Efeitos de intervenção educativa no letramento em saúde e no conhecimento sobre diabetes: estudo quase-experimental / Efectos de la intervención educativa en la alfabetización en salud y el conocimiento sobre la diabetes: estudio cuasiexperimental / Effects of educational intervention on health literacy and knowledge about diabetes: a quasi-experimental study

RESUMO Objetivo Analisar os efeitos de intervenção educativa no letramento em saúde e no conhecimento sobre diabetes em adultos atendidos na atenção primária à saúde. Método Trata-se de estudo quase-experimental com intervenção educativa durante a consulta de enfermagem, atividade em grupo e acompanhamento telefônico com 33 adultos diagnosticados com diabetes mellitus tipo 2, cadastrados em uma Unidade Estratégia Saúde da Família no Sul do Brasil. Aplicaram-se instrumentos sociodemográfico e clínico (Spoken Knowledge in Low Literacy Patients with Diabetes e Eight-Item Health Literacy Assessment Tool) antes e após a intervenção. Os dados foram analisados pelos testes de Wilcoxom, coeficiente de correlação de Spearman e McNemar. Resultados A maioria dos participantes eram mulheres (69,7%), com idade média de 57,0 anos, tempo de escolaridade inferior a nove anos (69,7%) e tempo de diagnóstico ≤10 anos (51,5%). Após a intervenção, obteve-se aumento do conhecimento sobre a diabetes (p = 0,001), correlacionado ao letramento em saúde (r = 0,494; p = 0,001) e ao tempo do diagnóstico (r = 0,455; p = 0,001). Conclusão e implicação para a prática A utilização de instrumentos para mensurar o letramento em saúde e o conhecimento sobre diabetes possibilitou a construção de estratégias educativas voltadas para as lacunas existentes, promovendo aumento do conhecimento, o qual favorece o desenvolvimento das habilidades para a autogestão.

RESUMEN Objetivo Analizar los efectos de la intervención educativa sobre la alfabetización en salud y el conocimiento sobre diabetes en adultos tratados en la Atención Primaria de Salud. Método Se trata de un estudio cuasiexperimental, con intervención educativa, durante la consulta de enfermería en 33 adultos diagnosticados de Diabetes Mellitus tipo 2 registrados en una Unidad de Estrategia de Salud Familiar en el sur de Brasil, con actividades grupales y seguimiento telefónico. Antes y después de la intervención, se aplicaron instrumentos sociodemográficos y clínicos: Spoken Knowledge in Low Literacy Patients with Diabetes and the Eight-Item Health Literacy Assessment Tool. Los datos se analizaron mediante las pruebas de coeficiente de correlación de Wilcoxom, Spearman y McNemar. Resultados La mayoría fueron mujeres (69,7%), con una edad media de 57,0 años, menos de nueve años de escolaridad (69,7%) y tiempo de diagnóstico ≤ 10 años (51,5%). Después de la intervención, hubo un aumento en el conocimiento sobre diabetes (p = 0,001), correlacionado con la alfabetización en salud (r = 0,494 p = 0,001) y el tiempo desde el diagnóstico (r = 0,455 p = 0,001). Conclusión e implicaciones para la práctica El uso de instrumentos para medir la alfabetización en salud y el conocimiento sobre la diabetes permitieron la construcción de estrategias educativas orientadas a las brechas existentes, aumentando su conocimiento, lo que favorece el desarrollo de habilidades para el autocuidado.

ABSTRACT Objective To analyze the effects of educational intervention on health literacy and knowledge about diabetes in adults assisted in primary health care. Method This is a quasi-experimental study with educational intervention during the nursing consultation with 33 adults diagnosed with type 2 diabetes mellitus registered in a Family Health Strategy Unit in southern Brazil and involving group activity and telephone follow-up. Sociodemographic and clinical instruments were applied before and after the intervention; these instruments included the Spoken Knowledge in Low Literacy Patients with Diabetes and the Eight-Item Health Literacy Assessment Tool. Data were analyzed using the Wilcoxon, Spearman, and McNemar correlation coefficient tests. Results Most participants were women (69.7%), with a mean age of 57.0 years, less than nine years of schooling (69.7%), and ≤10 years of diagnosis (51.5%). After the intervention, there was an increase in knowledge about diabetes (p = 0.001), correlated with health literacy (r = 0.494; p = 0.001) and the time of diagnosis (r = 0.455; p = 0.001). Conclusion and implications for practice The instruments to measure health literacy and knowledge about diabetes enabled the construction of educational strategies aimed at existing gaps, increasing the knowledge, thereby favoring the development of skills for self-management.

Letramento funcional em saúde de idosos hipertensos e diabéticos atendidos na Estratégia Saúde da Família / Alfabetización en la salud de ancianos hipertensos y diabéticos atendidos en la Estrategia Salud de la Familia / Functional health literacy among hypertensive and diabetic elderly assisted by the Family Health Strategy

Resumo Objetivo avaliar o letramento funcional em saúde de idosos hipertensos e diabéticos adscritos a Estratégia Saúde da Família. Método estudo transversal, desenvolvido com 78 idosos acometidos por Diabetes Mellitus tipo II e Hipertensão Arterial Sistêmica, residentes em município do interior do estado do Rio Grande do Sul. Para a coleta dos dados foi aplicado questionário com informações sociodemográficas e de saúde e o instrumento S-TOFHLA. Para análise dos dados foram utilizados os testes qui quadrado de Pearson; Medidas de Tendência Central (média e mediana) e dispersão, α=5% e p≤0,05. Resultados o nível de letramento funcional em saúde demonstrou-se inadequado em 55,1% (N=43) dos participantes, e limítrofe em 30,8% (N=24). Identificou-se o predomínio de hipertensão arterial e tempo de tratamento superior a 10 anos. Os resultados mostraram associação entre baixa escolaridade e inadequado letramento funcional em saúde (p<0,002). Conclusão e implicações para a prática o letramento funcional em saúde inadequado em idosos portadores de doenças crônicas, muitas vezes responsáveis pelo seu autocuidado, pode contribuir para agravos na condição de saúde e doença dessa população, sendo relevante seu reconhecimento para o estabelecimento de estratégias e ações que visem melhores resultados na produção do cuidado.

