Disentangling health information appraisal competence: Results from an interdisciplinary scoping review and online consultation among Swiss stakeholders.

BACKGROUND: The ability to critically appraise health information-often referred to as critical health literacy-is recognized as a crucial component of health literacy. Yet to date, it is not clear what specific abilities are needed to adequately accomplish this task, thereby hindering both its assessment and the development and evaluation of related interventions. By systematically building on past research, this study aimed to operationally define the concept of health information appraisal competence. METHODS: We systematically searched five scholarly databases to identify the conceptualizations and operational definitions of information appraisal in different disciplines. The resulting operationalization was subsequently validated through an online consultation exercise among 85 Swiss stakeholders. RESULTS: Ninety-four publications were included in the review to the point of saturation. We extracted 646 skills, attitudes, and knowledge for health information appraisal. We then collated overlapping or duplicate statements, which produced a list of 43 unique statements belonging to six emergent themes or core competences: (1) basic competence, (2) predisposition, (3) identification competence, (4) critical evaluation competence, (5) selection competence, and (6) application competence. The consultation exercise enriched the operationalization of some of the core competences and confirmed the importance of all competences. Most skills, attitudes, and knowledge, however, were assigned low feasibility by the stakeholders. CONCLUSIONS: This study was the first attempt to systematically operationalize health information appraisal competence. From a theoretical perspective, it sheds light on an understudied, health literacy domain, thus contributing to clarity around the concept. From a practical perspective, it provides a strong theoretical basis for the development of a tool to measure health information appraisal competence. This could be used routinely as a screening tool, as an outcome measure for public health interventions, or to identify citizens who are most at risk. Furthermore, it will provide support for the development of future interventions to build health information appraisal competence in the population.

[Nosocomial infections in the intensive care units].

BACKGROUND/AIM: The risk for nosocomial infections (NIs) is 5-10 times higher in patients hospitalized in the Intensive Care Units (ICUs) than in patients staying in other wards. The higher incidence rates of NIs in the ICUs may be explained by the fact that the patients in the ICUs have more severe underlying disease, and are exposed to the invasive diagnostic and therapeutical procedures. The unreasonable use of antibiotics leads to the selection of multiresistant agents, which have been increasingly recorded as the NIs causative agents. The aim of this study was to investigate the characteristics of NIs in the ICUs in the period January-June 2005. METHODS: The study of incidence was performed in accordance with the methodology of the Centers for Diseases and Prevention. Any infections in the patients hospitalized in the ICUs in the period from January to June 2005 were registered. The results both from medical documentation and from the direct contacts with the medical personnel were analyzed. The samples were tested using standard methods in the microbiological laboratory. RESULTS: The incidence rates of NIs patients ranged from 1.5 to 40.8, and the incidence rates of infections were 1.5 to 65.6 per 1 000 patient's days. Out of the total number of NIs, urinary infections accounted for 44.6%, blood infections for 37.6%, and surgical site infections for 16.9%. CONCLUSION: The most frequent cause of nosocomial urinary infections was Klebsiella, of nosocomial sepsis--coagulase--negative staphylococci, and of surgical site infections--Staphylococcus aureus.