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A New Comprehensive Short-form Health Literacy Survey Tool for Patients in General
Tuyen Van Duong1, Peter WuShou Chang2, Shih-Hsien Yang3
1School of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institutional Research Center, Yuanpei University of Medical Technology, Hsin-Chu, Taiwan.
Purpose:
To validate a conceptual short-form health literacy 12 items questionnaire (HL-SF12) in patient populations.
Methods:
A cross-sectional study was conducted via a convenient sample of 403 patients from three departments of a community general hospital in the northern Taiwan. Patients' health literacy was assessed with a validated HL-SF12, derived from the full scale, the European Health Literacy Survey Questionnaire (HLS-EU-Q), as well as a single-item from Chew's Set of Brief Health Literacy Question. A reference population in Northern Taiwan (n=928) via the HLS-EU-Q in 2013-2014 was used as a reference to compare the health literacy between that of the general public and the patients. Data was analyzed by confirmatory factor analysis (CFA), internal consistency analysis, correlation analysis, and linear regression models.
Results:
Patients' health literacy assessed with the HL-SF12 was shown with high internal consistency (Cronbach α=.87), and moderately correlated with the single-item from Chew's Set of Brief Health Literacy Question, with satisfactory item-scale convergent validity (item-scale correlation ≥ .40), without floor/ceiling effect, and with satisfactory goodness of fit indices of the three-factor construct model for most of the patients. Their health literacy was significantly positively associated with female gender, higher income, and more often watching health-related TV programs. On the other hands, patients were reported with significantly higher healthcare health literacy than the general public, but not in general health literacy, disease prevention health literacy, or health promotion health literacy.
Conclusion:
The comprehensive HL-SF12 was a valid and easy to use tool for assessing patients' health literacy in the hospitals to facilitate healthcare providers in enhancing patients' health literacy and healthcare qualities.