossRef Rijken M, Close J, Menting J, Lette M, Stoop A, Zonneveld N, de Bruin SR, Lloyd H, Heijmans M (2022) Assessing the experience of person-centred coordinated care of people with chronic conditions in the Netherlands: validation of the Dutch P3CEQ. Heal Expect 25(3):1069–1080CrossRef
go back to reference Rouquette A, Nadot T, Labitrie P, Van den Broucke S, Mancini J, Rigal L, Ringa V (2018) Validity and measurement invariance across sex, age, and education level of the French short versions of the European health literacy survey questionnaire. PLoS ONE 13(12):1–15CrossRef Rouquette A, Nadot T, Labitrie P, Van den Broucke S, Mancini J, Rigal L, Ringa V (2018) Validity and measurement invariance across sex, age, and education level of the French short versions of the European health literacy survey questionnaire. PLoS ONE 13(12):1–15CrossRef
go back to reference Santana S, Brach C, Harris L, Ochiai E, Blakey C, Bevington F, Kleinman D, Pronk N (2021) Updating health literacy for healthy people 2030: defining its importance for a new decade in public health. J Public Heal Manag Pract 27(12):S258–S264CrossRef Santana S, Brach C, Harris L, Ochiai E, Blakey C, Bevington F, Kleinman D, Pronk N (2021) Updating health literacy for healthy people 2030: defining its importance for a new decade in public health. J Public Heal Manag Pract 27(12):S258–S264CrossRef
go back to reference Sheridan R, Martin-Kerry J, Hudson J, Parker A, Bower P, Knapp P (2020) Why do patients take part in research? An overview of systematic reviews of psychosocial barriers and facilitators. Trials 21(1):259CrossRefPubMedPubMedCentral Sheridan R, Martin-Kerry J, Hudson J, Parker A, Bower P, Knapp P (2020) Why do patients take part in research? An overview of systematic reviews of psychosocial barriers and facilitators. Trials 21(1):259CrossRefPubMedPubMedCentral
go back to reference Sinnott C, McHugh S, Browne J, Bradley C (2013) GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research. BMJ Open 3(9):e003610CrossRefPubMedPubMedCentral Sinnott C, McHugh S, Browne J, Bradley C (2013) GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research. BMJ Open 3(9):e003610CrossRefPubMedPubMedCentral
go back to reference Smith SG, Curtis LM, Wardle J, von Wagner C, Wolf MS (2013) Skill set or mind set? Associations between health literacy, Patient activation and health. Plos One 8(9):1–7CrossRef Smith SG, Curtis LM, Wardle J, von Wagner C, Wolf MS (2013) Skill set or mind set? Associations between health literacy, Patient activation and health. Plos One 8(9):1–7CrossRef
go back to reference Sørensen K, Van Den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, Kondilis B, Stoffels V, Osborne RH, Brand H (2013) Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health 13–948 Sørensen K, Van Den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, Kondilis B, Stoffels V, Osborne RH, Brand H (2013) Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health 13–948
go back to reference Twisk JWR (2017) Inleiding in de toegepaste biostatistiek, 4th edn. Bohn Stafleu en van Loghum Twisk JWR (2017) Inleiding in de toegepaste biostatistiek, 4th edn. Bohn Stafleu en van Loghum
go back to reference Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D (2007) Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med 22(SUPPL. 3):391–395CrossRefPubMedPubMedCentral Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D (2007) Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med 22(SUPPL. 3):391–395CrossRefPubMedPubMedCentral
Metadata
Title
Patient activation and health literacy in Dutch patients with multiple involved specialties
Authors
Hidde Dijkstra
Liann I. Weil
Y. Vermeeren
M. Verhoeff
Barbara C. van Munster
Publication date
25-04-2024
Publisher
Springer Berlin Heidelberg
Published in
Journal of Public Health
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-024-02248-5