Critical Health-literacy of Working-age Indonesians living with Early-stage Chronic Kidney Disease: A Cross-sectional Study

Document Type : Original Article

Authors

1 Faculty of Nursing, Universitas Airlangga, Indonesia.

2 College of Nursing, Kaohsiung Medical University, Taiwan.

3 Department of Renal Care, College of Medicine, Kaohsiung Medical University, Taiwan.

4 Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.

Abstract

Background and Objectives: Working-age living with chronic kidney disease requires a sufficient level of health-literacy to enable them to sustain their productivity and manage the progressivity of their disease. However, the paucity continues in terms of critical health-literacy.  This study aims to examine health-literacy of working-age living with early-stage chronic kidney disease (CKD). 

Materials and Methods: A total of 226 working-age living with early-stage CKD was recruited from 63 Public Health Centres in the second biggest city of Indonesia. The Mandarin Multidimensional Health Literacy Questionnaire (MMHLQ) was used to measure the level of health literacy. Descriptive and inferential statistics were performed to analyse data. This study adhered to the EQUATOR checklist, STROBE.

Results: An average age of the participants was 56.61 years (standard deviation [SD] = 7.48), whereas the estimated glomerular filtration rate was 63.45 mL/min/1.73 m2 (SD = 15.34). A cut point of high health-literacy is above 34.00.  This study found out of 10 individuals, six (61.95%) reported low levels of health-literacy with an average level of 32.11 (SD = 4.46). Of five dimensions of health-literacy; obtaining, understanding, evaluating, and applying health information were below the adequate level while communication and interaction exhibited a sufficient level. 

Conclusion: Factors that influence health-literacy were further characterized by low levels of education and low income. High rates of poor health-literacy among working-age patients with early-stage chronic kidney disease are deemed threatening. The lack of support toward elevating the levels of health-literacy may threaten the severity of the disease and shorten the period of productivity. A group which was characterised by low levels of education and income need to be supported by a simply accessible, understandable, and applicable of health-literacy program. Future studies examine novel factors, such as measuring health-literacy by specific health-literacy instruments and potential impact of multidisciplinary teams on the multifaceted aspects of health-literacy is warranty.

Keywords

Acknowledgement: The authors are grateful to all participants who participated in this study and the research assistants for their assistance.


Availability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.


Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.


Consent for publication: Not applicable.


Ethical approval and consent to participate: This study was reviewed and approved by the Institutional Review Board of Universitas Airlangga, Indonesia (IRB Approval Number: 1863-KEPK) also this study was conducted in accordance with the Declaration of Helsinki, All participants provided written informed consent to participate in the study. Participants were informed about the study's purpose, procedures, potential risks, and benefits, and they were assured that their data would be kept confidential and handled ethically.

 

Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.


Author’s contributions: IS, CCL conceptualized and designed the study, IS collected the data and analyze, IS, CCL interpreted and drafted the manuscript. All the authors critically revised the manuscript for important intellectual content and approved the final version for submission.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