Resumen Objetivo evaluar la alfabetización funcional en la salud de ancianos hipertensos y diabéticos inscritos en la Estrategia Salud de la Familia. Método estudio transversal, desarrollado en 78 ancianos afectados por Diabetes Mellitus tipo II e Hipertensión Arterial Sistémica, residentes en un municipio del interior del estado de Rio Grande del Sur. Para la recolección de datos fue aplicado un cuestionario con informaciones sociodemográficas y de salud y el instrumento S-TOFHLA. Para el análisis de los datos fueron utilizadas, las pruebas Chi-cuadrado de Pearson, Medidas de Tendencia Central (media y mediana) y de dispersión; con α=5% y p≤0,05. Resultados el nivel de alfabetización funcional en salud se demostró inadecuado en 55,1% (N=43) de los participantes, y limítrofe en 30,8% (N=24). Se identificó el predominio de hipertensión arterial y del tiempo de tratamiento superior a 10 años. Los resultados mostraron asociación entre baja escolaridad e inadecuada alfabetización funcional en salud (p<0,002). Conclusión e implicaciones para la práctica la alfabetización funcional en salud inadecuada en ancianos afectados por enfermedades crónicas, muchas veces responsables, por su propio autocuidado, puede contribuir para agravar la condición de la salud y de las enfermedades de esa población, siendo relevante su reconocimiento para el establecimiento de estrategias y acciones que tengan por objetivo obtener mejores resultados en la producción del cuidado.

Abstract Objective to assess functional health literacy among hypertensive and diabetic elderly individuals enrolled in the Family Health Strategy. Method cross-sectional study conducted among 78 elderly individuals with type 2 Diabetes Mellitus and Systemic Arterial Hypertension, residing in a city in the interior of Rio Grande do Sul, Brazil. Data were collected using a questionnaire addressing sociodemographic and health information and the S-TOFHLA. Data analysis included Pearson's Chi-square, Central Tendency Measures (mean and median), and measures of dispersion, α=5% and p≤0.05. Results inadequate functional health literacy was found among 55.1% (N=43) of the participants, while 30.8% (N=24) presented marginal literacy skills. Hypertension was the most frequent disease with duration of more than 10 years. The results show an association between schooling and inadequate functional health literacy (p<0.002). Conclusion and implications for practice inadequate health literacy among elderly individuals with chronic diseases who are often responsible for self-care may worsen this population's health conditions and diseases. Thus, identifying literacy levels among these individuals is vital to devise strategies and implement actions intended to promote care.

Associação entre o alfabetismo funcional e o reconhecimento da palavra bruxismo em adolescentes / Association between functional literacy and the recognition of the word bruxism in adolescents

Objetivo: Avaliar a associação entre alfabetismo funcional e o reconhecimento da palavra "bruxismo" entre adolescentes. Métodos: Foi um estudo transversal realizado em uma cidade de porte médio no Brasil. A amostra consistiu em 375 escolares de 12 anos e 368 de 15 a 19 anos selecionados aleatoriamente. Dois examinadores calibrados (Kappa > 0,80) aplicaram o instrumento de alfabetismo em saúde bucal validado para adolescentes o Rapid Estimate of Adult Literacy in Dentistry ­ BREALD-30 e o reconhecimento da palavra "bruxismo" foi utilizado como variável dependente, além de um questionário sobre o alfabetismo funcional (Índice de Alfabetismo Funcional ­INAF). Os pais/cuidadores responderam um questionário sociodemográfico. Foi realizada análise não-ajustada e regressão logística para amostras complexas(p < 0,05). Resultados: No modelo final, os adolescentes de 12 anos que tiveram mais chances de não reconhecer a palavra "bruxismo" foram os de escola pública (OR = 2,83; 95% IC: 1,79-4,46; p = 0,001), sem plano de saúde (OR = 2,02; 95% IC: 1,21-3,37; p = 0,007) e com menor nível de alfabetismo funcional (OR = 2,66; 95% IC: 1,66-4,26; p < 0,001). Adolescentes de 15 a 19 anos que tiveram maior chance de não reconhecer a palavra "bruxismo" foram os com menor nível de alfabetismo funcional (OR = 3,29; 95% IC: 1,93-5,60; p < 0,001), que residiam com mais pessoas em casa (OR = 2,04; 95% IC: 1,02-4,11; p = 0,040), que tinham pais/responsáveis com baixo nível de escolaridade (OR = 1,97; 95% IC: 1,15-3,36; p = 0,013) e que nunca foram ao dentista (OR = 3,08;95% IC: 1,26-7,52; p = 0,03). Conclusão:O reconhecimento do termo "bruxismo" entre os adolescentes de 12 anos foi influenciado pela presença deplano de saúde e por um maior nível de alfabetismo funcional. Na faixa etária maior, o maior nível de alfabetismo funcional, o menor número de pessoas em casa, a maior escolaridade do responsável e a ida ao dentista influenciaram no reconhecimento do termo.

Aim: To evaluate the association between functional literacy and the recognition of the word "bruxism" among adolescentes.Method: This was a cross-sectional study carried out in a mid-sized city in Brazil. The sample consisted of 375 schoolchildren, age 12, and 368, aged 15 to 19 years, selected at random. Two calibrated examiners (Kappa > 0.80) applied the oral health literacy instrument, validated for adolescents, the "Rapid Estimate of Adult Literacy in Dentistry" (BREALD-30) and the recognition of the word "bruxism" was used as a dependent variable, in addition to a questionnaire on functional literacy (Functional Literacy Index ­ INAF). Parents/caregivers answered a sociodemographic questionnaire. Unadjusted analysis and logistic regression were performed for complex samples (p < 0.05). Results: In the final model, the 12-year-old adolescents who were most likely not to recognize the word "bruxism" were those from public schools (OR = 2.83; 95% CI: 1.79-4.46; p = 0.001), without health insurance (OR = 2.02; 95% CI: 1.21-3.37; p = 0.007), and with a lower level of functional literacy (OR = 2.66; 95% CI: 1, 66-4.26; p < 0.001). Adolescents, aged 15 to 19, who had a greater chance of not recognizing the word "bruxism" were those with the lowest level of functional literacy (OR = 3.29; 95% CI: 1.93-5.60; p < 0.001), who lived with more people at home (OR = 2.04; 95% CI: 1.02-4.11; p = 0.040), who had parents/guardians with a low level of education (OR = 1.97; 95% CI: 1.15-3.36; p = 0.013). and who had never been to the dentist (OR = 3.08; 95% CI: 1.26-7.52; p = 0.03). Conclusion: The recognition of the term "bruxism" among 12-year-olds was influenced by the presence of a health plan and a higher level of functional literacy. In the older age group, the higher level of functional literacy, the smaller number of people at home, the higher level of education of the person in charge, and the individual's visit to the dentist influenced the recognition of the term.

