ORCID Profile
0000-0002-2287-0723
Current Organisation
Taipei Medical University
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Publisher: Informa UK Limited
Date: 2021
Publisher: SLACK, Inc.
Date: 04-2019
DOI: 10.3928/24748307-20190225-01
Abstract: No comprehensive short-form health literacy (HL) survey tool has been available for general use across Asia. This study aimed to develop and validate a short-form HL instrument derived from the 47-item European Health Literacy Questionnaire (HLS-EU-Q47). A population survey ( N = 10,024) was conducted from 2013 to 2015 using the HLS-EU-Q47 in 1,029 participants from Indonesia, 1,845 from Kazakhstan, 462 from Malaysia, 1,600 from Myanmar, 3,015 from Taiwan, and 2,073 from Vietnam. Validation of the short form was evaluated by principle component analysis, internal consistency, Pearson correlation, and regression analysis. Based on responses from six countries, a 12-item short-form HL questionnaire (HLS-SF12) was developed, retaining the conceptual framework of the HLS-EU-Q47 and accounting for the high variance of the full-form (i.e., 90% in Indonesia, 91% in Myanmar, 93% in Malaysia, 94% in Taiwan, and 95% in both Kazakhstan and Vietnam). The HLS-SF12 was demonstrated to have adequate psychometric properties, including high reliability (Cronbach's alpha = .85), good criterion-related validity, a moderate and high level of item-scale convergent validity, no floor or ceiling effect, and good model-data-fit throughout the populations in these countries. The HLS-SF12 was shown to be a valid and reliable tool for HL surveys in the general public in six Asian countries. [ HLRP: Health Literacy Research and Practice . 2019 (2):e90–e102.] A health literacy survey was conducted from 2013 to 2015 in six Asian countries using the European Health Literacy Questionnaire (HLS-EU-Q47). The collected data were used to develop and validate a comprehensive short-form questionnaire. A health literacy questionnaire with 12 items (HLS-SF12) that retains the original conceptual framework of the HLS-EU-Q47 was demonstrated to be reliable and valid.
Publisher: JMIR Publications Inc.
Date: 12-11-2020
DOI: 10.2196/22894
Abstract: The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance satisfactory criterion validity as correlated with HL (ρ=0.42) satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84) and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P .001 B=0.72, 95% CI 0.43-1.00, P .001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P .001 B=0.60, 95% CI 0.34-0.86, P .001), doctors (B=1.29, 95% CI 0.73-1.84, P .001 B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P .001 B=0.64, 95% CI 0.38-0.91, P .001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P .001 B=0.22, 95% CI 0.19-0.26, P .001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001 OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P .001 OR 1.04, 95% CI 1.03-1.05, P .001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P .001 OR 0.96, 95% CI 0.95-0.98, P .001), respectively. The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.
Publisher: MDPI AG
Date: 12-05-2023
DOI: 10.3390/NU15102292
Abstract: Treatment adherence (TA) is a critical issue and is under-investigated in hemodialysis patients. A multi-center study was conducted from July 2020 to March 2021 on 972 hemodialysis patients in eight hospitals in Vietnam to explore the factors associated with TA during the COVID-19 pandemic. Data were collected, including socio-demographics, an End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), 12-item short-form health literacy questionnaire (HLS-SF12), 4-item digital healthy diet literacy scale (DDL), 10-item hemodialysis dietary knowledge scale (HDK), 7-item fear of COVID-19 scale (FCoV-19S), and suspected COVID-19 symptoms (S-COVID19-S). Bivariate and multivariate linear regression models were used to explore the associations. Higher DDL scores were associated with higher TA scores (regression coefficient, B, 1.35 95% confidence interval, 95%CI, 0.59, 2.12 p = 0.001). Higher FCoV-19S scores were associated with lower TA scores (B, −1.78 95%CI, −3.33, −0.24 p = 0.023). In addition, patients aged 60–85 (B, 24.85 95%CI, 6.61, 43.11 p = 0.008) with “very or fairly easy” medication payment ability (B, 27.92 95%CI, 5.89, 44.95 p = 0.013) had higher TA scores. Patients who underwent hemodialysis for ≥5 years had a lower TA score than those who received years of hemodialysis (B, −52.87 95%CI, −70.46, −35.28 p 0.001). These findings suggested that DDL and FCoV-19S, among other factors, should be considered in future interventions to improve TA in hemodialysis patients.
