Kronik Hastalığı Olan Bireylerde E-Sağlık Okuryazarlık ve Hasta Aktivasyon Düzeylerinin İncelenmesi/Investigation of E-Health Literacy and Patient Activation Levels in Individuals with Chronic Disease

Betül Nur Zaimoğlu; Zülfünaz Özer

doi:10.47565/ndthdt.2023.63

Araştırma Makalesi

Investigation of E-Health Literacy and Patient Activation Levels in Individuals with Chronic Disease/ Kronik Hastalığı Olan Bireylerde E-Sağlık Okuryazarlık ve Hasta Aktivasyon Düzeylerinin İncelenmesi

Yıl 2023, Cilt: 18 Sayı: 1, 12 - 21, 31.01.2023

Betül Nur Zaimoğlu Zülfünaz Özer

https://doi.org/10.47565/ndthdt.2023.63

Öz

Aim: This study was conducted to analyse e-health literacy and patient activation levels of individuals with chronic disease.
Material and Methods: This descriptive and cross-sectional study was conducted with 307 patients who had chronic disease and who were admitted to the internal medicine outpatient clinic of a training and research hospital in İstanbul between March 22 and September 30, 2021. Research data were collected face-to-face by using the Personal Information Form, e-health Literacy Scale, and Patient Activation Measure.
Results: Mean age of the patients was found as 47.78±11.27 years, while the mean chronic disease duration was found as 72.94±56.43 months. 62.2% of the patients evaluated their health status as moderate, 40.4% stated that they had diabetes and 30.6% stated that they had hypertension. The mean e-health literacy scale score was 23.3±5.32 and the mean Patient Activation Measure score was 28.88±15.54. A positive significant correlation was found between e-health literacy and Patient Activation Measure (r=.268, p<0.01).
Conclusion: It was found that the patients had a moderate e-health literacy level and their activity level was one. e-Health literacy level was found to decrease as age and chronic disease duration increased. In addition, patient activity was found to increase as e-health literacy levels increased.