The effect of health literacy on health status among residents in Qingdao, China: a path analysis

BACKGROUND@#Health literacy is a public health goal which can be used as an independent factor of health outcomes. This study aimed to assess the association between health literacy and health status, as well as the two mediating factors of behavior and self-efficacy among residents aged 15-69 years in Qingdao.@*METHODS@#A cross-sectional survey was implemented among residents aged 15-69 years (N = 3793) in Qingdao, China. A combination of stratified cluster random and proportional probability sampling methods was used to select subjects for this study. Data were collected using "The Chinese Citizen Health Literacy Questionnaire (2019)". We proposed a hypothetical model for the relationship between sociodemographic characteristics, health literacy, self-efficacy, health behavior, and health status, and used path analysis to validate the hypothesis.@*RESULTS@#The path analysis showed that higher education (β = 0.293) and income (β = 0.135) are positively and directly associated with greater health literacy, which was positively associated with health status (β = 0.057). Health literacy is a direct influencing factor of health behavior (β = 0.070) and self-efficacy (β = 0.099). Health behavior (β = 0.041) and self-efficacy (β = 0.173) exerted a positive direct effect on health status. The model explained 14.1% of variance for health literacy, 3.8% for self-efficacy, 5.7% for health behavior, and 15.0% for health status.@*CONCLUSIONS@#Health literacy was identified to be a critical factor in health status. The results emphasized that the dissemination of health knowledge, development of healthy behavior, and cultivation of self-efficacy should be jointly promoted to reinforce the level of health status among residents in future work.

Alfabetización en salud y adherencia farmacológica en adultos mayores con enfermedades crónicas, de la ciudad de Temuco / Association between health literacy and adherence to medications among older adults

Background: Lack of compliance with medication prescription is common among older adults and hamper an adequate management of chronic conditions. Aim: To study the association between health literacy and medication adherence in older adults with chronic diseases in Temuco, Chile. Material and Methods: The Health Literacy survey for Spanish-speaking Adults, MiniMental examination and the Morisky-Green test to assess compliance with medication prescription were applied to 119 older adults aged 60 to 88 years. Results: All participants had an adequate global cognitive performance; 24% had inadequate literacy, and 42% did not comply with medication prescription. There was a significant correlation between health literacy and medication adherence. Conclusions: Health literacy influences medication adherence in Chilean older adults.

Socioeconomic status and family functioning influence oral health literacy among adolescents

ABSTRACT OBJECTIVE Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87-0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS The following variables remained associated with better OHL: high mother's schooling level (RR = 1.07; 95%CI: 1.03-1.12), high income (RR = 1.04; 95%CI: 1.01-1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01-1.10), married parents (RR = 1.04; 95%CI: 1.01-1.09), "enmeshed" family cohesion (RR = 1.21; 95%CI: 1.12-1.30), "structured" (RR = 1.06; 95%CI: 1.01-1.12) or "rigid" (RR = 1.11; 95%CI: 1.04-1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01-1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03-1.13). CONCLUSION Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.

El grado de alfabetización en salud y adherencia al tratamiento en pacientes con hipertensión arterial en un hospital nacional de Lima, Perú / The degree of health literacy and treatment compliance in patients with high blood pressure in a national hospital in Lima, Peru

RESUMEN Objetivos . Evaluar el nivel de alfabetización en salud y el grado de adherencia al tratamiento en pacientes hipertensos que acuden al consultorio externo en un hospital de Lima, Perú. Materiales y métodos. Se realizó un estudio transversal en 276 pacientes, quienes llenaron un cuestionario con características generales, el test de SAHLSA-50 y el test de Morisky-Green. Se utilizó la prueba de Chi Cuadrado para evaluar la asociación entre las variables independientes con la adherencia al tratamiento y con la alfabetización en salud. Resultados. Se encontró un 36% de inadecuada alfabetización sanitaria en salud y un 15% de adherencia al tratamiento. No se halló asociación entre estas variables (p=0,155). Hubo asociación entre ser jefe de familia (p=0,033) y tener pareja (p=0,044) con el grado de alfabetización en salud. Conclusiones. El porcentaje de alfabetización en salud fue similar al de estudios peruanos y latinoamericanos, y el grado de adherencia al tratamiento fue una de las más bajas reportadas. No se encontró asociación significativa entre éstas dos variables.

ABSTRACT Objectives. To assess the level of health literacy and treatment compliance in high-blood pressure patients attending an outpatient clinic in a hospital in Lima, Peru. Materials and Methods. A cross-sectional study was conducted in 276 patients, who filled out a questionnaire with general characteristics, the SAHLSA-50 Test, and the Morisky-Green Test. The Chi-square test was used to assess the association between independent variables with treatment compliance and health literacy. Results. We found a 36% of inadequate health literacy and 15% treatment compliance. No association was found between these variables (p=0.155). There was an association between being a head of household (p=0.033) and having a partner (p=0.044) with the degree of health literacy. Conclusions. The percentage of health literacy was similar to that of Peruvian and Latin American studies, and the degree of treatment compliance was one of the lowest reported. No significant association was found between these two variables.

