Diabetessykepleiere i Norge sine oppfatninger av pasienters «health literacy»

AimTo identify diabetes nurses' experience with patients’ three hierarchical levels of health literacy (HL): Functional HL (FHL), interactive HL (IHL) and critical HL (CHL). Background Diabetic patients receive health information from many sources of varying quality, while individual responsibility for their own health is emphasized. This requires that patients can evaluate the quality of health information. Such skills reflect health literacy (HL), which focuses on understanding, gaining access to, critical evaluation and use of health information for the acquisition of good health. Method A questionnaire, mainly consisting of 5-point Likert-scaled attitude statements reflecting FHL, IHL and CHL, was developed. A total of 108 diabetes nurses responded (40% response rate). Through factor and reliability analysis, FHL, IHL and CHL constructs of the statements were established. Results The FHL, IHL and CHL constructs were consistent with HL-theory. Some construct statements achieved low mean scores. The mean score on CHL construct was lower than the corresponding scores on the FHL and IHL constructs. Conclusion Diabetes patient’s HL should preferably be explored. Since the patients might have varying degrees of HL, diabetes nurses should take this into account during health communication between them and the patient

Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents

Background The Hopkins Symptom Checklist-10 (HSCL-10) is widely used to measure psychological distress in adolescents. To provide valid and reliable results and generate recommendations for practice and policies, instruments with sound psychometric properties are required. The purpose of this study is to use Rasch measurement theory to assess the psychometric properties of the HSCL-10 among adolescents aged 13–19. Methods In this cross-sectional study, 6445 adolescents responded to a web-based questionnaire. Data were collected from lower and upper secondary schools in Norway during 2018. The data were analysed using the partial credit parameterisation of the unidimensional Rasch model. Results HSCL-10 was found to be unidimensional and to have acceptable reliability. One pair of items showed response dependency. The targeting of the instrument could have been better. All items had ordered thresholds. Three items under-discriminated and three displayed differential item functioning regarding gender. Conclusions HSCL-10 has potential for measuring psychological distress in adolescents, though there is room for improvement. To further improve this instrument, some items should be rephrased.publishedVersio

Using Rasch Analysis to Assess the Psychometric Properties of a Five-Item Version of the General Self-Efficacy Scale in Adolescents

The aim of the present study was to use Rasch analysis to assess the psychometric properties of the five-item version of the General Self-Efficacy Scale (GSES) amongst adolescents aged 13 to 19. In this cross-sectional study, 6265 adolescents responded to a web-based questionnaire. Data collected from lower and upper secondary schools in Norway, during 2018, were analysed using the partial credit parameterisation of the unidimensional Rasch model. The five-item version of the GSES was found to be unidimensional and to have acceptable reliability. The targeting of the scale could have been better. All items had ordered thresholds, indicating that the response categories worked quite well. The five-item version of the GSES has potential for measuring self-efficacy in a general population of adolescents. In surveys concerning adolescents’ mental health, it is important to include aspects of positive mental health and health-promoting factors, such as self-efficacy.publishedVersio

Diabetes nurses' perception of patients health literacy

AimTo identify diabetes nurses' experience with patients’ three hierarchical levels of health literacy (HL): Functional HL (FHL), interactive HL (IHL) and critical HL (CHL). Background Diabetic patients receive health information from many sources of varying quality, while individual responsibility for their own health is emphasized. This requires that patients can evaluate the quality of health information. Such skills reflect health literacy (HL), which focuses on understanding, gaining access to, critical evaluation and use of health information for the acquisition of good health. Method A questionnaire, mainly consisting of 5-point Likert-scaled attitude statements reflecting FHL, IHL and CHL, was developed. A total of 108 diabetes nurses responded (40% response rate). Through factor and reliability analysis, FHL, IHL and CHL constructs of the statements were established. Results The FHL, IHL and CHL constructs were consistent with HL-theory. Some construct statements achieved low mean scores. The mean score on CHL construct was lower than the corresponding scores on the FHL and IHL constructs. Conclusion Diabetes patient’s HL should preferably be explored. Since the patients might have varying degrees of HL, diabetes nurses should take this into account during health communication between them and the patients

Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents

Background The Hopkins Symptom Checklist-10 (HSCL-10) is widely used to measure psychological distress in adolescents. To provide valid and reliable results and generate recommendations for practice and policies, instruments with sound psychometric properties are required. The purpose of this study is to use Rasch measurement theory to assess the psychometric properties of the HSCL-10 among adolescents aged 13–19. Methods In this cross-sectional study, 6445 adolescents responded to a web-based questionnaire. Data were collected from lower and upper secondary schools in Norway during 2018. The data were analysed using the partial credit parameterisation of the unidimensional Rasch model. Results HSCL-10 was found to be unidimensional and to have acceptable reliability. One pair of items showed response dependency. The targeting of the instrument could have been better. All items had ordered thresholds. Three items under-discriminated and three displayed differential item functioning regarding gender. Conclusions HSCL-10 has potential for measuring psychological distress in adolescents, though there is room for improvement. To further improve this instrument, some items should be rephrased.publishedVersio

Using Rasch measurement theory to assess the psychometric properties of a depressive symptoms scale in Norwegian adolescents