Anahtar Kelimeler

e-Health literacy, patient activation, chronic disease, nurse

Kaynakça

1. World Health Organization (WHO). Management of non-communicable diseases-non-communicable. https://www.who.int/ activities/management-of-noncommunicable-diseases. Accessed June 5, 2022.
2. Koşar C. Hasta Aktiflik Düzeyi Ölçüm Aracı’nın Türkçe’ye ayarlanması: geçerlik ve güvenirlik çalışması. 2015; (Yüksek Lisans Tezi), Dokuz Eylül Üniversitesi, İzmir
3. Koşar C, Büyükkaya Besen D. Kronik hastalıklarda hasta aktifliği: kavram analizi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektron Dergisi. 2015;8(1):45–51.
4. Hibbard JH, Mahoney ER, Stock R, Tusler M. Do increases in patient activation result in improved self-management behaviors? Health Services Research. 2007;42(4):1443–1463. https://doi.org/10.1111/j.1475-6773.2006.00669.x.
5. Donald M, Ware RS, Ozolins IZ, Begum N, Crowther R, Bain C. The role of patient activation in frequent attendance at primary care: A population-based study of people with chronic disease. Patient Education and Counseling. 2011;83(2):217–21. http://dx.doi.org/10.1016/j.pec.2010.05.031.
6. Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Affairs. 2013;32(2):207–14. https://doi.org/10.1377/hlthaff.2012.1061.
7. Yılmazel G, Çetinkaya F. Sağlık okuryazarlığının toplum sağlığı açısından önemi. TAF Preventive Medicine Bulletin. 2016;15(1):69–74. DOI: 10.5455/pmb.1-1448870518.
8. Copurlar C, Kartal M. What is health literacy? How to measure it? Why is it important? Turkish Journal of Family Medicine and Primary Care. 2016;10(1):40. https://doi.org/10.5455/tjfmpc.193796.
9. Denktaş K. Kırsal kesimde ilköğretim son sınıf öğrencilerinin sağlık okuryazarlığı ve e-Sağlık okuryazarlığı. 2019; (Yüksek Lisans Tezi). Celal Bayar Üniversitesi, Manisa.
10. 1Paige SR, Krieger JL, Stellefson M, Alber JM. eHealth literacy in chronic disease patients: An item response theory analysis of the eHealth literacy scale (eHEALS). Patient Education and Counseling. 2017;100(2):320–326. http://dx.doi.org/10.1016/ j.pec.2016.09.008.
11. Yüksel O, Deniz S. Bireylerin e-sağlık okuryazarlık düzeyinin belirlenmesine yönelik bir araştırma. 2nd International Conference on Data Science and Applications (ICONDATA’19), October 3-6, 2019, Balıkesir, Turkey. https://www. researchgate.net/profile/Onur-Yueksel-3/publication/339377377_Bireylerin_E-Saglik_Okuryazarlik_Duzeyinin_ Belirlenmesine_Yonelik_Bir_Arastirma_A_Research_on_Determining_the_Level_of_E-Health_Literacy_of_Individuals/links/ 5e4e6f3892851c7f7f48cde2/Bireylerin-E-Saglik-Okuryazarlik-Duezeyinin-Belirlenmesine-Yoenelik-Bir-Arastirma-AResearch-on-Determining-the-Level-of-E-Health-Literacy-of-Individuals.pdf Accessed July 5, 2022.
12. Milne RA, Puts MTE, Papadakos J, Le LW, Milne VC, Hope AJ, et al. Predictors of high eHealth literacy in primary lung cancer survivors. Journal of Cancer Education. 2015;30(4):685–92. DOI 10.1007/s13187-014-0744-5.
13. Kim H, Goldsmith JV, Sengupta S, Mahmood A, Powell MP, Bhatt J, et al. Mobile health application and e-Health literacy: opportunities and concerns for cancer patients and caregivers. Journal of Cancer Education. 2019;34(1):3–8. https://doi.org/10.1007/s13187-017-1293-5.
14. Shi Y, Ma D, Zhang J, Chen B. In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults. Journal of Public Health. 2021; 1-9. https://doi.org/10.1007/s10389-021-01604-z.
15. Tamer Gencer Z. Norman ve Skinner’ın e-Sağlık Okuryazarlığı Ölçeğinin kültürel uyarlaması için geçerlilik ve güvenilirlik çalışması. İstanbul Üniversitesi İletişim Fakültesi Dergisi| Istanbul University Faculty of Communication Journal. 2017; (52), 131-145. https://doi.org/10.17064/iuifd.333165.
16. Yayla K, Caylan A, Öztora S, Çeçen CE, Ertuğrul C, Yılmaz AC, et al. Reliability Analysis Of The Turkish Version Of The Patient Activation Measure. Eurasian J Fam Med. 2016;5(1):20–24. DOI: 10.4314/ahs.v19i1.58.
