Functional health literacy: protective role in adherence to treatment for hypertensive patients
DOI:
https://doi.org/10.5020/18061230.2020.10503Palavras-chave:
Health Literacy, Health Education, Hypertension, Treatment Adherence and ComplianceResumo
Objective: To investigate factors associated with Functional Health Literacy (FHL), as well as its role as a probable protective factor for treatment adherence in individuals with hypertension (SAH), attended in Primary Health Care (Atenção Primária à Saúde - APS) units. Methods: This is a cross-sectional study with APS users under antihypertensive medication in the city of Salvador, Bahia. Illiterate or functionally illiterate patients were excluded, as well as those with a history of ischemic stroke. Data were collected between November 2015 and August 2016. Sociodemographic and clinical data were accessed utilizing a structured instrument developed by the authors, and the FHL was assessed using the REALM. Descriptive analyses and logistic regression were performed. Results: The population comprised 286 individuals and it was observed that low schooling was associated with inadequate FHL, both in the gross and adjusted analysis (OR = 9.25; CI95%: 4.49 – 19.05) and with the professional activity of manual labor (OR = 9.90; CI95%: 2.08 – 46.90). In patients with schooling levels of over 8 years, it was observed that the FHL was significantly associated with non-adherence to medical treatment, even after adjustment by gender, age, civil status, physical activity, and skin color (OR = 3.0; CI95%: 1.2 – 7.9). Conclusions: Inadequate FHL was significantly associated with non-adhesion to treatment only for those with over 8 years of schooling. Improvements in health promotion actions should be reinforced to address chronic diseases such as SAH.Downloads
Referências
İlgün G, Turaç İS, Orak S. Health literacy. Procedia Soc Behav Sci [Internet] 2015 [accessed on 2020 Apr 2];(174):2629-33. Available from: https://core.ac.uk/download/pdf/82010742.pdf
Duong TV, Chang PW, Yang SH, Chen MC, Chao WT, Chen T, et al. A New Comprehensive Shortform Health Literacy Survey Tool for Patients in General. Asian Nurs Res [Internet]. 2017 [accessed on 2020 Apr 4];11(1):30-5. Available from: https://www.asian-nursingresearch.com/article/S1976-1317(17)30070-1/fulltext
Halladay JR, Donahue KE, Cené CW, Li Q, Cummings DM, Hinderliter AL, et al. The association of health literacy and blood pressure reduction in a cohort of patients with hypertension: the heart healthy lenoir trial. Patient Educ Couns [Internet]. 2017 [accessed on 2020 Apr 2];100(3):542-9. Available from: https://pubmed.ncbi.nlm.nih.gov/27776790/?from_single_result=Health+literacy+and+blood+pressure+reduction+in+a+cohort&expanded_search_query=Health+literacy+and+blood+pressure+reduction+in+a+cohort
Náfrádi L, Galimberti E, Nakamoto K, Schulz PJ. Intentional and unintentional medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs. J Public Health Res [Internet].2016 [accessed on 2020 Apr 5];5(3):762: 111-5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206775/pdf/jphr-2016-3-762.pdf
McNeil A, Arena R. the evolution of health literacy and communication: introducing health harmonics. Prog Cardiovasc Dis [Internet]. 2017 [accessed on 2020 Apr 2];59(5):463-70. Available from: https://reader.elsevier.com/reader/sd/pii/S0033062017300269?token=03D7A073B7F776ED3F91398C03B6F4FB4E285460626BAC2B7569F4796E6C4B1EABDB01253905A8D077D8B033FA929980
Falcão AS, Silva MGC, Rodrigues AF Jr, Moura SR, Silva FRS, Sousa ASJ, et al. Estilo de vida e adesão ao tratamento de hipertensão arterial sistêmica em homens idosos. Rev Bras Promoç Saúde [Internet]. 2018 [accessed on 2020 Apr 2];31(2):1-10. Available from: https://periodicos.unifor.br/RBPS/article/view/7402/pdf