Background Scales measuring depressive symptoms in adolescents and adults are widely used for epidemiological purposes. The purpose of this study is to use Rasch measurement theory to examine the psychometric properties of a six-item scale intended to measure depressive symptoms in Norwegian adolescents. Methods The study is based on cross-sectional data from Ungdata, a survey conducted by the Norwegian Social Research Institute in cooperation with Regional Centres for Drug Rehabilitation in 2017. The target group comprised 13- to 19-years olds in Norway. Six items with four response categories, intended to measure depressive symptoms, were analysed. The analysis focused on invariance, including differential item functioning across gender and school levels. In addition, targeting, possible multidimensionality, response dependency, and the categorisation of the items were analysed. Results The scale measuring depressive symptoms shows good reliability and, on the whole, the items work well. However, one item, ‘had sleep problems’, clearly misfit and another, ‘worried too much about things’, works differently for males and females. Conclusions The scale has the potential to measure depressive symptoms in adolescents though there is room for improvement. To further improve the scale, the item concerning sleep problems should be rephrased.publishedVersio

Developing the HLS19-YP12 for measuring health literacy in young people: a latent trait analysis using Rasch modelling and confirmatory factor analysis

Background Accurate and precise measures of health literacy (HL) is supportive for health policy making, tailoring health service design, and ensuring equitable access to health services. According to research, valid and reliable unidimensional HL measurement instruments explicitly targeted at young people (YP) are scarce. Thus, this study aims at assessing the psychometric properties of existing unidimensional instruments and developing an HL instrument suitable for YP aged 16–25 years. Methods Applying the HLS19-Q47 in computer-assisted telephone interviews, we collected data in a representative sample comprising 890 YP aged 16–25 years in Norway. Applying the partial credit parameterization of the unidimensional Rasch model for polytomous data (PCM) and confirmatory factor analysis (CFA) with categorical variables, we evaluated the psychometric properties of the short versions of the HLS19-Q47; HLS19-Q12, HLS19-SF12, and HLS19-Q12-NO. A new 12-item short version for measuring HL in YP, HLS19-YP12, is suggested. Results The HLS19-Q12 did not display sufficient fit to the PCM, and the HLS19-SF12 was not sufficiently unidimensional. Relative to the PCM, some items in the HLS19-Q12, the HLS19-SF12, and the HLS19-Q12-NO discriminated poorly between participants at high and at low locations on the underlying latent trait. We observed disordered response categories for some items in the HLS19-Q12 and the HLS19-SF12. A few items in the HLS19-Q12, the HLS19-SF12, and the HLS19-Q12-NO displayed either uniform or non-uniform differential item functioning. Applying one-factorial CFA, none of the aforementioned short versions achieved exact fit in terms of non-significant model chi-square statistic, or approximate fit in terms of SRMR ≤ .080 and all entries ≤ .10 that were observed in the respective residual matrix. The newly suggested parsimonious 12-item scale, HLS19-YP12, displayed sufficiently fit to the PCM and achieved approximate fit using one-factorial CFA. Conclusions Compared to other parsimonious 12-item short versions of HLS19-Q47, the HLS19-YP12 has superior psychometric properties and unconditionally proved its unidimensionality. The HLS19-YP12 offers an efficient and much-needed screening tool for use among YP, which is likely a useful application in processes towards the development and evaluation of health policy and public health work, as well as for use in clinical settings.publishedVersio

Health Literacy in the Norwegian Population. English Summary. In Befolkningens helsekompetanse, del I. The International Health Literacy Population Survey 2019 – 2021 (HLS19) – et samarbeidsprosjekt med nettverket M-POHL tilknyttet WHO-EHII

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Health Literacy in Five Immigrant Populations in Norway: Pakistan, Poland, Somalia, Turkey, and Vietnam. English summary. In Helsekompetansen i fem innvandrerpopulasjoner i Norge: Pakistan, Polen, Somalia, Tyrkia og Vietnam. Befolkningens helsekompetanse, del II

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Nursing students’ experiences with concept cartoons as an active learning strategy for developing conceptual understanding in anatomy and physiology: A mixed-method study

Aim: The aim of this study was to explore bachelor-level nursing students’ experiences with concept cartoons as an active learning strategy and formative assessment to develop conceptual understanding in anatomy and physiology (A&P). Background: Many first-year nursing students struggle to understand central concepts in A&P. Concept cartoons–cartoon characters proposing scientifically acceptable statements and misconceptions combined with an illustration–might facilitate active learning in lectures, overcome misconceptions and promote deep learning. Voting on the most precise statement using a student response system gives formative information about the students’ conceptual understanding. Design: Parallel mixed methods design with an emphasis on a qualitative approach. Methods: Nine concept cartoons were developed based on former students’ written answers to exam items and applied in lectures at three universities/university colleges. Qualitative data of students’ experiences were collected in three focus group interviews during November 2019, one focus group at each of the three universities/university colleges (n = 5, 8 and 8). A short questionnaire was also applied (n = 343) to all students at the three universities/university colleges. Qualitative data were analysed using qualitative content analyses, whereas frequency analysis and Chi-square statistics were applied for the quantitative data. The study was approved by the Norwegian Centre for Research Data, ref. 779586. Results: Qualitative data analysis indicated that the use of concept cartoons addresses different learning styles and could promote deep learning and enhance the environment for learning. The concept cartoons were also seen as valuable for examination preparation. Regarding potential improvements, more information about concept cartoons, how they were developed and how they were supposed to be used would be beneficial, and the cartoons could be used in a more time-efficient manner during lectures. Quantitative data indicated that most of the students thought that concept cartoons were useful and inspiring in learning A&P, and they would recommend further use to increase their understanding of central concepts. There were no significant differences across sex, age, or entrance qualifications when it comes to the benefits of using concept cartoons in learning A&P.publishedVersio