17. Kleiven HH, Ljunggren B, Solbjør M. Health professionals’ experiences with the implementation of a digital medication dispenser in home care services- a qualitative study. BMC Health Services Research. 2020;20(1):1–10. https://doi.org/10.1186/s12913-020-05191-9.
18. Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the patient activation measure. Health Services Research. 2005;40(6 I):1918–1930. https://doi.org/10.1111/j.1475-6773.2005.00438.x.
19. Tüter M. Aile hekim polikliniğine başvuran hast siberkondri düzeyinin ve ilişkili faktörlerin değerlendirilmesi. 2019; Tıpta Uzmanlık Tezi. Sağlık Bilimleri Üniversitesi, İstanbul.
20. Tusa N, Kautiainen H, Elfving P, Sinikallio S, Mäntyselkä P. Relationship between patient activation measurement and selfrated health in patients with chronic diseases. BMC Family Practice. 2020;21(1):1–8. https://doi.org/10.1186/s12875-020- 01301-y.
21. Koşar C, Sezgi ÇP, Dedeli Çaydam Ö. Hemodiyaliz tedavisi alan hastaların sıvı kısıtlamasına uyumları ve hasta aktifliği arasındaki ilişkinin değerlendirilmesi. Adnan Menderes Üniversitesi Sağlık Bilim Fakültesi Dergisi. 2018;2(3):126–137.
22. Schmaderer MS, Zimmerman L, Hertzog M, Pozehl B, Paulman A. Correlates of patient activation and acute care utilization among multimorbid patients. Western Journal of Nursing Research. 2016; 38(10):1335-1353. https://doi.org/10.1177/0193945916651264.
23. Ahn YH, Kim BJ, Ham OK, Kim SH. Factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. Journal of Korean Academy of Community Health Nursing. 2015;26(3):303-311. DOI: https://doi.org/10.12799/jkachn.2015.26.3.303.
24. Magnezi R, Glasser S. Psychometric properties of the hebrew translation of the patient activation measure (PAM-13). PLoS One. 2014;9(11):9–14. https://doi.org/10.1371/journal.pone.0113391.
25. Shiferaw KB, Tilahun BC, Endehabtu BF, Gullslett MK, Mengiste SA. E-Health literacy and associated factors among chronic patients in a low-income country: a cross-sectional survey. BMC Medical Informatics and Decision Making. 2020;20(1):1–9. https://doi.org/10.1186/s12911-020-01202-1.
26. Kurtoğlu İ, Yılmaz N, Taş MA. Kronik hastaların e-Sağlık okuryazarlık düzeyleri üzerine bir araştırma. Mehmet Akif Ersoy Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2021; (35):126-136. https://doi.org/10.20875/makusobed.1009918
27. Connolly KK, Crosby ME. Examining e-Health literacy and the digital divide in an underserved population in Hawai’i. Hawai'i Journal of Medicine & Public Health. 2014;73(2):44–48.
28. Günler OE. Bilgi toplumunda internetin önemi ve sağlık üzerindeki etkileri. KMÜ Sosyal ve Ekonomik Araştırmalar Dergisi. 2015;17(29):33-40.
29. Fowles JB, Terry P, Xi M, Hibbard J, Bloom CT, Harvey L. Measuring self-management of patients’ and employees’ health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics. Patient Educ Couns. 2009;77(1):116–22. https://doi.org/10.1016/j.pec.2009.02.018.
30. Zhou J, Fan T. Understanding the factors influencing patient e-Health literacy in online health communities (OHCs): A social cognitive theory perspective. Int J Environ Res Public Health. 2019;16(14). https://doi.org/10.3390/ijerph16142455.
31. MacKert M, Whitten P, Garcia A. Interventions for low health literate audiences. J Comput Commun. 2008;13(2):504–15. https://doi.org/10.1111/j.1083-6101.2008.00407.x.
32. González-Chica DA, Mnisi Z, Avery J, Duszynski K, Doust J, Tideman P, et al. Effect of health literacy on quality of life amongst patients with ischaemic heart disease in Australian General Practice. PLoS One. 2016;11(3):1–15. https://doi.org/10.1371/journal.pone.0151079.
33. RobatSarpooshi D, Mahdizadeh M, Siuki HA, Haddadi M, Robatsarpooshi H, Peyman N. The Relationship between health literacy and self-care behaviors in patients with Type 2 Diabetes. J Nurs Res. 2015;10(4):43–5.
34. Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed June 5, 2022.