Health literacy and adherence to drug treatment of type 2 diabetes mellitus / Alfabetización en salud y adhesión al tratamiento farmacológico del diabetes mellitus tipo 2 / Letramento em saúde e adesão ao tratamento medicamentoso do diabetes mellitus tipo 2

ABSTRACT Objective: To analyze the relationship between health literacy and medication adherence of patients with Type 2 Diabetes Mellitus. Method: Quantitative cross-sectional study developed in five Family Health Strategies in the city of Picos, Piauí. Participants comprised 78 users of health services. The "Short Test of Functional Health Literacy in Adults" and the "Treatment Adherence Measurement Test" forms were applied to obtain sociodemographic variables. Descriptive and inferential statistical analysis. Results: Regarding health literacy, 51.3% of the participants were considered inadequate, and 87.2% were adherent to the drug treatment. The average of health literacy varied according to the level of medication adherence and sociodemographic variables. Conclusion: Most patients reported to adhere to the medication. Implications for practice: This study identified the health literacy and medication adherence profile of the patients, thus subsidizing the planning of nursing interventions in the attention of diabetes mellitus.

RESUMEN Objetivo: Analizar la relación entre alfabetización en salud y adhesión al tratamiento medicamentoso de pacientes con Diabetes Mellitus Tipo 2. Método: Estudio cuantitativo y transversal desarrollado en cinco Estrategias de Salud de la Familia en Picos, Piauí. Participaron 78 usuarios de los servicios de salud. Se utilizó un formulario con variables sociodemográficas ("Short Test of Functional Healthy Literacy in Adults") y el "Test de Medida de Adhesión al Tratamiento". Análisis estadístico descriptivo e inferencial. Resultados: Para alfabetización en salud, el 51,3% de los participantes fueron clasificados como inadecuados y 87,2%, adherentes al tratamiento. Hubo variación del promedio de la alfabetización de acuerdo con el nivel de adhesión a la medicación y las variables sociodemográficas. Conclusión: La mayoría confirmó adhesión a la medicación. Implicaciones para la práctica: Se identificó el perfil de alfabetización y adhesión al tratamiento en pacientes, subsidiando la planificación de intervenciones de enfermería en atención al Diabetes Mellitus.

RESUMO Objetivo: Analisar a relação entre letramento em saúde e adesão ao tratamento medicamentoso de pacientes com diabetes mellitus tipo 2. Método: Estudo quantitativo e transversal desenvolvido em cinco Estratégias de Saúde da Família da cidade de Picos-Piauí. Participaram 78 usuários dos serviços de saúde. Foram utilizados um formulário para obtenção das variáveis sociodemográficas, o "Short Test of Functional Helathy Literacy in Adults", e o "Teste de Medida da Adesão ao Tratamento". Para a análise, utilizou-se estatística descritiva e inferencial. Resultados: Quanto ao letramento em saúde, 51,3% dos participantes foram classificados como inadequados, e 87,2% dos participantes foram considerados aderentes ao tratamento medicamentoso. Houve variação da média do letramento em saúde de acordo com o nível de adesão ao tratamento medicamentoso e as variáveis sociodemográficas. Conclusão: Identificou-se relação entre o letramento em saúde e a adesão ao tratamento medicamentoso. Os pacientes, mesmo apresentando, em sua maioria, um letramento em saúde inadequado, referem aderir à terapêutica medicamentosa. Implicações para a prática: O estudo possibilitou identificar o perfil de letramento em saúde e de adesão à terapêutica dos pacientes, subsidiando o planejamento das intervenções de enfermagem na atenção ao diabetes mellitus.

Development of a health literacy instrument related to diabetic foot / Desarrollo de un instrumento de evaluación de la literacía en salud relacionada al pie diabético / Desenvolvimento de um instrumento de avaliação da literacia em saúde relacionada ao pé diabético

ABSTRACT Objective: To develop and verify the validity, reliability and interpretability of an assessment instrument of the Health Literacy regarding Diabetic Foot (HLDF). Method: Methodological study among people with diabetes enrolled in Family Health Strategy (FHS) program, composed of eight phases: selection of participants; development of LSPD; verification of content validity by the committee of experts; pre-test (n=20); reliability estimation (n=62): Cronbach's alpha (CA), Kappa (K) and Intraclass Correlation Coefficient (ICC), satisfactory results (≥0.60); estimation of concurrent validity (n=62); interpretability of scores: range from 0-18, if ≤14 HLDF inadequate; hypothesis test (multiple logistic regression): OR/IC95% in a sample estimated for infinite population, using SPSS. Results: The HLDF has adequate and fast application, being relevant as to its content and to the construct that proposes to evaluate. About the reliability CA=0.73, two items presented Kappa<0.60, ICC=0.79. About the concurrent validity, there was correlation between the HLDF and schooling (rs=0.647; p=0.000). Interpretability: 50.2% (n=112) presented inadequate HLDF. The younger ones presented lower levels of inadequate HLDF (0.96/0.93-0.99); as to those with lower scholarship (1.15/1.06-1.25) and lower family income (1.01/1.00-1.01) presented higher levels of inadequate HLDF. Conclusion and implications for practice: The HLDF was considered as valid, reliable and interpretable. The HLDF can identify people with more effective educational strategies needs.

RESUMEN Objetivo: Desarrollar y verificar la validad, fiabilidad e interpretabilidad de un instrumento de evaluación que propone evaluar la Literacia en Salud en lo que concierne al Pie Diabético (LSPD). Método: Estudio metodológico entre personas con diabetes catastradas en Estrategias de Salud de la Familia, compuesto por ocho fases: selección de los participantes; desarrollo del LSPD; verificación de validad del contenido por el comité de expertos; pre-test (n=20); estimación de la confiabilidad (n=62); Alfa de Cronbach (AC), Kappa y Coeficiente de Correlación Intraclase (CCI); resultados satisfactorios (≥0,60); estimación de la validez concurrente (n=62); interpretabilidad de los scores: varían de 0-18 se ≥14 LSPD adecuado; prueba de hipótesis (regresión logística múltiple): OR/IC95% en una muestra estimada para población infinita, utilizando el SPSS. Resultados: El LSPD tiene una aplicación adecuada y rápida, siendo relevante en relación con su contenido y al constructo que propone evaluar; en relación con su confiabilidad AC=0,73; dos de los elementos presentaron Kappa<0,60; CCI=0,79. En cuanto a la validez concurrente, hubo correlación del LSPD con la escolaridad (rs=0,647; p=0,000). Interpretabilidad: 50,2% (n=112) presentaron LSPD inadecuada. Los más jóvenes presentaron niveles más bajos de LSPD inadecuada (0,96/0,93-0,99); ya aquellos con menor nivel de educación (1,15/1,06-1,25) y menor renda familiar (1,01/1,00-1,01) presentaron niveles más altos de LSPD inadecuada. Conclusión e Implicaciones para la práctica: El LSPD fue considerado válido, confiable e interpretable. El LSPD podrá identificar personas con necesidades de estrategias educativas más efectivas.

