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Health Literacy Among Patients With Chronic Lung Disease Entering Pulmonary Rehabilitation and Their Resident Loved
Miranda M J Coenjaerds1, Martijn A Spruit, Fiona A H M Cleutjens
1Departments of Research and Development (Ms Coenjaerds and Drs Spruit, Franssen, Wouters, and Janssen) and Psychology (Dr Cleutjens), CIRO, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands (Ms Coenjaerds and Drs Spruit and Franssen); Reval Rehabilitation Research, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium (Dr Spruit); Department of Medical Psychology, Maastricht UMC+, School for Mental Health and Neurosciences (MHeNS), Maastricht, the Netherlands (Dr Ponds); Department of Respiratory Medicine, Maastricht UMC+, Maastricht, the Netherlands, and Ludwig Boltzmann Institute for Lung Health, Vienna, Austria (Dr Wouters); and Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands (Dr Janssen).
Purpose:
The objective of this study was determine the prevalence of low health literacy (HL) and low reading ability among patients with chronic lung disease referred for pulmonary rehabilitation (PR) in the Netherlands and their loved ones; and to understand whether low HL or low reading ability influence PR outcomes.
Methods:
Health literacy was measured using the Health Literacy Survey-Europe Q16 (HLS-EU-Q16). Reading ability and cognitive functioning were measured using the Rapid Estimate of Adult Literacy in Medicine-Dutch (REALM-D) and the Montreal Cognitive Assessment. Exercise capacity, health status, and symptoms of anxiety and depression were assessed.
Results:
Patients (n = 120) entering PR and loved ones (n = 41) participated. Of all patients, 51% had low HL and 29% had low reading ability. Also, 39% of all loved ones had low HL. PR outcomes were comparable between patients with low or adequate HL. Patients with adequate reading ability showed greater improvement in symptoms of depression than patients with low reading ability (P = .047).
Conclusion:
Low HL and low reading ability are common among patients entering PR and their loved ones. For patients with low or adequate HL, PR is an effective treatment. Whether considering low HL and low reading ability by offering tailored education during treatment could augment the benefits of PR warrants further study.
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