  1. Chronic kidney disease in the United States [Internet]. 2019 [cited 31 August 2020]. Available from: https://fluoridealert.org/studytracker/38332/.
  2. Indonesia Renal Registry. 11th Report of Indonesian Renal Registry 2018 [Available from: https://www.indonesianrenalregistry.org/data/IRR%202018.pdf.
  3. Wong KK, Velasquez A, Powe NR, Tuot DS. Association between health literacy and self-care behaviors among patients with chronic kidney disease. BMC Nephrology. 2018;19(1):N.PAG-N.PAG. https://doi.org/10.1186/s12882-018-0988-0 PMid:30081951 PMCid:PMC6091174
  4. Musavi Ghahfarokhi M, Tartifizadeh H, Tartifizadeh H, Asakereh S, Eskandari N, Kogani M. Relationship between the Level of Health Literacy, Diet Adherence and Dialysis Adequacy in Patients Undergoing Dialysis. Journal of Health Literacy. 2024;9(2):106-18.
  5. Taylor DM, Fraser SD, Bradley JA, Bradley C, Draper H, Metcalfe W, et al. A Systematic Review of the Prevalence and Associations of Limited Health Literacy in CKD. Clin J Am Soc Nephrol. 2017;12:1070-84. https://doi.org/10.2215/CJN.12921216 PMid:28487346 PMCid:PMC5498363
  6. Devraj R, Borrego ME, Vilay AM, Pailden J, Horowitz B. Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice. World journal of nephrology. 2018;7(1):41-50. https://doi.org/10.5527/wjn.v7.i1.41 PMid:29359119 PMCid:PMC5760511
  7. Griva K, Yoong RK, Nandakumar M, Rajeswari M, Khoo EY, Lee VY, et al. Associations between health literacy and health care utilization and mortality in patients with coexisting diabetes and end‐stage renal disease: A prospective cohort study. British Journal of Health Psychology. 2020;25(3):405-27. https://doi.org/10.1111/bjhp.12413 PMid:32304286
  8. Stømer UE, Gøransson LG, Wahl AK, Urstad KH. A cross‐sectional study of health literacy in patients with chronic kidney disease: Associations with demographic and clinical variables. Nursing open. 2019;6(4):1481-90. https://doi.org/10.1002/nop2.350 PMid:31660176 PMCid:PMC6805284
  9. Stømer UE, Wahl AK, Gøransson LG, Urstad KH. Exploring health literacy in patients with chronic kidney disease: a qualitative study. BMC Nephrology. 2020;21(1):1-9. https://doi.org/10.1186/s12882-020-01973-9 PMid:32727397 PMCid:PMC7392653
  10. Chen Y-C, Chang L-C, Liu C-Y, Ho Y-F, Weng S-C, Tsai T-I. The Roles of Social Support and Health Literacy in Self-Management Among Patients With Chronic Kidney Disease. Journal of Nursing Scholarship. 2018;50(3):265-75. https://doi.org/10.1111/jnu.12377 PMid:29569423
  11. Taylor DM, Fraser S, Dudley C, Oniscu GC, Tomson C, Ravanan R, et al. Health literacy and patient outcomes in chronic kidney disease: a systematic review. Nephrology Dialysis Transplantation. 2018;33(9):1545-58. https://doi.org/10.1093/ndt/gfx293 PMid:29165627
  12. Wei M-H, Wang Y-W, Chang M-C, Hsieh J-G. Development of mandarin multidimensional health literacy questionnaire (MMHLQ). Taiwan Gong Gong Wei Sheng Za Zhi. 2017;36(6):556.
  13. Altin SV, Finke I, Kautz-Freimuth S, Stock S. The evolution of health literacy assessment tools: a systematic review. BMC Public Health. 2014;14:1207. https://doi.org/10.1186/1471-2458-14-1207 PMid:25418011 PMCid:PMC4289240
  14. Badan Pusat Statistik. Indonesia Population 2019 [cited 2019 13 November 2019]. Available from: https://www.bps.go.id/.
  15. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ. 2007;85(11):867-72. https://doi.org/10.2471/BLT.07.045120 PMid:18038077 PMCid:PMC2636253
  16. Davies SJ, Russell L, Bryan J, Phillips L, Russell GI. Comorbidity, urea kinetics, and appetite in continuous ambulatory peritoneal dialysis patients: their interrelationship and prediction of survival. American journal of kidney diseases. 1995;26(2):353-61. https://doi.org/10.1016/0272-6386(95)90657-6 PMid:7645541
  17. World-Bank. World Development Indicators 2017 [updated Available from: https://databank.worldbank.org/reports.aspx?source=2&series=SH.DYN.NCOM.ZS&country=WLD.
  18. Ancker JS, Grossman LV, Benda NC. Health Literacy 2030: Is It Time to Redefine the Term? Journal of general internal medicine. 2020;35(8):2427-30. https://doi.org/10.1007/s11606-019-05472-y PMid:31659662 PMCid:PMC7403287
  19. Dinh HT, Nguyen NT, Bonner A. Health literacy profiles of adults with multiple chronic diseases: A cross‐sectional study using the Health Literacy Questionnaire. Nursing & Health Sciences. 2020;22(4):1153-60. https://doi.org/10.1111/nhs.12785 PMid:33034404
  20. Sykes S, Wills J, Rowlands G, Popple K. Understanding critical health literacy: a concept analysis. BMC public health. 2013;13(1):1-10. https://doi.org/10.1186/1471-2458-13-150 PMid:23419015 PMCid:PMC3583748
  21. Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annual Review of Public Health. 2021;42. https://doi.org/10.1146/annurev-publhealth-090419-102529 PMid:33035427
  22. Lin C-C, Hwang S-J. Patient-Centered Self-Management in Patients with Chronic Kidney Disease: Challenges and Implications. International Journal of Environmental Research and Public Health. 2020;17(24):9443. https://doi.org/10.3390/ijerph17249443 PMid:33339300 PMCid:PMC7766278
  23. Priyanto KE, Sutrisno S, Effendy MA. Health Promotion Strategies in Integrated Healthcare Program Park of Public Health Center. Jurnal Ners. 2020;15(2 Special Issue):563-8. https://doi.org/10.20473/jn.v15i1Sp.20544

Files

Share

How to cite

Statistics