Sleath et al., 2014(11)
|
United States of America |
Multi-center, cross-sectional, observational. |
228 English-speaking adults with glaucoma in self-administration of medications. |
REALM |
14.5% of patients obtained a score of 0-60 in REALM and 83.3% obtained a score of 61-66. There was no association between HL and adherence to medication. |
Izard et al., 2014(12)
|
United States of America |
Cross-sectional observational. |
50 patients with prostate cancer (aged ≥ 21 years) and 50 health professionals. |
1) REALM-SF 2) Graphical Literacy Scale |
Mean score in REALM-SF: 6.8 (maximum: 7, SD: 1.0), equivalent to high HL. |
van der Vaart et al., 2014(13)
|
The Netherlands |
Pretest/ posttest. |
360 patients with rheumatoid arthritis aged 20-86 years. |
1) MFCCHL– Ishikawa (Version in Dutch) 2) 5-item version of PEPPI-5 |
Mean score in HL: 38.6 (scale from 14 (low HL) to 56 (high HL)) (SD: 7.2). Significant association between portal use and HL: Higher HL = higher frequency of access to the portal. |
Tsai et al., 2014(14)
|
Taiwan |
Cross-sectional observational. |
347 women living in the regions of great Taipei or Taoyuan (north of Taiwan). |
1) THLS-modified version 2) HPLP Chinese |
Mean score in HL: 2.60 (maximum: 4, SD: 0.55) = moderate HL. 33.2% of the participants presented inadequate HL and 66.8%, adequate HL. There was an association between HL and health-promoting behaviors. |
Wei et al., 2014(15)
|
Taiwan |
Cross-sectional observational. |
752 Taiwanese adults (372 from Taipei and 380 from Hualien). |
MHLS |
Mean score in MHLS: 43.2 (maximum: 50, SD: 6.6). Adequate HL: 68.6%, marginal HL: 25.3%, and inadequate HL: 6.1%. |
Smedberg et al., 2014(16)
|
15 European countries |
Multi-center, cross-sectional, observational. |
8,344 pregnant women or women with children younger than one year. |
SBSQ |
HL among non-smokers and smokers: low: 5.0% and 7.4%, medium: 39.7% and 47.4%, high: 55.3% and 45.1% (p-value <0.001). Women with low HL were more likely to continue smoking during pregnancy. |
Lupattelli et al., 2014(17)
|
Countries in Europe, Oceania, and the Americas |
Multi-center, cross-sectional, observational. |
4,999 pregnant women. |
SBSQ |
High HL: 54.5%, medium: 40.3% and low: 5.2%. HL was significantly associated with non-adherence to medication, risk perception and beliefs about the medication. |
Nesbitt et al., 2014(18)
|
United States of America |
Cross-sectional observational. |
612 patients with cardiac insufficiency, age ≥ 18 years, rural area. |
STOFHLA |
Mean score in HL: 25.5 (maximum: 36, SD: 8.8). HL had no influence on health-related quality of life. |
Hirsh et al., 2014(19)
|
United States of America |
Randomized clinical trial. |
300 patients with rheumatoid arthritis, age ≥ 18 years. |
STOFHLA |
28% of patients with inadequate or marginal HL. Mean score in HL: 77.6 (maximum: 100; SD: 23.5%). Limited HL is a predictor of the presence of significant discrepancies between verbal and written assessments. |
Riebl et al., 2013(20)
|
United States of America |
Cross-sectional, observational - pilot study |
60 adults aged ≥ 21 years. |
NVS |
Mean score in HL: 5.2 (ranges from 0-6: 4-6 = adequate HL). Individuals with lower level of schooling presented lower HL scores. |
Inoue et al., 2013(21)
|
Japan |
Cross-sectional observational. |
269 patients with type 2 diabetes, age ≥ 20 years and < 75 years. |
1) MFCCHL– Ishikawa 2) Question with a Likert scale. |
Functional HL: 3.36 (SD: 0.58); communicative: 2.65 (SD: 0.68); critical: 2.28 (SD: 0.59). HL and patient-physician communication were associated with the understanding and management of diabetes. |
Jovic´-Vranes et al., 2013(22)
|
Serbia |
Cross-sectional observational (instrument validation). |
120 patients, age ≥ 18 years. |
1) TOFHLA 2)STOFHLA (Serbian versions) |
Adequate HL: 59.0% and 82.9%, limited HL: 41.0% and 17.1% (respectively in TOFHLA and STOFHLA). Sex, age, level of schooling, self-perception of health and presence of chronic disease were associated with HL. |
Kiser et al., 2012(23)
|
United States of America |
Randomized clinical trial. |
99 adult patients with chronic obstructive pulmonary disease. |
STOFHLA |
Low HL: 36%. Patients with low or high HL benefited from the intervention of self-management of an inhalation technique. |
Anger et al., 2012(24)
|
United States of America |
Cross-sectional observational - pilot study |
36 women with pelvic floor disorder, aged between 42 and 94 years. |
TOFHLA |