Publisher: MDPI AG
Date: 06-05-2021
Abstract: Background: The COVID-19 pandemic has been disseminating fear in the community, which has affected people’s quality of life, especially those with health problems. Health literacy (HL), eHealth literacy (eHEAL), and digital healthy diet literacy (DDL) may have potential impacts on containing the pandemic and its consequences. This study aimed to examine the association between the fear of COVID-19 scale (FCoV-19S) and the health-related quality of life (HRQoL), and to examine the effect modification by HL, eHEAL, and DDL on this association. Methods: A cross-sectional study was conducted in 11 hospitals across Vietnam from 7 April to 31 May 2020. Data were collected on 4348 outpatients, including demographic characteristics, HL, eHEAL, DDL, FCoV-19S, and HRQoL. Multiple linear regression and interaction models were used to explore associations. Results: Patients with higher FCoV-19S scores had lower HRQoL scores (unstandardized coefficient, B = −0.78, p 0.001). HL (B = 0.20, p 0.001), eHEAL (B = 0.24, p 0.001), and DDL (B = 0.20, p 0.001) were positively associated with higher HRQoL scores. The negative impact of FCoV-19S on HRQoL was significantly attenuated by higher eHEAL score groups (from one standard deviation (SD) below the mean, B = −0.93, p 0.001 to the mean, B = −0.85, p 0.001 and one SD above the mean, B = −0.77, p 0.001) and by higher DDL score groups (from one SD below the mean, B = −0.92, p 0.001 to the mean, B = −0.82, p 0.001 and one SD above the mean, B = −0.72, p 0.001). Conclusions: eHealth literacy and digital healthy diet literacy could help to protect patients’ health-related quality of life from the negative impact of the fear of COVID-19 during the pandemic.
Publisher: MDPI AG
Date: 31-03-2020
DOI: 10.3390/JCM9040965
Abstract: The coronavirus disease 2019 (COVID-19) epidemic affects people’s health and health-related quality of life (HRQoL), especially in those who have suspected COVID-19 symptoms (S-COVID-19-S). We examined the effect of modifications of health literacy (HL) on depression and HRQoL. A cross-sectional study was conducted from 14 February to 2 March 2020. 3947 participants were recruited from outpatient departments of nine hospitals and health centers across Vietnam. The interviews were conducted using printed questionnaires including participants’ characteristics, clinical parameters, health behaviors, HL, depression, and HRQoL. People with S-COVID-19-S had a higher depression likelihood (OR, 2.88 p 0.001), lower HRQoL-score (B, −7.92 p 0.001). In comparison to people without S-COVID-19-S and low HL, those with S-COVID-19-S and low HL had 9.70 times higher depression likelihood (p 0.001), 20.62 lower HRQoL-score (p 0.001), for the people without S-COVID-19-S, 1 score increment of HL resulted in 5% lower depression likelihood (p 0.001) and 0.45 higher HRQoL-score (p 0.001), while for those people with S-COVID-19-S, 1 score increment of HL resulted in a 4% lower depression likelihood (p = 0.004) and 0.43 higher HRQoL-score (p 0.001). People with S-COVID-19-S had a higher depression likelihood and lower HRQoL than those without. HL shows a protective effect on depression and HRQoL during the epidemic.
Publisher: MDPI AG
Date: 13-05-2021
DOI: 10.3390/NU13051641
Abstract: Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24 95% confidence interval, 95%CI, 6.66, 9.83 p 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48 p 0.05), and a higher DASH-Q score (B, −0.32 p 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes.
Publisher: MDPI AG
Date: 11-06-2020
Abstract: The coronavirus disease 2019 (COVID-19) pandemic causes fear, as its immediate consequences for the public have produced unprecedented challenges for the education and healthcare systems. We aimed to validate the fear of COVID-19 scale (FCoV-19S) and examine the association of its scores with health literacy and health-related behaviors among medical students. A cross-sectional study was conducted from 7 to 29 April 2020 on 5423 students at eight universities across Vietnam, including five universities in the North, one university in the Center, two universities in the South. An online survey questionnaire was used to collect data on participants’ characteristics, health literacy, fear of COVID-19 using the FCoV-19S, and health-related behaviors. The results showed that seven items of the FCoV-19S strongly loaded on one component, explained 62.15% of the variance, with good item–scale convergent validity and high internal consistency (Cronbach’s alpha = 0.90). Higher health literacy was associated with lower FCoV-19S scores (coefficient, B, −0.06 95% confidence interval, 95%CI, −0.08, −0.04 p 0.001). Older age or last academic years, being men, and being able to pay for medication were associated with lower FCoV-19S scores. Students with higher FCoV-19S scores more likely kept smoking (odds ratio, OR, 1.11 95% CI, 1.08, 1.14 p 0.001) or drinking alcohol (OR, 1.04 95% CI, 1.02, 1.06 p 0.001) at an unchanged or higher level during the pandemic, as compared to students with lower FCoV-19S scores. In conclusion, the FCoV-19S is valid and reliable in screening for fear of COVID-19. Health literacy was found to protect medical students from fear. Smoking and drinking appeared to have a negative impact on fear of COVID-19. Strategic public health approaches are required to reduce fear and promote healthy lifestyles during the pandemic.
