Health Literacy predicts incident foot ulcers after 4 years - the SHELLED cohort study.

IF 2.5 3区医学 Q1 ORTHOPEDICS

Journal of Foot and Ankle Research Pub Date : 2023-07-27 DOI:10.1186/s13047-023-00644-w

Pamela Chen, Michele Callisaya, Karen Wills, Timothy Greenaway, Tania Winzenberg

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Abstract

Aims/hypothesis: To determine whether health literacy is associated with an index diabetes-related foot ulcer (DFU).

Methods: The SHELLED Study is a 4-year prospective study of people with diabetes aged over 40 with no history of DFU. The primary outcome was development of a first foot ulcer. Health Literacy was measured using the short form Test of Functional Health Literacy in Adults (s-TOFHLA) and nine domains of the Health Literacy Questionnaire (HLQ).

Results: Of 222 participants, 191 (86.0%) completed the study, of whom 13 (5.9%) developed an incident ulcer. In multivariable models, every unit increase in S-TOFHLA was associated with a reduced odds of foot ulcer development by 6% (OR 0.94, 95% CI 0.88 to 0.99). Better scores on two HLQ domains reduced the odds of foot ulcer (actively managing my health (OR 0.23, 95% CI 0.08 to 0.65) and understanding health information well enough to know what to do (OR 0.39, 95% CI 0.19 to 0.78). This was independent of baseline risk for foot disease.

Conclusions/interpretation: These data provide novel evidence that health literacy is an important clinical risk factor for index foot ulceration. This is an area of potential focus for research and development of educational programs or policy aimed at reducing development of incident foot ulceration.

Abstract Image

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健康素养预测4年后足溃疡事件——shell队列研究。

目的/假设:确定健康素养是否与糖尿病相关性足溃疡(DFU)指数相关。方法:shell研究是一项为期4年的前瞻性研究，研究对象为40岁以上无DFU病史的糖尿病患者。主要结局是首次足部溃疡的发生。健康素养采用成人功能健康素养简短测试(s-TOFHLA)和健康素养问卷(HLQ)的九个领域进行测量。结果:222名参与者中，191名(86.0%)完成了研究，其中13名(5.9%)发生了溃疡。在多变量模型中，S-TOFHLA每增加一个单位与足部溃疡发生几率降低6%相关(OR 0.94, 95% CI 0.88至0.99)。两个HLQ域得分较高的患者患足溃疡的几率降低(积极管理自己的健康(OR 0.23, 95% CI 0.08至0.65)和充分了解健康信息以知道该怎么做(OR 0.39, 95% CI 0.19至0.78)。这与足部疾病的基线风险无关。结论/解释:这些数据提供了新的证据，表明健康素养是指数足溃疡的重要临床危险因素。这是一个潜在的研究和发展的教育计划或政策的重点领域，旨在减少事件足部溃疡的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Foot and Ankle Research ORTHOPEDICS-

CiteScore

4.50

自引率

10.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.