ABSTRACT
Background: Health literacy is a determinant, powerful predictor of health. The Newest Vital Sign test (NVS) evaluates health literacy assessing the capacity of participants to understand the nutrition information label of an ice cream. Aim: To validate The NVS test for its application in the sociocultural context on primary care patients in Chile. Material and Methods: In a descriptive cross-sectional study, 1,117 people aged 58 ± 14 years (70% women) registered in the Cardiovascular Health Program of different Family Health Centers, answered the NVS test. They also answered the Test of Functional Health Literacy for Adults (TOFHLA) and the Health Literacy Survey, European Union (HLS-EU-32). An exploratory analysis was carried out. In addition, the Kuder-Richarson-20 reliability coefficient and Item-Test Point Biserial Correlations were calculated. The construct validity of the NVS was obtained using the Item Response Theory. The sensitivity and specificity of NVS were estimated using receiver operating characteristic curves using the TOFHLA score as gold standard. To establish the cutoff points, the Stratum-Specific Likelihood Ratio analysis was used. Results: The reliability of the test was adequate (KR-20 = 0.7478) and the values of the two logistic parameters model confirmed that the NVS items account for the health literacy construct. Conclusions: The NVS test turned out to be a valid and reliable instrument, and its application is recommended to measure the level of health literacy.
ABSTRACT
Background: Placing central venous lines under ultrasonographic guidance reduces the complications of the procedure. Aim: To compare prevalences of complications of central venous line placements with or without ultrasonographic guidance. Material and Methods: Descriptive study that contemplated the comparison of two groups of patients subjected to a central venous line placement at a nephrology service for renal replacement therapy. In one group of 100 patients, the line was placed without ultrasonographic guidance between 2008 and 2012. Between 2015 and 2017 the line was placed in 138 patients using ultrasonographic guidance. The prevalences of complications with both types of procedures were recorded. Results: The frequency of complications of procedures with and without ultrasonographic guidance was 0.7 and 18% respectively (prevalence ratio 0.04, 95% confidence interval 0-0.3). Ninety five percent of recorded complications were arterial puncture, followed by hematomas in 10% and pneumothorax in 5%. The higher prevalence of complications was observed in emergency line placement without ultrasonographic guidance. There was a direct association between the number of line placement attempts in a single procedure and the prevalence of complications. Conclusions: Ultrasonographic guidance is associated with a reduction in the prevalence of central venous line complications.