Tavakoly Sany S, Behzhad, F, Ferns G, Peyman N. Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial. BMC Health Serv Res [Internet]. 2020 [accessed on 2020 Apr 2];20(60):1-10. Available from: https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-020-4901-8
Beraldo PC, Moysés ST, Werneck RI, Araujo ES, Moysés SJ. Educational approaches focusing on the quality of life of people with chronic kidney disease receiving hemodialysis: an integrative review. Fisioter Mov [Internet]. 2017 [accessed on 2020 Apr 12];30(3):595-605. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-51502017000300595&lng=en
Silva AI, Loccioni MFL, Orlandini RF, Rodrigues J, Peres GM, Maftum MA. Projeto terapêutico singular para profissionais da estratégia de saúde da família. Cogitare Enferm [Internet]. 2016 [accessed on 2020 Apr 2];21(3):1-8. Available from: https://revistas.ufpr.br/cogitare/article/view/45437/pdf
Costa VRS, Costa PDR, Nakano EY, Apolinário D, Santana ANC. Functional health literacy in hypertensive elders at primary health care. Rev Bras Enferm [Internet]. 2019 [accessed on 2020 Apr 2];72(Suppl2):266-73. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672019000800266&lng=en. Epub Dec 05, 2019
Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Estratégias para o cuidado da pessoa com doenças crônicas nas redes de atenção e nas linhas de cuidado prioritárias [Internet]. Brasília: Ministério da Saúde; 2013 [accessed on 2019 Sept 15]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes%20_cuidado_pessoas%20_doencas_cronicas.pdf
Prefeitura Municipal de Salvador, Secretaria Municipal da Saúde, Diretoria Estratégica de Planejamento e Gestão. Plano Municipal de Saúde do Salvador 2018-2021 [Internet]. Salvador: Prefeitura Municipal de Salvador; 2018 [accessed on 2020 apr 6]. Available from: http://www.saude.salvador.ba.gov.br/secretaria/informativos-e-documentacoes/
Park Y, Shin JA, Yang SW, Yim HW, Kim HS, Park Y-H, et al. The Relationship between Visual Impairment and Health-Related Quality of Life in Korean Adults: The Korea National Health and Nutrition Examination Survey (2008–2012). PLoS ONE [Internet]. 2015 [accessed on 2015 dec 15];10(7): e0132779. Available from: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0132779&type=printable
Sawkin MT, Deppe SJ, Thelen J, Stoner SC, Dietz CA, Rasu RS. Health Literacy and Medication Adherence Among Patients Treated in a Free Health Clinic: A Pilot Study. Health Serv Res Manag Epidemiol [Internet]. 2015 [accessed on 2016 jan 10]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266426/pdf/10.1177_2333392815589094.pdf
Pandey A, Raza F, Velasco A, Brinker S, Ayers C, Das SR, et al. Comparison of Morisky Medication Adherence Scale with therapeutic drug monitoringin apparent treatment resistant hypertension. J Am Soc Hypertens [Internet]. 2015 [accessed on 2015 dec 10];9(6):420-6. Available from: https://reader.elsevier.com/reader/sd/pii/S1933171115004623?token=DFF9FFCE2EE29EB6F046AE551CE4DE54896F0DF52EBB873F68C5F3929D8922B90A18FEF60D6822A160DB7BD35CA12506
Instituto Paulo Montenegro. Indicador de Alfabetismo Funcional – INAF: Estudo especial sobre alfabetismo e mundo do trabalho [Internet]. São Paulo: IPM; 2016 [accessed on 2017 Jan 20]. Available from: http://acaoeducativa.org.br/wp-content/uploads/2016/09/INAFEstudosEspeciais_2016_Letramento_e_Mundo_do_Trabalho.pdf
Mafutha NG, Mogotlane S, Swardt HC. Development of a Hypertension Health Literacy Assessment Tool for use in primary healthcare clinics in South Africa, Gauteng. Afr J Prim Health Care Fam Med [Internet].