Kronik Hastalığı Olan Bireylerde E-Sağlık Okuryazarlık ve Hasta Aktivasyon Düzeylerinin İncelenmesi/Investigation of E-Health Literacy and Patient Activation Levels in Individuals with Chronic Disease

Yıl 2023, Cilt: 18 Sayı: 1, 12 - 21, 31.01.2023

Betül Nur Zaimoğlu Zülfünaz Özer

https://doi.org/10.47565/ndthdt.2023.63

Öz

Amaç: Bu çalışma kronik hastalığı olan bireylerin e-sağlık okur-yazarlık ve hasta aktivasyon düzeylerini incelemek amacıyla yapıldı.
Gereç ve Yöntemler: Tanımlayıcı ve kesitsel tipteki bu çalışma 22 Mart- 30 Eylül 2021 tarihleri arasında İstanbul’da bulunan bir eğitim araştırma hastanesinin dâhiliye polikliniğine başvuran kronik hastalığı olan 307 hasta ile veri toplama işlemi gerçekleştirildi. Araştırma verileri, Kişisel Bilgi Formu, e-Sağlık Okuryazarlığı Ölçeği ve Hasta Aktivasyonu Ölçeği ile yüz yüze görüşme yoluyla toplandı.
Bulgular: Hastaların yaş ortalamsı 47,78±11,27 yıl olup kronik hastalık süre ortalaması 72,94±56,43 aydır. Hastaların %62,2’si sağlık durumunu orta olarak değerlendirmekte, %40,4'ünün diyabet ve %30,6'sının hipertansiyon hastalığı bulunmaktaydı. e-Sağlık Okuryazarlığı Ölçeği puanı 23,3±5,32 ve Hasta Aktivasyonu Ölçeği puanı 28,88±15,54 bulunmuştur. e-Sağlık okuryazarlık ile Hasta Aktivasyonu Ölçeği arasında pozitif yönde anlamlı bir ilişki bulunmaktadır (r=,268, p<0,01)
Sonuç: Hastaların e-sağlık okuryazarlık düzeyi orta ve aktiflik düzeyilerinin 1’de yer aldığı saptandı. Yaş ve kronik hastalık süresi artıkça e-sağlık okuryazarlık düzeyi azalmaktadır. Bunun yanı sıra, e-sağlık okuryazarlık düzeyi arttıkça hasta aktifliğinin arttığı belirlendi.