Publisher: MDPI AG
Date: 18-09-2021
DOI: 10.3390/NU13093258
Abstract: Background: Healthy eating and physical activity are effective non-pharmacological approaches to boost immune function and contain the pandemic. We aimed to explore the associations and interactions between physical activity and healthy eating behavior with COVID-19-like symptoms (Slike-CV19S). Methods: A cross-sectional study was conducted on 3947 outpatients, from 14 February to 2 March 2020, at nine health facilities in Vietnam. Data collection included sociodemographic characteristics, healthy eating behavior (using the healthy eating score (HES) questionnaire), physical activity (using the short form international physical activity questionnaire), and Slike-CV19S. The associations and interactions were tested using logistic regression models. Results: Frequent intake of fruits (OR = 0.84 p = 0.016), vegetables (OR = 0.72 p = 0.036), and fish (OR = 0.43 p 0.001) were associated with a lower Slike-CV19S likelihood, as compared with infrequent intake. Patients with higher HES levels (OR = 0.84 p = 0.033 for medium HES OR = 0.77 p = 0.006 for high HES) or being physically active (OR = 0.69 p 0.001) had a lower Slike-CV19S likelihood, as compared to those with low HES or physical inactivity, respectively. Patients with medium HES who were physically active (OR = 0.69 p = 0.005), or with high HES and physically active (OR = 0.58 p 0.001), had a lower Slike-CV19S likelihood, as compared to those with low HES and physical inactivity. Conclusions: Healthy eating behavior and physical activity showed single and combinative impacts on protecting people from Slike-CV19S. Strategic approaches are encouraged to improve healthy behaviors, which may further contribute to containing the pandemic.
Publisher: JMIR Publications Inc.
Date: 26-07-2020
Abstract: he COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. he aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. e conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. he eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance satisfactory criterion validity as correlated with HL (ρ=0.42) satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84) and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, i P /i & .001 B=0.72, 95% CI 0.43-1.00, i P /i & .001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, i P /i & .001 B=0.60, 95% CI 0.34-0.86, i P /i & .001), doctors (B=1.29, 95% CI 0.73-1.84, i P /i & .001 B 0.56, 95% CI 0.20-0.93, i P /i =.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, i P /i & .001 B=0.64, 95% CI 0.38-0.91, i P /i & .001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, i P /i & .001 B=0.22, 95% CI 0.19-0.26, i P /i & .001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, i P /i =.001 OR 1.04, 95% CI 1.02-1.07, i P /i =.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, i P /i & .001 OR 1.04, 95% CI 1.03-1.05, i P /i & .001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, i P /i & .001 OR 0.96, 95% CI 0.95-0.98, i P /i & .001), respectively. he eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.
Publisher: MDPI AG
Date: 19-11-2020
Abstract: People with pre-existing health conditions (PEHC) are vulnerable to viral infection while health literacy (HL) and preventive behaviors (PB) have been shown to benefit people during the COVID-19 pandemic. The aim of this study was to examine the association between PEHC and suspected COVID-19 symptoms (S-COVID-19-S), and to investigate the modification effect of HL and PB. A cross-sectional study was conducted on 8291 participants visiting outpatient departments at 18 hospitals and health centers across Vietnam from 14 February to 31 May 2020. Data were collected regarding participant’s characteristics, HL, PB, PEHC, and S-COVID-19-S. Regression models were used for analyzing the associations. Results showed that people with PEHC had a 3.38 times higher likelihood of having S-COVID-19-S (odds ratio, OR, 3.38 95% confidence interval, 95% CI, 3.01, 3.79 p 0.001). In comparison to participants without PEHC and with the lowest HL score, those with PEHC and one HL score increment had a 7% lower likelihood of having S-COVID-19-S (OR, 0.93 95% CI, 0.92, 0.94 p 0.001). In comparison to participants without PEHC and not adhering to mask wearing, those with PEHC and adhering to mask wearing had a 77% lower likelihood of having S-COVID-19-S (OR, 0.23 95% CI, 0.16, 0.32 p 0.001). Higher HL and adherence to mask wearing can protect people from having S-COVID-19-S, especially in those with PEHC.
