Health literacy among main caregivers of Children with Special Health Care Needs: a cross-sectional study

Kuntz, Sara Raquel; Moraes, Katarinne Lima; Vaccari, Alessandra; Theis, Thailine Stodulski; Cogo, Ana Luísa Petersen; Wegner, Wiliam

doi:10.1590/1518-8345.7860.4689

person Sara Raquel Kuntz

Substantial contributions to the conception or design of the work · or the acquisition, analysis, or interpretation of data for the work · drafting the work or reviewing it critically for important intellectual content · final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved · Data curation

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.schoolHospital de Clínicas de Porto Alegre, Serviço de Enfermagem Pediátrica, Porto Alegre, RS, Brazil.

0000-0002-7991-0546

person Katarinne Lima Moraes

Substantial contributions to the conception or design of the work · or the acquisition, analysis, or interpretation of data for the work · drafting the work or reviewing it critically for important intellectual content · final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

schoolUniversidade de Brasília, Faculdade de Ceilândia, Brasília, DF, Brazil.

0000-0001-6169-0461

person Alessandra Vaccari

Substantial contributions to the conception or design of the work · or the acquisition, analysis, or interpretation of data for the work · drafting the work or reviewing it critically for important intellectual content · final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.

0000-0003-0195-073X

person Thailine Stodulski Theis

Substantial contributions to the conception or design of the work · or the acquisition, analysis, or interpretation of data for the work · drafting the work or reviewing it critically for important intellectual content · final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.schoolScholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.

0009-0008-9301-5266

person Ana Luísa Petersen Cogo

Substantial contributions to the conception or design of the work · or the acquisition, analysis, or interpretation of data for the work · drafting the work or reviewing it critically for important intellectual content · final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.

0000-0003-2168-7801

person Wiliam Wegner

Substantial contributions to the conception or design of the work · or the acquisition, analysis, or interpretation of data for the work · drafting the work or reviewing it critically for important intellectual content · final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved · Project supervision and management

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.schoolHospital de Clínicas de Porto Alegre, Serviço de Enfermagem Pediátrica, Porto Alegre, RS, Brazil.

0000-0002-0538-9655

personCorresponding author: E-mail:
sarasrkuntz@gmail.com

Conflict of interest:

the authors have declared that there is no conflict of interest.

Associate Editor:

Maria Lúcia Zanetti

HLQ-Br * scales and questions	Mean	Standard Deviation
Part 1 (Scores 1-4)
Scale 1 – Feel understood and supported by healthcare providers	3.02	0.53
Q ^‡ 17 – I have the health professionals I need to…	3.25	0.71
Q ^‡ 8 – I have at least one health professional with whom to…	2.79	0.91
Scale 2 – Have sufficient information to manage my health	3.03	0.47
Q ^‡ 23 – I have all the information I need to…	3.68	0.64
Q ^‡ 14 – I am certain that I have all the information that…	3.01	0.73
Scale 3 – Actively managing health	2.82	0.51
Q ^‡ 6 – I spend much time with…	3.40	0.95
Q ^‡ 21 - I do something regularly to…	2.51	0.70
Scale 4 – have social support for health	2.96	0.59
Q ^‡ 19 – I have strong support…	3.24	0.76
Q ^‡ 5 – When I feel ill, people around me…	2.75	0.78
Scale 5 – Appraise health information	3.13	0.45
Q ^‡ 7 – When I see new health information…	3.37	0.62
Q ^‡ 4 – I compare all the health information I get…	2.94	0.76
Part 2 (Scores 1-5)
Scale 6 – Ability to actively engage with healthcare providers	4.00	0.57
Q ^‡ 20 – Asking questions to health professionals to…	4.39	0.83
Q ^‡ 2 – Being certain that health professionals…	3.60	0.96
Scale 7 – Ability to navigate the healthcare system	3.70	0.74
Q ^‡ 13 – Being certain to find the right place to…	4.01	1.07
Q ^‡ 1 – Finding the health service…	3.31	1.08
Scale 8 – Ability to find good health information	3.60	0.64
Q ^‡ 10 – Finding health information to…	3.81	0.91
Q ^‡ 18 – Finding information about…	3.37	1.19
Scale 9 – Ability to understand health information well enough to know what to do	3.99	0.57
Q ^‡ 21 – Understanding that health professionals are…	4.38	0.71
Q ^‡ 12 – Reading and understanding information…	3.81	1.06