RESUMO Objetivo: Desenvolver e verificar a validade, confiabilidade e interpretabilidade de um instrumento de avaliação da Literacia em Saúde no que diz respeito ao Pé Diabético (LSPD). Método: Estudo metodológico entre pessoas com diabetes cadastradas na Estratégia de Saúde da Família, composto por oito fases: seleção dos participantes; desenvolvimento do LSPD; verificação da validade de conteúdo pelo comitê de especialistas; pré-teste (n=20); estimativa da confiabilidade (n=62): Alfa de Cronbach (AC), Kappa (K) e Coeficiente de Correlação Intraclasse (CCI), resultados satisfatórios (≥0,60); estimativa da validade concorrente (n=62); interpretabilidade dos escores: variam de 0-18, se ≤14 LSPD inadequada; teste de hipótese (regressão logística múltipla): OR/IC95% em uma amostra estimada para população infinita, usando o SPSS. Resultados: O LSPD possui aplicação adequada e rápida, sendo relevante quanto ao seu conteúdo e ao construto que propõe avaliar; quanto à confiabilidade: AC=0,73, dois itens apresentaram K<0,60; CCI=0,79. Quanto à validade concorrente, houve correlação do LSPD com a escolaridade (rs=0,647;p=0,000). Interpretabilidade: 50,2% (n=112) apresentaram LSPD inadequada. Os mais jovens apresentaram menores níveis de LSPD inadequada (0,96/0,93-0,99); já aqueles com menor escolaridade (1,15/1,06-1,25) e menor renda familiar (1,01/1,00-1,01) apresentaram maiores níveis de LSPD inadequada. Conclusão e implicações práticas: O LSPD foi considerado válido, confiável e interpretável. O LSPD poderá identificar pessoas com necessidades de estratégias educacionais mais efetivas.

Estudio Transversal: Alfabetización de Salud en Once Parroquias Bajo la Lupa, Cuenca - Ecuador, 2016 / Transversal Research: Health Literacy in Eleven Parishes under the Microscope, Cuenca- Ecuador, 2016

INTRODUCCIÓN: La alfabetización en salud está relacionada en la competitividad y preparación del personal frente a los complejos sistemas de salud; siguiendo una gradiente social que puede profundizar desigualdades existentes. Teniendo como objetivo de esta investigación la recopilación de datos para establecer una línea de base. MÉTODOS: Este estudio observacional transversal, que aplica una modificación del cuestionario HLS-EU-Q16 para medir competencias en salud, a una muestra de 871 personas de 11 parroquias del cantón Cuenca - Ecuador. Adicionalmente se recopilaron variables sociodemográficas y sanitarias. Se realizó un análisis mediante estadística descriptiva e inferencial. RESULTADOS: Tres parroquias presentan índices de alfabetización en salud significativamente mejores que las demás. Una parroquia se destaca por resultados muy malos. Los subíndices de alfabetización siguen un patrón común. Las variables independientes presentan variaciones menores o ninguna entre las parroquias. CONCLUSIONES: Se conoce el impacto positivo de la alfabetización en salud sobre el gasto público. Reduce el número de consultas en el primer nivel de atención y permite dedicar más tiempo a los pacientes. Esta inversión de tiempo evitaría futuros problemas. Se propone realizar estudios para analizar los programas educacionales de las unidades operativas del Ministerio de Salud Pública y una encuesta en línea basada en el cuestionario HLS-EU-Q16.

BACKGROUND: Health literacy concerns our competencies to meet the demands of complex health systems. It follows a social gradient and can deepen existing inequalities. For this reason this research was undertaken to collect data for a baseline. METHODS: A cross-sectional, observational study was performed, using a modification of the HLS-EU-Q16 questionnaire to measure health competencies in a sample of 871 people from 11 parishes of the district of Cuenca. Additionally, sociodemographic and health variables were collected. For analysis descriptive and inferential statistics were used. RESULTS: Three parishes have significantly better health literacy rates than others. A parish stands out for very bad results. Literacy sub-indices follow a common pattern. Independent variables have minor or no variations between parishes. CONCLUSIONS: Health literacy's positive impact on public spending is well known. It reduces the number of primary care consultations and allows spending more time for patients. This investment of time would avoid future problems. We propose to perform further studies to analyze the educational programs of the Health Ministry's dependencies and do launch an online survey based on the HLS-EU-Q16 questionnaire.

Literacia em saúde à pessoa idosa: uma revisão integrativa / Health literacy in older adults: an integrative review

A literacia em saúde preocupa-se com o aprendizado resultante das estratégias educativas em saúde, avaliando não apenas a efetividade do ensino, mas principalmente o impacto do conteúdo apreendido e utilizado na prática por cada pessoa, sua aplicabilidade nas atividades da vida diária. É considerada uma importante ferramenta no empoderamento da pessoa idosa, porém ainda é incipiente sua utilização como método de capacitação para autogestão da saúde. Assim, percebe-se que a literacia em saúde avalia as multidimensões da pessoa quanto ao acesso à informação, a habilidade de apreensão e compreensão, e a competência para tomada de decisão, enxergando seus saberes multifacetados que nos obrigam a estar conscientes do 118 cunho singular que é o cuidado em saúde. Sugere-se, portando incremento das investigações e desenvolvimento de literacia direcionadas as carências da população idosa no cenário nacional de saúde

Letramento em saúde e autopercepção de saúde em adultos usuários da atenção primária / Health literacy and self-rated health in adults primary care patients