Anahtar Kelimeler

e-Sağlık okuryazarlık, hasta aktifliği, kronik hastalık, hemşire

Kaynakça

1. World Health Organization (WHO). Management of non-communicable diseases-non-communicable. https://www.who.int/ activities/management-of-noncommunicable-diseases. Accessed June 5, 2022.
2. Koşar C. Hasta Aktiflik Düzeyi Ölçüm Aracı’nın Türkçe’ye ayarlanması: geçerlik ve güvenirlik çalışması. 2015; (Yüksek Lisans Tezi), Dokuz Eylül Üniversitesi, İzmir
3. Koşar C, Büyükkaya Besen D. Kronik hastalıklarda hasta aktifliği: kavram analizi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektron Dergisi. 2015;8(1):45–51.
4. Hibbard JH, Mahoney ER, Stock R, Tusler M. Do increases in patient activation result in improved self-management behaviors? Health Services Research. 2007;42(4):1443–1463. https://doi.org/10.1111/j.1475-6773.2006.00669.x.
5. Donald M, Ware RS, Ozolins IZ, Begum N, Crowther R, Bain C. The role of patient activation in frequent attendance at primary care: A population-based study of people with chronic disease. Patient Education and Counseling. 2011;83(2):217–21. http://dx.doi.org/10.1016/j.pec.2010.05.031.
6. Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Affairs. 2013;32(2):207–14. https://doi.org/10.1377/hlthaff.2012.1061.
7. Yılmazel G, Çetinkaya F. Sağlık okuryazarlığının toplum sağlığı açısından önemi. TAF Preventive Medicine Bulletin. 2016;15(1):69–74. DOI: 10.5455/pmb.1-1448870518.
8. Copurlar C, Kartal M. What is health literacy? How to measure it? Why is it important? Turkish Journal of Family Medicine and Primary Care. 2016;10(1):40. https://doi.org/10.5455/tjfmpc.193796.
9. Denktaş K. Kırsal kesimde ilköğretim son sınıf öğrencilerinin sağlık okuryazarlığı ve e-Sağlık okuryazarlığı. 2019; (Yüksek Lisans Tezi). Celal Bayar Üniversitesi, Manisa.
10. 1Paige SR, Krieger JL, Stellefson M, Alber JM. eHealth literacy in chronic disease patients: An item response theory analysis of the eHealth literacy scale (eHEALS). Patient Education and Counseling. 2017;100(2):320–326. http://dx.doi.org/10.1016/ j.pec.2016.09.008.
11. Yüksel O, Deniz S. Bireylerin e-sağlık okuryazarlık düzeyinin belirlenmesine yönelik bir araştırma. 2nd International Conference on Data Science and Applications (ICONDATA’19), October 3-6, 2019, Balıkesir, Turkey. https://www. researchgate.net/profile/Onur-Yueksel-3/publication/339377377_Bireylerin_E-Saglik_Okuryazarlik_Duzeyinin_ Belirlenmesine_Yonelik_Bir_Arastirma_A_Research_on_Determining_the_Level_of_E-Health_Literacy_of_Individuals/links/ 5e4e6f3892851c7f7f48cde2/Bireylerin-E-Saglik-Okuryazarlik-Duezeyinin-Belirlenmesine-Yoenelik-Bir-Arastirma-AResearch-on-Determining-the-Level-of-E-Health-Literacy-of-Individuals.pdf Accessed July 5, 2022.
12. Milne RA, Puts MTE, Papadakos J, Le LW, Milne VC, Hope AJ, et al. Predictors of high eHealth literacy in primary lung cancer survivors. Journal of Cancer Education. 2015;30(4):685–92. DOI 10.1007/s13187-014-0744-5.
13. Kim H, Goldsmith JV, Sengupta S, Mahmood A, Powell MP, Bhatt J, et al. Mobile health application and e-Health literacy: opportunities and concerns for cancer patients and caregivers. Journal of Cancer Education. 2019;34(1):3–8. https://doi.org/10.1007/s13187-017-1293-5.
14. Shi Y, Ma D, Zhang J, Chen B. In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults. Journal of Public Health. 2021; 1-9. https://doi.org/10.1007/s10389-021-01604-z.
15. Tamer Gencer Z. Norman ve Skinner’ın e-Sağlık Okuryazarlığı Ölçeğinin kültürel uyarlaması için geçerlilik ve güvenilirlik çalışması. İstanbul Üniversitesi İletişim Fakültesi Dergisi| Istanbul University Faculty of Communication Journal. 2017; (52), 131-145. https://doi.org/10.17064/iuifd.333165.
16. Yayla K, Caylan A, Öztora S, Çeçen CE, Ertuğrul C, Yılmaz AC, et al. Reliability Analysis Of The Turkish Version Of The Patient Activation Measure. Eurasian J Fam Med. 2016;5(1):20–24. DOI: 10.4314/ahs.v19i1.58.
17. Kleiven HH, Ljunggren B, Solbjør M. Health professionals’ experiences with the implementation of a digital medication dispenser in home care services- a qualitative study. BMC Health Services Research. 2020;20(1):1–10. https://doi.org/10.1186/s12913-020-05191-9.
18. Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the patient activation measure. Health Services Research. 2005;40(6 I):1918–1930. https://doi.org/10.1111/j.1475-6773.2005.00438.x.
19. Tüter M. Aile hekim polikliniğine başvuran hast siberkondri düzeyinin ve ilişkili faktörlerin değerlendirilmesi. 2019; Tıpta Uzmanlık Tezi. Sağlık Bilimleri Üniversitesi, İstanbul.
20. Tusa N, Kautiainen H, Elfving P, Sinikallio S, Mäntyselkä P. Relationship between patient activation measurement and selfrated health in patients with chronic diseases. BMC Family Practice. 2020;21(1):1–8. https://doi.org/10.1186/s12875-020- 01301-y.
21. Koşar C, Sezgi ÇP, Dedeli Çaydam Ö. Hemodiyaliz tedavisi alan hastaların sıvı kısıtlamasına uyumları ve hasta aktifliği arasındaki ilişkinin değerlendirilmesi. Adnan Menderes Üniversitesi Sağlık Bilim Fakültesi Dergisi. 2018;2(3):126–137.
22. Schmaderer MS, Zimmerman L, Hertzog M, Pozehl B, Paulman A. Correlates of patient activation and acute care utilization among multimorbid patients. Western Journal of Nursing Research. 2016; 38(10):1335-1353. https://doi.org/10.1177/0193945916651264.
23. Ahn YH, Kim BJ, Ham OK, Kim SH. Factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. Journal of Korean Academy of Community Health Nursing. 2015;26(3):303-311. DOI: https://doi.org/10.12799/jkachn.2015.26.3.303.
24. Magnezi R, Glasser S. Psychometric properties of the hebrew translation of the patient activation measure (PAM-13). PLoS One. 2014;9(11):9–14. https://doi.org/10.1371/journal.pone.0113391.
25. Shiferaw KB, Tilahun BC, Endehabtu BF, Gullslett MK, Mengiste SA. E-Health literacy and associated factors among chronic patients in a low-income country: a cross-sectional survey. BMC Medical Informatics and Decision Making. 2020;20(1):1–9. https://doi.org/10.1186/s12911-020-01202-1.
26. Kurtoğlu İ, Yılmaz N, Taş MA. Kronik hastaların e-Sağlık okuryazarlık düzeyleri üzerine bir araştırma. Mehmet Akif Ersoy Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2021; (35):126-136. https://doi.org/10.20875/makusobed.1009918
27. Connolly KK, Crosby ME. Examining e-Health literacy and the digital divide in an underserved population in Hawai’i. Hawai'i Journal of Medicine & Public Health. 2014;73(2):44–48.
28. Günler OE. Bilgi toplumunda internetin önemi ve sağlık üzerindeki etkileri. KMÜ Sosyal ve Ekonomik Araştırmalar Dergisi. 2015;17(29):33-40.
29. Fowles JB, Terry P, Xi M, Hibbard J, Bloom CT, Harvey L. Measuring self-management of patients’ and employees’ health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics. Patient Educ Couns. 2009;77(1):116–22. https://doi.org/10.1016/j.pec.2009.02.018.
30. Zhou J, Fan T. Understanding the factors influencing patient e-Health literacy in online health communities (OHCs): A social cognitive theory perspective. Int J Environ Res Public Health. 2019;16(14). https://doi.org/10.3390/ijerph16142455.
31. MacKert M, Whitten P, Garcia A. Interventions for low health literate audiences. J Comput Commun. 2008;13(2):504–15. https://doi.org/10.1111/j.1083-6101.2008.00407.x.
32. González-Chica DA, Mnisi Z, Avery J, Duszynski K, Doust J, Tideman P, et al. Effect of health literacy on quality of life amongst patients with ischaemic heart disease in Australian General Practice. PLoS One. 2016;11(3):1–15. https://doi.org/10.1371/journal.pone.0151079.
33. RobatSarpooshi D, Mahdizadeh M, Siuki HA, Haddadi M, Robatsarpooshi H, Peyman N. The Relationship between health literacy and self-care behaviors in patients with Type 2 Diabetes. J Nurs Res. 2015;10(4):43–5.
34. Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed June 5, 2022.

Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Hemşirelik
Bölüm	Makale
Yazarlar	Betül Nur Zaimoğlu Bu kişi benim 0000-0001-7144-5662 Zülfünaz Özer 0000-0002-2431-2346
Yayımlanma Tarihi	31 Ocak 2023
Yayımlandığı Sayı	Yıl 2023 Cilt: 18 Sayı: 1

Kaynak Göster

Vancouver	Zaimoğlu BN, Özer Z. Kronik Hastalığı Olan Bireylerde E-Sağlık Okuryazarlık ve Hasta Aktivasyon Düzeylerinin İncelenmesi/Investigation of E-Health Literacy and Patient Activation Levels in Individuals with Chronic Disease. NefroHemDergi. 2023;18(1):12-21.

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Nefroloji Hemşireliği Dergisi/ Journal of Nephrology Nursing Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.