Publisher: MDPI AG
Date: 14-05-2023
DOI: 10.3390/NU15102305
Abstract: Background: Hypertension and oxidative stress are involved in the pathophysiological mechanism of stroke. We aimed to investigate the modification impact of the pro-oxidant–anti-oxidant balance (PAB) on the association between hypertension and stroke recurrence (SR). Methods: A cross-sectional design was conducted from December 2019 to December 2020 in 951 stroke patients in six hospitals across Vietnam. Hypertension was defined using antihypertensive medication or systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg. PAB was estimated using weighting methods based on smoking, drinking, and overweight/obesity with pro-oxidant capacity, diet quality, fruit intake, vegetable intake, and physical activity with antioxidant capacity. The higher PAB scores indicated a beneficial balance shifting toward antioxidant dominance. SR was diagnosed by neurologists. Moreover, sociodemographic and health conditions were included as covariates. Multiple logistic regression analyses were used to explore the associations and interactions. Results: The hypertension and SR proportions were 72.8% and 17.5%, respectively. hypertension was associated with an increased SR likelihood (odds ratio (OR) = 1.93 p = 0.004), whereas a higher PAB score was associated with a lowered SR likelihood (OR = 0.87 p = 0.003). Moreover, hypertension interacting with every one-point increment of PAB was associated with a lowered SR likelihood (OR = 0.83 p = 0.022). Conclusions: The harmful impact of hypertension on SR could be alleviated by PAB. The interplay of health behaviors should be highlighted in the intervention strategies for stroke prevention.
Publisher: MDPI AG
Date: 07-06-2022
DOI: 10.3390/NU14122364
Abstract: During the COVID-19 pandemic, it is essential to evaluate hemodialysis patients’ dietary knowledge, especially among those with COVID-19 related symptoms, in order to identify appropriate strategies in managing their mental health. The study’s purposes were to test the psychometric properties of the hemodialysis dietary knowledge (HDK) scale, and to investigate the modifying impact of HDK on the associations of suspected COVID-19 symptoms (S-COVID-19-S) with anxiety and depression among hemodialysis patients. A cross-sectional study was conducted from July 2020 to March 2021 at eight hospitals across Vietnam. Data of 875 hemodialysis patients were analyzed, including socio-demographic, anxiety (the generalized anxiety disorder scale, GAD-7), depression (the patient health questionnaire, PHQ-9), S-COVID-19-S, HDK, health literacy, and digital healthy diet literacy. Confirmatory factor analysis (CFA) and logistic regression models were used to analyze the data. The HDK scale demonstrates the satisfactory construct validity with good model fit (Goodness of Fit Index, GFI = 0.96 Adjusted Goodness of Fit Index, AGFI = 0.90 Standardized Root Mean Square Residual, SRMR = 0.05 Root Mean Square Error of Approximation, RMSEA = 0.09 Normed Fit Index, NFI = 0.96 Comparative Fit Index, CFI = 0.96, and Parsimony goodness of Fit Index, PGFI = 0.43), criterion validity (as correlated with HL (r = 0.22, p 0.01) and DDL (r = 0.19, p 0.01), and reliability (Cronbach alpha = 0.70)). In the multivariate analysis, S-COVID-19-S was associated with a higher likelihood of anxiety (odds ratio, OR, 20.76 95% confidence interval, 95%CI, 8.85, 48.70 p 0.001) and depression (OR, 12.95 95%CI, 6.67, 25.14, p 0.001). A higher HDK score was associated with a lower likelihood of anxiety (OR, 0.70 95%CI, 0.64, 0.77 p 0.001) and depression (OR, 0.72 95%CI, 0.66, 0.79 p 0.001). In the interaction analysis, the negative impacts of S-COVID-19-S on anxiety and depression were mitigated by higher HDK scores (p 0.001). In conclusion, HDK is a valid and reliable tool to measure dietary knowledge in hemodialysis patients. Higher HDK scores potentially protect patients with S-COVID-19-S from anxiety and depression during the pandemic.