RESUMO Objetivo Verificar a associação entre o letramento em saúde, determinantes sociais e autopercepção da saúde em adultos usuários da Atenção Primária à Saúde. Método Estudo observacional analítico transversal no qual foram entrevistados 380 usuários do Sistema Único de Saúde no contexto da Atenção Primária à Saúde. A amostra foi probabilística, estratificada por gênero, faixa etária e Unidade Básica de Saúde. O letramento em saúde foi avaliado por meio de instrumento de análise da percepção de adultos sobre o entendimento de orientações em saúde e possíveis dificuldades nesse processo (Escala de Letramento em Saúde). Foram realizadas análises descritivas e de associação (teste Qui quadrado de Pearson, p≤0,05). Resultados Verificou-se que a maioria dos entrevistados pertence às classes C1 e C2 e cursou o ensino médio. Quanto à autopercepção da saúde, considerar-se saudável e com boa saúde foram as percepções predominantes. Na Escala de Letramento em Saúde, verificou-se que a maior parte dos usuários relatou nunca apresentar dificuldades nas situações desse instrumento, exceto compreensão de orientações por escrito. Observou-se associação com significância estatística da melhor percepção de letramento em saúde com maior escolaridade e classificação econômica, bem como com a autopercepção da saúde boa. Conclusão Houve associação estatística entre letramento em saúde, determinantes sociais e autopercepção da saúde nos adultos avaliados. Ressalta-se a contribuição da Escala de letramento em saúde por enfatizar a percepção de dificuldades nas situações cotidianas da saúde. Faz-se necessário desenvolver relações dialógicas que construam processos comunicativos robustos entre equipe e usuário para favorecer as habilidades de letramento em saúde.

ABSTRACT Purpose To verify the association between health literacy, social determinants and self-rated health in adult's primary health care patients. Methods this is an Observational cross-sectional study in which a total of 380 patients of the Unified Health System in the context of primary health care were interviewed. The sample was probabilistic, stratified by gender, age, and Basic Health Unit. Health literacy was evaluated by an instrument of analysis of the perception of adults about the understanding of health orientations and possible difficulties in this process (Health Literacy Scale). Descriptive and association analyses were performed (Pearson's chi-square test, p≤0.05). Results It was verified that the majority of the interviewees belongs to classes C1 and C2 and attended high school (complete or incomplete). Regarding self-rated health, to be considered healthy and with good health were the predominant perceptions. In the Health Literacy Scale, it was verified that most patients reported never presenting difficulties in the situations of this instrument, except understanding written orientations. It was observed the association with a statistical significance of the better perception of health literacy with higher educational level and economic classification, as well as with self-rated of good health. Conclusion There was a statistical association between health literacy, social determinants, and self-rated health in the analyzed adults. It is noteworthy the contribution of the Health Literacy Scale for emphasizing the perception of difficulties in everyday health situations. It is necessary to develop dialogic relationships that build more robust communication processes between professionals and healthcare patients to favor health literacy skills.

Alfabetización en salud y control de la diabetes en pacientes de un hospital universitario de Argentina / Health literacy and diabetes control in patients attending a university outpatient clinic in Argentina

La alfabetización en salud (AS) es una medida de la capacidad de los pacientes de leer, comprender y tomar decisiones en base a instrucciones médicas. La inadecuada AS se asocia con peor estado de salud en pacientes con enfermedades crónicas. Es escasa la información sobre el nivel de alfabetización en pacientes diabéticos en Argentina. Se realizó este estudio con el objeto de estimar la relación de inadecuada AS y el control de la diabetes, evaluada a través del valor de la hemoglobina A1c en diabéticos tratados con insulina que concurren a un hospital universitario de Argentina. La AS se evaluó con el Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA) y se evaluó el control de la glucemia por el último valor de hemoglobina A1c. Participaron 156 pacientes seleccionados en forma aleatoria, 58% mujeres. El puntaje promedio de SALHSA fue 35 (rango: 11-50). Se encontró inadecuada AS en 94 pacientes (60.3%). La HbA1c promedio en los pacientes con inadecuada AS fue 8.15% vs 7.15% entre los que tenían adecuada AS (p = 0.0001). La regresión lineal múltiple mostró que la inadecuada AS se asocia en forma significativa con el mal control de la glucemia (β = -0.05 IC 95% -0.07; -0.02, p < 0.001). En conclusión, sería necesario implementar medidas para garantizar la educación de los pacientes con limitada AS.

Health literacy (HL) is a measure of a patient ability to read, understand and to take decisions on medical instructions. Patients with inadequate HL have poorer health outcomes than those with adequate HL. There is little information on HL levels in diabetic patients in Argentina. The aim of this study was to explore the association between HL and glycemic control in diabetic patients from a university hospital in Argentina. HL was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), glycemic control through glycosylated hemoglobin A1c (HbA1c); 156 patients (58% women) took part in the study. Average SAHLSA score was 35 (range: 11-50). Patients with inadequate values of HL had HbA1c of 8.15% vs. 7.15% among those with adequate HL (p = 0.0001). The multiple linear regression shows that inadequate HL was significantly associated with poorer glycemic control (β = -0.05 IC 95% -0.07; -0.02, p < 0.001). Efforts should focus on developing interventions to improve glycemic control among patients with inadequate HL.

Letramento funcional em saúde na adolescência: associação com determinantes sociais e percepção de contextos de violência / Functional health literacy and quality of life of high-school adolescents in state schools in Belo Horizonte

RESUMO Objetivo Investigar a associação entre letramento funcional em saúde e fatores sociodemográficos, qualidade de vida, autopercepção da saúde e percepção de contextos de violência em adolescentes de escolas estaduais de Belo Horizonte. Método Trata-se de estudo observacional analítico transversal com amostra probabilística estratificada composta por 384 adolescentes entre 15 e 19 anos. A coleta de dados foi realizada em 16 escolas e incluiu questionários autoaplicáveis de avaliação do letramento funcional em saúde, classificação socioeconômica, autopercepção de saúde e de qualidade de vida. A confiabilidade da consistência interna do instrumento de letramento funcional em saúde foi determinada por meio do cálculo do coeficiente de Alfa de Cronbach. Foram realizadas análises descritivas, bivariada e de regressão logística múltipla com entrada hierarquizada dos dados segundo o nível de determinação do modelo teórico estabelecido. Foi considerado o nível de significância de 5% e utilizada como medida de magnitude das associações o Odds Ratio. Resultados O instrumento de letramento funcional em saúde apresentou coeficiente de 0,766, indicando consistência interna aceitável. Mais da metade dos adolescentes apresentou letramento funcional em saúde bom. No modelo final da análise multivariada, permaneceram associadas ao letramento funcional em saúde as variáveis: não praticar religião (p = 0,006; OR = 2,108); domínio social da qualidade de vida (p = 0,004; OR = 1,022); e domínio escolar da qualidade de vida (p = 0,009; OR = 1,019). Conclusão Adolescentes com melhor percepção do convívio social e da inserção escolar tendem a apresentar melhor letramento funcional em saúde. A presença da prática de religião na vida do adolescente também interfere no letramento funcional em saúde.

