ArticlePloS one2021
Risk factors for poorer health literacy in patients with liver cirrhosis.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Reducing the Risk of Overt Hepatic Encephalopathy Recurrence: A Narrative Review.Journal of clinical and translational hepatology · 2026Review
- Towards a Better Understanding of MASLD: Patient Health Literacy, Illness Perception, and Awareness.Diseases (Basel, Switzerland) · 2026Article
- Digital divide and healthcare service utilization among older adults with chronic liver disease in China: a nationwide cross-sectional study.Scientific reports · 2026Article
- Lower Health Literacy Is Associated With Greater Severity of Metabolic Dysfunction and Steatotic Liver Disease.Gastro hep advances · 2026Article
- From Isolation to Information: Launching an Online Community for Patients with Primary Sclerosing Cholangitis, Primary Biliary Cholangitis, and Autoimmune Hepatitis in Romania-A Descriptive Study.Healthcare (Basel, Switzerland) · 2025Article
- Predictors of health-seeking behavior in patients with chronic liver disease and a comparison of health-seeking based on patient-type.BMC gastroenterology · 2025Article
- The Effect of Nutritional Education on Nutritional Status and Quality of Life in Patients with Liver Cirrhosis.Healthcare (Basel, Switzerland) · 2025Article
- Health disparities in cirrhosis care and liver transplantation.Nature reviews. Gastroenterology & hepatology · 2025Review
- Predictive factors for limited health literacy among persons with cirrhosis: A Swedish explorative cross-sectional study.PloS one · 2025Article
- Multimedia-Based Education Led to Improvement in Disease Knowledge Among Patients with Cirrhosis.Digestive diseases and sciences · 2024Article
- Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review.Healthcare (Basel, Switzerland) · 2023Article
- Testing a Digital Health App for Patients With Alcohol-Associated Liver Disease: Mixed Methods Usability Study.JMIR formative research · 2023Article
- Knowledge needs in patients with Liver Disease: a qualitative study.BMC nursing · 2023Article
- How do (false) positively screened patients experience a screening programme for liver cirrhosis or fibrosis in Germany? A qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- A Beta-Prototype Chatbot for Increasing Health Literacy of Patients With Decompensated Cirrhosis: Usability Study.JMIR human factors · 2023Article
- Health literacy in gastrointestinal diseases: a comparative analysis between patients with liver cirrhosis, inflammatory bowel disease and gastrointestinal cancer.Scientific reports · 2022Article
- Scaffold-mediated liver regeneration: A comprehensive exploration of current advances.Journal of tissue engineeringReview
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth literacy is a concept that refers to patients' ability to manage their disease and the health system's ability to guarantee access to services. There is evidence that health literacy impacts the health outcomes of patients with chronic diseases, but detailed information on this topic in patients with liver cirrhosis is scarce. It was the aim of this study to identify risk factors for poorer health literacy in patients with liver cirrhosis.
methods89 patients with liver cirrhosis were enrolled in this study and health literacy was measured using the Health Literacy Questionnaire (HLQ). Covert hepatic encephalopathy (CHE) was diagnosed clinically according to the West-Haven Criteria (HE grade 1) and the PHES (minimal HE). Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HDRS). Based on the nine subscales of the HLQ, risk factors for poor health literacy were identified using linear regression models.
resultsNormalized HLQ scores ranged between 65-76%, while appraisal of health information had lowest score (65%) and ability to actively engage with healthcare providers had highest score (76%). Multivariable regression analyses revealed an association of poorer health literacy and liver function as determined by MELD score and complications of liver cirrhosis such as a history of ascites or CHE. Additionally, we identified modifiable or preventable factors such as depressive symptoms, a history of falls, and active smoking as risk factors for poorer health literacy.
conclusionMultiple factors seem to impact on health literacy in patients with liver cirrhosis. Addressing modifiable and preventable factors may improve health literacy.
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