Publisher: MDPI AG
Date: 02-12-2022
DOI: 10.3390/NU14235122
Abstract: Osteoporosis is a common bone health disorder in hemodialysis patients that is linked with a higher morbidity and mortality rate. While previous studies have explored the associated factors of osteoporosis, there is a lack of studies investigating the impacts of health literacy (HL) and digital healthy diet literacy (DDL) on osteoporosis. Therefore, we aimed to investigate the associations of HL, DDL, and other factors with osteoporosis among hemodialysis patients. From July 2020 to March 2021, a cross-sectional study was conducted on 675 hemodialysis patients in eight hospitals in Vietnam. The data were collected by using the osteoporosis self-assessment tool for Asians (OSTA) and the 12-item short form of the health literacy questionnaire (HLS-SF12) on digital healthy diet literacy (DDL) and hemodialysis dietary knowledge (HDK). In addition, we also collected information about the socio-demographics, the clinical parameters, the biochemical parameters, and physical activity. Unadjusted and adjusted multinomial logistic regression models were utilized in order to investigate the associations. The proportion of patients at low, medium, and high levels of osteoporosis risk was 39.6%, 40.6%, and 19.8%, respectively. In the adjusted models, women had a higher likelihood of osteoporosis risk than men (odds ratio, OR, 3.46 95% confidence interval, 95% CI, 1.86, 6.44 p 0.001 and OR, 6.86 95% CI, 2.96, 15.88 p 0.001). The patients with rheumatoid arthritis (OR, 4.37 95% CI, 1.67, 11.52 p = 0.003) and stomach ulcers (OR, 1.95 95% CI, 1.01, 3.77 p = 0.048) were more likely to have a higher likelihood of osteoporosis risk than those without. The patients who had a higher waist circumference (WC), HL, and DDL were less likely to have a medium level of osteoporosis risk (OR, 0.95 95% CI, 0.92, 0.98 p = 0.004 OR, 0.92 95% CI, 0.88, 0.96 p 0.001 OR, 0.96 95% CI, 0.93, 0.99 p = 0.017, respectively) and a high level of osteoporosis risk (OR, 0.93 95% CI, 0.89, 0.97 p = 0.001 OR, 0.89 95% CI, 0.84, 0.94 p 0.001 OR, 0.95 95% CI, 0.91, 0.99 p = 0.008, respectively) compared with a low level of osteoporosis risk and to those with a lower WC, HL, and DDL. In addition, higher levels of hemoglobin (Hb) (OR, 0.79 95% CI, 0.66, 0.95 p = 0.014), hematocrit (Hct) (OR, 0.95 95% CI, 0.92, 0.99 p = 0.041), albumin (OR, 0.91 95% CI, 0.83, 0.99 p = 0.030), and education (OR, 0.37 95% CI, 0.16, 0.88 p = 0.025) were associated with a lower likelihood of a high level of osteoporosis risk. In conclusion, osteoporosis risk is highly prevalent in hemodialysis patients. Improved HL, DDL, education, WC, albumin, Hb, and Hct levels should be considered in preventing hemodialysis patients from developing osteoporosis.
Publisher: MDPI AG
Date: 30-09-2020
Abstract: Assessing healthy diet literacy and eating behaviors is critical for identifying appropriate public health responses to the COVID-19 pandemic. We examined the psychometric properties of digital healthy diet literacy (DDL) and its association with eating behavior changes during the COVID-19 pandemic among nursing and medical students. We conducted a cross-sectional study from 7 April to 31 May 2020 at 10 public universities in Vietnam, in which 7616 undergraduate students aged 19–27 completed an online survey to assess socio-demographics, clinical parameters, health literacy (HL), DDL, and health-related behaviors. Four items of the DDL scale loaded on one component explained 71.32%, 67.12%, and 72.47% of the scale variances for the overall s le, nursing, and medical students, respectively. The DDL scale was found to have satisfactory item-scale convergent validity and criterion validity, high internal consistency reliability, and no floor or ceiling effect. Of all, 42.8% of students reported healthier eating behavior during the pandemic. A 10-index score increment of DDL was associated with 18%, 23%, and 17% increased likelihood of healthier eating behavior during the pandemic for the overall s le (OR, 1.18 95%CI, 1.13, 1.24 p 0.001), nursing students (OR, 1.23 95%CI, 1.10, 1.35 p 0.001), and medical students (OR, 1.17 95%CI, 1.11, 1.24 p 0.001), respectively. The DDL scale is a valid and reliable tool for the quick assessment of digital healthy diet literacy. Students with higher DDL scores had a higher likelihood of healthier eating behavior during the pandemic.
No related grants have been discovered for Tuyen Van Duong.