Mean score in HL: 93 (maximum 100). HL score decreased as age increased. Patients had low recall of the diagnosis and poor understanding of their pelvic floor condition, despite the fact that 97.2% of them presented high HL. |
Coughlan et al., 2012(25)
|
Ireland |
Cross-sectional observational - pilot study |
199 patients, age ≥ 18 years, attending an anticoagulation clinic. |
REALM |
Median of the HL score: 64 (maximum: 66). Low HL: 19.1%, adequate HL: 80.9%. There was an association between HL and level of schooling. |
Apolinário et al., 2012(26)
|
Brazil |
Cross-sectional observational (instrument validation). |
226 elderly patients, age ≥ 60 years, both sexes. |
SAHLPA (full and short versions: SAHLPA-50 and SAHLPA-18) |
Score mean: 37.7 (SD: 9.0). Inadequate HL: 66% (SAHLPA-50). The developed instrument presents good validity and consistence. |
Eriksson-Backa et al., 2012(27)
|
Finland |
Cross-sectional observational. |
281 elderly patients aged 65-79 years, both sexes. |
Questionnaire adapted from eHEALS |
Greater vulnerability to the obtention/use of health information: low level of schooling and self-perception of health, disinterest and low proactivity in the search for health information. |
Convery et al., 2011(28)
|
Australia |
Cross-sectional observational. |
80 adults with hearing loss aged 45-90 years, both sexes. |
STOFHLA |
Mean score in HL: 34 (adequate HL), (maximum: 36; SD: 4.61). Higher HL levels were associated with increased likelihood of completing the task in an independent and successful way. |
van der Vaart et al., 2011(29)
|
The Netherlands |
Cross-sectional observational. |
227 patients of a rheumatology clinic aged <70 years. |
MFCCHL– Ishikawa (Version in Dutch) |
Mean score in the functional HL: 3.4 (SD: 0.55), communicative: 2.8 (SD: 0.64) and critical: 2.0 (SD: 0.67). |
Myaskovsky et al., 2011(30)
|
United States of America |
Multi-center, cross-sectional, observational. |
275 subjects with spinal cord injury, wheelchair users for at least one year, age ≥16 years. |
1) REALM – Revised. 2) 9-item Healthcare System Distrust Scale. |
Mean score in HL: 7.37 (maximum: 8, SD: 1.55). Afro-Americans obtained a lower HL compared to whites. |
Hahn et al., 2011(31)
|
United States of America |
Cross-sectional observational (instrument validation). |
608 English speakers, primary care patients, age ≥21 years. |
Health LiTT |
The proportions of correct answers in the Health LiTT ranged from 30% to 95%. The test provides reliable and valid scores. Lower scores were associated with lower income and level of schooling, absence of previous use of computers and self-report of poor reading skills. |
Rawson et al., 2010(32)
|
United States of America |
Cross-sectional observational (instrument validation). |
155 patients referred to outpatient cardiology. |
1) REALM 2) METER |
Mean score: METER: 36.1 (SD: 5.0; maximum: 40); REALM: 62.2 (SD: 6.5; maximum: 66). METER measures HL in a fast and practical way. |
Fink et al., 2010(33)
|
United States of America |
Multi-center randomized clinical trial. |
502 patients with indication for elective surgeries. |
REALM |
HL mean score: 62.3 in the group with the repeat back technique and 62.5 in the group without the technique. |
Fink et al., 2010(34)
|
United States of America |
Multi-center randomized clinical trial. |
502 patients with indication for elective surgeries. |
REALM |
Patients with limited HL: 16% with score <60 and 2% with score <40 in REALM. HL was not significantly associated with understanding. |
Sox et al., 2010(35)
|
United States of America |
Cross-sectional observational. |
15 parents/guardians of students undergoing diagnostic analysis for ADHD |
TOFHLA |
HL score ranged from 79 to 100. The inclusion of user support items in the developed application was based on HL or on experience of technology. |
Ishikawa et al., 2009(36)
|
Japan |
Cross-sectional observational. |
134 patients with type 2 diabetes being regularly monitored at an outpatient clinic. |
1) MFCCHL– Ishikawa 2) PPPM - adapted 3) IPCDP - adapted |
Functional HL: 3.4, communicative: 2.5 and critical: 2.0 (maximum = 4). HL is related to patient-physician communication and to patient’s perception of the process. |
Carthery-Goulart et al., 2009(37)
|
Brazil |
Cross-sectional observational (instrument validation). |
312 healthy patients, age ≥ 18 years, both sexes. |
STOFHLA (in Portuguese) |
32.4% of patients with inadequate or borderline performance in the instrument. Among elderly patients, 51.6%. Association between S-TOFHLA results and level of schooling. The instrument is adequate to the Brazilian population. |