ABSTRACT Purpose To investigate the association between functional health literacy and sociodemographic factors, quality of life, self-perception of health, and perception of contexts of violence in adolescents in state schools in Belo Horizonte. Methods This is a cross-sectional analytical observational study with a probabilistic sample of 384 adolescents between 15 and 19 years old. Data collection was carried out in schools and included self-reporting questionnaires to assess the functional health literacy, socioeconomic classification, self-perceived health, and quality of life. The reliability of internal consistency of the functional health literacy instrument was determined by calculating Cronbach's alpha coefficient. A multivariate logistic regression analysis was performed using hierarchical data entry according to the level of determination of the theoretical model established. In order to evaluate the association, a significance level of 5% was considered, while the Odds Ratio used as a measure of the magnitude of the associations. Results The functional health literacy instrument presented a coefficient of 0.766, indicating adequate internal consistency. More than half of teenagers presented good functional health literacy. In the final model of multivariate analysis, the variables not practicing a religion (p = 0.006; OR = 2.108); social domain of quality of life (p = 0.004; OR = 1.022); and educational domain of quality of life (p = 0.009; OR = 1.019) remained associated with functional health literacy. Conclusion Not practicing a religion and the increase in the scores of social and educational domains of quality of life increased the chances of better functional health literacy.

Validación del test Short Assessment of Health Literacy for Spanish-speaking Adults en Chile, para medir alfabetización en salud / Validation of the short assessment of health literacy for spanish-speaking adults test in Chile

Background: Health literacy is defined as the degree to which individuals obtain, process and understand basic health information and services. It is necessary to make appropriate decisions about their health. Evidence has shown that the level of health literacy is critical to the prognosis of chronic diseases. The Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA-50) is a short and simple health literacy adult assessment. Aim: To determine the validity and reliability indicators of SAHLSA-50 in Chilean adults. Material and Methods: The survey was applied to 84 older adults living in high and low income neighborhoods. Results: The survey had an adequate construct validity and reliability, its Comparative Fit Index was 0.93, its Tucker-Lewis index was 0.927 and its Root Mean Square Error of Approximation was 0.044. “Close fit” was not statistically significant (p = 0.828). Reliability was estimated by K-Richardson, which reported a good outcome (0.9255). Despite the good global indicators obtained, it is necessary to pay attention to some items that would fail to explain the “Health literacy” construct or were beyond the parameters of difficulty and discrimination proposed by the authors of the test. Conclusions: We propose this test as a useful tool to assess health literacy in the adult population in Chile. Its use and incorporation into local research can be especially recommended in the areas of education and health promotion.

Basic life support knowledge of first-year university students from Brazil

We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

Estudio exploratorio del impacto del alfabetismo funcional sobre conductas sanitarias deficientes a nivel poblacional / An exploratory study of functional literacy on health care behaviors in Chile

Background: Health Literacy is the set of skills that constitute the ability to perform reading and numerical tasks to function in the health care environment. People with functional illiteracy are unable to understand written documents and therefore sanitary information. Aim: To explore the effects of functional illiteracy on personal health care behaviors in Chile. Material and Methods: Using the Chilean Social Characterization Survey of 2006, respondents were separated into those that had read a book in the last year and those that had not as a proxy variable for functional literacy. Using econometric models, the impact of this variable on having a Papanicolaou (PAP) smear done and consulting in primary health clinics rather than in emergency services, was explored. Results: The survey is nationally representative, and 76% interviewees declared not having read a book in the last year. Probability of having a PAP smear done during the last three years was higher among women who had read a book with an OR of 1.19 (1.15-1.25). Likewise, the probability of consulting in emergency services rather than in primary health clinics was lower among those who had read a book with an OR of 0.85 (0.80-0.91). Conclusions: This study provides evidence of possible impacts of low functional literacy in health care behaviors in the Chilean population.

Avaliação do conhecimento do termo "nefrologia" em uma amostra populacional / Evaluation of knowledge of the term "nephrology" in a population sample

INTRODUÇÃO: A consolidação da especialidade nefrologia é relativamente recente e sua denominação não remete intuitivamente à sua área de abrangência. OBJETIVO: Avaliar o grau de conhecimento de uma amostra populacional sobre o termo "nefrologia". MÉTODOS: Foi realizado um estudo transversal em Niterói, RJ, com transeuntes adultos respondendo "Você sabe o que é nefrologia?". As variáveis anotadas incluíram: sexo, idade, cor, residência, renda, nível de escolaridade e doença renal na família. Valores de p < 0,05 foram considerados significativos. RESULTADOS: De 564 pessoas abordadas, 504 dispuseram-se a responder. Dos que se recusaram, 64% eram homens, 58%, brancos, entre os quais 85% tinham idade > 30 anos. Entre os participantes, a idade média foi 39 (22-56) anos; 49% eram homens e 56% brancos. Conheciam o termo "nefrologia" 28% dos entrevistados. A origem do conhecimento foi predominantemente escolar (39%) e familiar (30%). Aqueles que conheciam nefrologia tinham maior idade (42 ± 17 vs. 39 ± 17 anos, p < 0,05), maior renda (R$ 4.522 vs. R$ 2.934, p < 0,05), maior escolaridade (27% vs. 12% com superior completo, p < 0,001), eram predominantemente brancos (64% vs. 53%, p = 0,001), com maior frequência de doença renal na família (55% vs. 36%, p < 0,001). Na análise multivariada, associações foram mantidas para idade (OR 1,02, IC 95% 1,00-1,03, p = 0,004), nível de escolaridade superior (OR 10,60, IC 95% 4,20-26,86, p < 0,001) e doença renal na família (OR 2,2, IC 95% 1,40-3,41, p < 0,001). CONCLUSÕES: Apenas 28% conheciam o termo "nefrologia", ilustrando a baixa penetração da especialidade. Esforços devem ser empreendidos para popularizar essa área da medicina visando melhor orientação acerca da prevenção e cuidado das enfermidades renais.