*HLQ-Br scales**	Schooling level	Family income	Hospitalizations of the CSHCNs ^†
Part 1
1 - Feel understood and supported by healthcare providers	r _s ^‡ =0.23 ^§	r _s ^‡ =0.23 ^§	r _s ^‡ =0.16
	(p=0.006)	(p=0.006)	(p=0.057)
2 - Have sufficient information to manage my health	r _s ^‡ =0.15	r _s ^‡ =0.09	r _s ^‡ =0.17
2 - Have sufficient information to manage my health	(p=0.084)	(p=0.302)	(p=0.053)
3 - Actively managing health	r _s ^‡ =0.10	r _s ^‡ =0.09	r _s ^‡ =0.08
3 - Actively managing health	(p=0.260)	(p=0.292)	(p=0.334)
4 - Have social support for health	r _s ^‡ =0.33 ^§	r _s ^‡ =0.32 ^§	r _s ^‡ =-0.004
4 - Have social support for health	(p=0.000)	(p=0.000)	(p=0.96)
5 - Appraise health information	r _s ^‡ =0.17 ^\|\|	r _s ^‡ =0.17 ^\|\|	r _s ^‡ =0.19 ^\|\|
5 - Appraise health information	(p=0.038)	(p=0.044)	(p=0.019)
Part 2
6 - Ability to actively engage with healthcare providers	r _s ^‡ =0.13	r _s ^‡ =0.15	r _s ^‡ =-0.12
	(p=0.115)	(p=0.064)	(p=0.158)
7 - Ability to navigate the healthcare system	r _s ^‡ =0.62	r _s ^‡ =0.20 ^\|\|	r _s ^‡ =-0.051
7 - Ability to navigate the healthcare system	(p=0.467)	(p=0.016)	(p=0.553)
8 - Ability to find good health information	r _s ^‡ =0.35 ^§	r _s ^‡ =0.26 ^§	r _s ^‡ =-0.01
8 - Ability to find good health information	(p=0.000)	(p=0.002)	(p=0.837)
9 - Ability to understand health information well enough to know what to do	r _s ^‡ =0.22 ^§	r _s ^‡ =0.16 ^\|\|	r _s ^‡ =0.01
	(p=0.009)	(p=0.049)	(p=0.838)

HLQ-Br ^† scales	S ^‡ 1	S ^‡ 2	S ^‡ 3	S ^‡ 4	S ^‡ 5	S ^‡ 6	S ^‡ 7	S ^‡ 8	S ^‡ 9
Variables	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|	M^§ ±SD ^\|\|
HIS^¶ - Another caregiver
No	2.97±0.51	3.01±0.52	2.73±0.53	2.83±0.58	3.03±0.43	4.04±0.54	3.74±0.76	3.58±0.59	4.04±0.50
Yes	3.06±0.55	3.04±0.44	2.88±0.49	3.05±0.59	3.10±0.45	3.97±0.59	3.68±0.73	3.60±0.67	3.97±0.60
p-value**	0.366	0.750	0.086	0.039	0.037	0.448	0.618	0.855	0.489
HIS ^¶ - Internet
No	2.87±0.44	3.06±0.49	2.93±0.49	2.97±0.56	2.91±0.51	4.00±0.61	3.96±0.93	3.55±0.74	4.10±0.54
Yes	3.05±0.54	3.02±0.47	2.81±0.51	2.96±0.59	3.16±0.43	4.00±0.57	3.66±0.70	3.60±0.62	3.98±0.57
p-value**	0.192	0.711	0.349	0.925	0.026	0.99	0.115	0.74	0.42
HIS ^¶ - Journal/Book
No	3.02±0.52	3.02±0.46	2.83±0.50	2.97±0.58	3.10±0.44	4.00±0.58	3.71±0.74	3.57±0.64	3.99±0.56
Yes	3.04±0.62	3.04±0.56	2.78±0.67	2.83±0.62	3.40±0.47	4.00±0.56	3.63±0.77	3.90±0.47	4.03±0.66
p-value**	0.915	0.914	0.760	0.452	0.041	0.993	0.751	0.098	0.820
HIS ^¶ - TV/Radio
No	3.06±0.53	3.04±0.46	2.83±0.49	2.97±0.59	2.94±0.59	3.15±0.42	3.74±0.69	3.60±0.61	4.03±0.50
Yes	2.91±0.523	2.98±0.49	2.80±0.56	2.94±0.59	3.07±0.52	3.80±0.56	3.60±0.85	3.59±0.72	3.88±0.71
p-value**	0.14	0.511	0.707	0.815	0.333	0.013	0.335	0.940	0.165
HIS ^¶ - Health professional
No	2.97±0.52	3.01±0.49	2.85±0.50	2.98±0.58	3.11±0.45	4.00±0.58	3.72±0.75	3.61±0.65	4.01±0.58
Yes	3.38±0.49	3.13±0.30	2.66±0.52	2.87±0.62	3.24±0.46	3.95±0.55	3.57±0.63	3.50±0.55	3.90±0.48
p-value**	0.002	0.320	0.134	0.468	0.458	0.725	0.397	0.484	0.446
HIS ^¶ - Caregivers
No	3.02±0.53	3.03±0.47	2.84±0.50	2.97±0.59	3.12±0.45	4.00±0.58	3.71±0.74	3.60±0.64	3.99±0.57
Yes	3.25±0.47	2.91±0.62	2.13±0.46	2.60±0.34	3.40±0.52	4.06±0.41	3.22±0.63	3.53±0.46	4.00±0.52
p-value**	0.47	0.676	0.017	0.280	0.304	0.844	0.257	0.853	0.997

[1] *HLQ-Br = Brazilian version of the Health Literacy Questionnaire; ^† CSHCNs = Children with Special Health Care Needs; ^‡ Q = Question

Health literacy among main caregivers of Children with Special Health Care Needs: a cross-sectional study ^*

Highlights:

Health literacy among main caregivers of Children with Special Health Care Needs: a cross-sectional study *

Highlights:

Health literacy among main caregivers of Children with Special Health Care Needs: a cross-sectional study ^*