[accessed on 2019 Feb 10];27;9(1):e1-e8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566124/
Prado ML, Velho MB, Espíndola DS, Sobrinho SH, Backes VMS. Arco de Charles Maguerez: refletindo estratégias de metodologia ativa na formação de profissionais de saúde. Arco de Charles Maguerez:refletindo estratégias de metodologia ativa na formação de profissionais de saúde. Esc Anna Nery [Internet].2012 [accessed on 2020 mar 15]; 16(1):172-7. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-81452012000100023&lng=en
Brandão ERM, Rocha SV, Silva SS. Práticas de Integração Ensino-Serviço Comunidade: Reorientando a Formação Médica. Rev Bras Educ Med [Internet]. 2013 [accessed on 2020-04-12];37(4):573-7. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022013000400013&lng=en&nrm=iso
Sampaio HAC, Silva DMA, Sabry MOD, Carioca AAF, Chayb APV. Letramento nutricional: desempenho de dois grupos populacionais brasileiros. Brazilian Soc. Food Nutr [Internet]. 2013 [accessed on 2020 Apr 12];38(2):144-55. Available from: http://sban.cloudpainel.com.br/files/revistas_publicacoes/391.pdf
Santos LTM, Mansur HN, Paiva TFPS, Colugnati FAB, Bastos MG. Letramento em Saúde: Importância da avaliação em nefrologia. J Bras Nefrol [Internet]. 2012 [accessed on 2020 Mar 18];34(3):293-302. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002012000300014&lng=en
Batterham RW, Hawkins M, Collins PA, Buchbinder R, Osborne RH. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health [Internet]. 2016 [accessed on 2020 Mar 18];132:3-12. Available from https://reader.elsevier.com/reader/sd/pii/S0033350616000044?token=C39B8BFCF2CDD9DE7BD0263BE3735DD48649E1E774AF05759E4DBA39C52A27596C45392AC4BE6002EACEBE874FE02D69
Ruppar TM, Dunbar-Jacob JM, Mehr DR, Lewis L, Conn VS. Medication adherence interventions among hypertensive black adults: a systematic review and meta-analysis. J Hypertens [Internet]. 2017 [accessed on 2020 Mar 18];35(6):1145-54. Available from: https://pubmed.ncbi.nlm.nih.gov/28106662/
Macquart de Terline D, Kane A, Kramoh KE, Ali Toure I, Mipinda JB, Diop IB, et al. Factors associated with poor adherence to medication among hypertensive patients in twelve low and middle income Sub-Saharan countries. PLoS ONE [Internet]. 2019 [accessed on 2020 Mar 20];14(7):e0219266. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619761/pdf/pone.0219266.pdf
Brown MT, Bussell J, Dutta S, Davis K, Strong S, Mathew S. Medication adherence: truth and consequences. Am J Med Sci [Internet]. 2016 [accessed on 2020 Mar 18];351(4):387-99. Available from: https://www.amjmedsci.org/article/S0002-9629(15)37996-9/fulltext
Chehuen JÁ Neto, Costa LA, Estevanin GM, Bignoto TC, Vieira CIR, Pinto FAR, et al. Letramento funcional em saúde nos portadores de doenças cardiovasculares crônicas. Ciênc Saúde Colet [Internet].
[accessed on 2020 Apr 2];24(3):1121-32. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232019000301121&lng=en
Passamai MPB, Sampaio HAC, Dias AMI, Cabal LA. Letramento funcional em saúde: reflexões e conceitos sobre seu impacto na interação entre usuários, profissionais e sistema de saúde. Interface (Botucatu) [Internet]. 2012 [accessed on 2020 Apr 2];16(41):301-14. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-32832012000200002&lng=en
Torquato R, Massi G, Santana AP. Envelhecimento e letramento: a leitura e a escrita na perspectiva de pessoas com mais de 60 anos de idade. Psicol Reflex Crit [Internet]. 2011 [accessed on 2020 Apr 2];24(1):89-98. Available from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-79722011000100011&lng=en&nrm=iso
Cunha M, Gaspar R, Fonseca S, Almeida D, Silva M, Nunes L. Implications of literacy for health for body mass index. Aten Primaria [Internet]. 2014 [accessed on 2020 Apr 2];46(Espec Cong 1):180-6. Available from:https://reader.elsevier.com/reader/sd/pii/S0212656714700885?token=051D87177EE43452A8771D6D9E2E049627291F3DB663E82667A0D0773D943A3110D53DD8EA83485AEB21429E7629AF95
Rocha PC, Lemos SMA. Letramento em saúde: Revisão. Rev CEFAC [Internet]. 2016 [accessed on 2020 Apr 5];18(1):214-25. Available from: http://www.scielo.br/pdf/rcefac/v18n1/1982-0216-rcefac-18-01-00214.pdf
Santos JEM, Brasil VV, Moraes KL, Cordeiro JABL, Oliveira GF, Bernardes CP, et al. Comprehension of the education handout and health literacy of pacemaker users. Rev Bras Enferm [Internet]. 2017 [accessed on 2020 Apr 4];70(3):633-9. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672017000300633&lng=en
Kaphingst KA, Goodman MS, MacMillan WD, Carpenter CR, Griffey RT. Effect of cognitive dysfunction on the relationship between age and health literacy. Pat Educ Couns [Internet]. 2014 [accessed on 2020 Apr 4];95(2):218-25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172373/pdf/nihms-618933.pdf
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os manuscritos apresentados devem destinar-se exclusivamente à RBPS, não sendo permitida sua apresentação a outro periódico. Junto ao envio do manuscrito, autores devem encaminhar a Declaração de Responsabilidade e de Direitos Autorais assinada por todos os autores, bem como, sua contribuição individual na confecção do mesmo e deverá ser enviada no formato pdf.
O autor poderá depositar a versão final do artigo, com revisão por pares “postprint” em qualquer repositório ou website de acordo com a Licença Creative Commons Atribuição 4.0 Internacional.