INTRODUCTION: The consolidation of nephrology as a medical specialty is relatively new and its denomination does not intuitively reflects its true scope. OBJECTIVE: To assess the degree of knowledge from a population sample regarding the term "nephrology". METHODS: We carried out a cross-sectional study in Niterói, RJ, with adult passerby individuals answering to the question "Do you know what nephrology is?". The variables recorded included: gender, age, skin-color, residence, income, educational level and kidneydisease history in the family. p values < 0.05 were considered significant. RESULTS: Of the 564 individuals asked, 504 were willing to answer. Of those who refused, 64% were males, 58% caucasians - from whom 85% were aged > 30 years. The mean age among participants was 39 (22-56) years, 49% were males and 56% caucasians. Twenty-eight percent of the interviewees knew the term "nephrology". Their knowledge came from school (39%) and family (30%). Those who knew about the term "nephrology" were older (42 ± 17 vs. 39 ± 17 years, p < 0.05), had higher income (R$ 4,522 vs. R$ 2,934, p < 0.05) and higher education (27% vs. 12% with complete higher education, p < 0.001). They were predominantly caucasians (64% vs. 53%, p = 0.001), and had a higher rate of renal disease in the family (55% vs. 36%, p < 0.001). In the multivariate analysis, associations were maintained for age (OR 1.02; 95% CI 1.00 to 1.03, p = 0.004); higher education (OR 10.60, 95% CI, 4.20 to 26.86, p < 0.001) and kidney disease in the family (OR 2.2, 95% CI, 1.40 to 3.41, p < 0.001). CONCLUSIONS: Only 28% knew the term "nephrology", illustrating the specialty's low penetration. We must strive to popularize this field of medicine aiming at better educating the population concerning the prevention and care of kidney diseases.

Letramento em saúde: importância da avaliação em nefrologia / Health literacy: importance of assessment in nephrology

Letramento em Saúde (LS) ou habilidade de leitura e numeramento que permite ao indivíduo transitar no ambiente de saúde, é um tema relativamente novo e que vem ganhando espaço nas agendas de pesquisa e política de saúde, particularmente nos países desenvolvidos. Onde estudado, o LS inadequado associa-se com cuidados de saúde de pior qualidade e maior custo. Mesmo assim, a maioria dos médicos não conseguem identificar o problema e não têm preparo para lidar com o paciente que apresenta LS inadequado. Na presente revisão, os autores discutem aspectos importantes do LS, tais como a sua epidemiologia, associações com desfechos clínicos, avaliação, determinantes e oportunidades de intervenções, particularmente na nefrologia. Por ser comum e associar-se com desfechos clínicos indesejáveis, o LS inadequado deveria ser regularmente avaliado nos pacientes com doença renal.

Health literacy (HL) or basic reading and numeracy that allow an individual to function in the health care environment, is a relatively new topic, yet has increasingly been gaining interest over the past few years both in the research and policy agendas, particularly in the develop countries. Where studied, inadequate HL has been associated with poor health care quality and more cost. Yet many physicians do not recognize the problem or is not skilled enough to approach the subject with their patients. In this review, important aspects of HL, such as its epidemiology, associations with poor outcomes, assessment, determinants and interventions, particularly in nephrology, are discussed. Because it is common and associated to adverse clinical outcomes, inadequate HL should be incorporated into the list of assessments of patients with renal disease.

Alfabetización en salud en pacientes que asisten a un hospital universitario / Health literacy in patients attending a University Hospital

La Alfabetización en Salud (AS), del inglés health literacy, es la habilidad para obtener, procesar y entender información básica con respecto a la salud, necesaria para tomar decisiones. Los pacientes con inadecuada AS presentan pobre cuidado de su salud, utilizan con mayor frecuencia los servicios de emergencia y sufren más internaciones hospitalarias. No hemos encontrado información acerca de la frecuencia de AS en nuestro país. Esta investigación se realizó con el propósito de estimar la prevalecencia de inadecuada AS en los pacientes que se atienden en un hospital universitario. Se llevó a cabo en el Hospital de Clínicas José de San Martín de la Universidad de Buenos Aires, en los consultorios externos de clínica médica y en las salas de internación durante 2007. La AS se evaluó con el Short Assessment of Health Literacy for Spanish-speaking Adults. Entre 2345 pacientes potencialmente elegibles durante el tiempo del estudio, 234 fueron seleccionados en forma aleatoria, 229 fueron entrevistados (tasa de respuesta 98%). La participación fue voluntaria. El 62% de los respondedores provenían del área ambulatoria, el 54.6% fueron mujeres; la edad promedio fue de 56 años. La frecuencia de inadecuada AS fue de 30.1%. Los pacientes con educación primaria tenían una probabilidad significativamente mayor de presentar inadecuada AS comparados con los que tenían instrucción universitaria OR = 45.1 (IC 9.6-211.6). La frecuencia estimada de inadecuada AS en los pacientes evaluados fue elevada. Se encontró una fuerte asociación entre el nivel educativo y el grado de AS. Estos hallazgos sugieren un alto porcentaje de inadecuada alfabetización en salud en nuestro medio. Resulta indispensable que los profesionales de la salud conozcan las implicancias que la inadecuada AS tiene en el cuidado de la salud.

Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during 2007. Health literacy was assessed through the Short Assessment of Health Literacy for Spanish-speaking Adults. Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during 2007.There were a total of 2345 patients potentially eligible during the time of the study, 234 were approached after random selection and 229 patients were interviewed (98% response); 54.6% of respondents were women and 62% were recruited from the ambulatory clinic. The respondents had a median age of 56 years. The prevalence of inadequate health literacy was 30.1% (69 patients). Patients with ≤ 7 years of formal education had more risk of having inadequate health literacy compared with those with > 12 years of education OR = 45.1 (IC 9.6-211.6). We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences.