Derya KAYA ŞENOL, ÖZLEM BULANTEKİN DÜZALAN, Sibel SARIKAYA, Büşra ÖZEN

Evaluation of Menopausal Perception and Health Literacy in Women Menopausal Period with Chronic Disease

Introduction: It is important to note that individuals with low health literacy are more likely to understand health risks, assessdifferent treatment opportunities, have less ability to comply with health care recommendations, use fewer preventive health services,increase spending with unnecessary hospital admissions, decrease the frequency of early diagnoses and higher morbidity and mortalityrates. Methods: Çankırı State Hospital was carried out with 175 women who were inpatient in the internal medicine clinic and were inmenopausal period. Before starting to work, permission was obtained from Çankırı Karatekin University Ethics Board and ÇankırıState Hospital. Data was analyzed using the IBM SPSS Statistics Version 20 package program. Results: Among the women in thestudy; 32.5% were primary school graduates, 37.1% had lower income and 94,3% were health insurance. The average age of firstmarriage was 17,5 ± 3,6. When the obstetric characteristics were examined, mean menarche age was 13,1 ± 1,9, menopause age was47,1 ± 5,8, number of pregnancy was 5,5 ± 3,3. Diabetes, 19.6% Diabetes + Hypertension, 23.4% Hypertension were seen in the firstthree ranks when participants were diagnosed with chronic diseases. It was found out that 91,4% of the women were using drugscontinuously and 9,1% were using cigarettes. In the study, 42.9% of women regard menopause as a natural process and 61,1% of themdid not receive any information about menopause. When educational status is examined in terms of health literacy scale; (p=0,001)were significantly higher than the mean scores of the participants who graduated from high school and over. The health literacy scoreof the women with high income in the survey was found to be statistically significantly higher. (p=0,001). The health literacy score ofthe participants who did not use a continuous drug was significantly higher than the drug users (p=0,001).Conclusion: It is seen that factors such as education, and high level of income in menopausal women with chronic illness affect healthliteracy positively.

Kronik Hastalığı Olan Menopozal Dönemdeki Kadınlarda Menopoz Algısı ve Sağlık Okur Yazarlığının Değerlendirilmesi

Giriş: Sağlık okuryazarlığı düşük olan bireylerin, sağlık risklerini anlama, sağlık bakım önerilerine uyma konusunda yeteneklerinin daha az olduğu, koruyucu sağlık hizmetlerini daha az kullandığı, gereksiz hastane başvuruları ile harcamalarda artışa, erken teşhis edilebilen durumların sıklığında azalmaya, yüksek morbidite ve mortalite oranlarına yol açtığı belirtilmektedir. Amaç: Çalışma, menopozal dönemdeki kadınların sağlık okuryazarlığı durumlarını belirlemek için yapılmıştır. Metod: Tanımlayıcı tipteki bu çalışma; Çankırı Devlet Hastanesi Dahiliye kliniğinde yatarak tedavi gören ve menopozal dönemde olan 175 kadınla yürütülmüştür. Çalışmadan elde edilen veriler, IBM SPSS Statistics Version 20 paket programı ile analiz edilmiştir. Bulgular: Araştırma kapsamındaki kadınların; %32.5’inin ilkokul mezunu, % 37,1’inin gelirinin giderden az ve %94,3'ünün sağlık güvencesinin olduğu saptanmıştır. Kadınların ilk evlilik yaş ortalaması 17,5 ±3,6 idi. Obstetrik özellikleri incelendiğinde, ortalama ilk adet yaşının 13,1 ±1,9, menapoz yaşının 47,1±5,8, gebelik sayısının 5,5± 3,3 saptanmıştır. Katılımcıların, tanı aldıkları kronik hastalıklara bakıldığında ise ilk üç sırada %19,8 ile diyabet, %19,6 ile diyabet+hipertansiyon, %23,4 ile hipertansiyon görülmektedir. Kadınların % 91,4’ünün sürekli kullandığı bir ilacı olduğu, % 9,1'inin sigara kullandığı belirlenmiştir. Çalışmada, kadınların %42,9’unun menopozu doğal bir süreç olarak gördüğü, % 61,1’inin bu döneminde menopoza yönelik bilgi almadığı belirlenmiştir. Sağlık okur-yazarlığı ölçeği bakımından eğitim durumu incelendiğinde; lise ve üzeri düzeyde mezun olan katılımcıların puan ortalamalarının anlamlı derecede yüksek olduğu saptanmıştır (p=0,001). Araştırmada, geliri fazla olan kadınların, sağlık okur-yazarlığı puanı istatistiksel olarak anlamlı derecede yüksek olduğu bulunmuştur. (p=0,001). Sürekli bir ilaç kullanmayan katılımcıların sağlık okur-yazarlığı puanı, ilaç kullananlara göre anlamlı derecede yüksek bulunmuştur(p=0,002). Sonuç: Kronik hastalığı olan menopoz dönemindeki kadınlarda eğitimin ve yüksek gelir düzeyi gibi faktörler sağlık okuryazarlığını olumlu yönde etkilemektedir.

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1. Rowlands G. Health literacy. Hum Vaccin Immunother. 2014; 10:7, 2130-2135, DOI: 10.4161/hv.29603

2. World Health Organization. 7th Global conference on health promotion. Track themes: Track. 2009;1. Erişim tarihi: 15.03.2017, http://www.who.int/healthpromotion/conf erenc es/7gchp/track2/en/

3. WHO regional office for Europe. Health literacy: the solid facts. 2013 [cited 04 Dec 2017]. Available from: http://www.euro.who.int/data/assets/pdf_fi le/0008/ 190655/e96854.pdf. Erişim tarihi: 04 Kasım 2017.

4. Berkman ND, Sheridan SL, Donahue KE, et al. Health literacy interventions and outcomes: an updated systematic review. Evid Rep Technol Assess (Full Rep) 2011;199:1–941.

5. Heijmans M, Waverijn G, Rademakers, et al. Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management. Patient Educ Counsel 2015;98: 41–48.

6. Friis K, Lasgaard M, Osborne RH, Maindal HT. Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in Danish citizens. BMJ Open. 2016; 14;6(1):e009627. doi: 10.1136/bmjopen2015-009627.

7. Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 2012; 344:e1602; PMID:22422872; http://dx.doi.org/10.1136/bmj. e1602.

8. Zhang NJ, Terry A, McHorney CA. Impact of health literacy on medication adherence: a systematic review and metaanalysis. Ann Pharmacother 2014; 48:741- 51; PMID:24619949; http://dx.doi. org/10.1177/1060028014526562.

9. Murray MD, Tu W, Wu J, Morrow D, Smith F, Brater DC. Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills. Clin Pharmacol Ther 2009; 85:651- 657

10. P. Giannouli, I. Zervas, E. Armeni, K. Koundi, A. Spyropoulou, A. Alexandrou, A. Kazani, A. Areti, M. Creatsa, I. Lambrinoudaki, Determinants of quality of life in Greek middle-age women: a population survey, Maturitas 2012; 71: 154–161.

11. M. Suka, A. Taniuchi, S. Igarashi, N. Shimbashi, B. Ishizuka, The menopause week 2012 questionnaire survey: determinants of quality of life in Japanese middle-aged women. J Jap Menopause Soc 2013; 21:391–398.

12. Sukaa M, Taniuchi A, Igarashi S, Yanagisawaa H, Ishizukac B. Menopausespecific health literacy in Japanese women Maturitas 2016; 91:51–59.

13. J.E. Blumel, P. Chedraui, G. Baron, E. Belzares, A. Bencosme, A.Calle, et al.Menopausal symptoms appear before the menopause and persist 5 years beyond: a detailed analysis of a multinational study Climacteric, 2012; 15:(6) 542-551.

14. Moreau KL, Hildreth KL, Meditz AL, Deane KD, Kohrt WM. Endothelial function is impaired across the stages of the menopause transition in healthy women. J Clin Endocrinol Metab 2012; 97(12): 4692-4700.

15. Freeman EW, Sammel MD, Boorman DW, Zhang R. Longitudinal pattern of depressive symptoms around natural menopause JAMA Psychiatry, 2014;71(1):36-43.

16. Sezer A, Kadıoğlu H. Yetişkin Sağlık Okuryazarlığı Ölçeği’nin Geliştirilmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 2014;17(3): 165-170.

17. Bozkurt H, Demirci H. Health literacy among older persons in Turkey, The Aging Male 2018; 10:1-6. https://doi.org/10.1080/13685538.2018.14 37901

18. Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun 2010;15:9–19.

19. Serper M1, Patzer RE, Curtis LM, Smith SG, O'Conor R, Baker DW, Wolf MS. Health literacy, cognitive ability, and functional health status among older adults. Health Serv Res. 2014;49:1249– 1267.

20. Schaffler J, Leung K, Tremblay S, Merdsoy L, Belzile E, Lambrou A, Lambert SD. The Effectiveness of SelfManagement Interventions for Individuals with Low Health Literacy and/or Low Income: A Descriptive Systematic Review J Gen Intern Med- 33(4):510-523. doi: 10.1007/s11606-017-4265-x. Epub 2018 Feb

21. Betancourt MT, Roberts KC, Bennett TL, Driscoll ER, Jayaraman G, Pelletier L. Monitoring chronic diseases in Canada: the Chronic Disease Indicator Framework. Chronic Dis Inj Can 2014, 34(1):1-30.

22. Dubay LC, Lebrun LA. Health, behavior, and health care disparities: disentangling the effects of income and race in the United States. Int J Health Serv 2012, 42:607-625.

23. Jarahi1 L, Asadi R, Hakimi H R. General health literacy assessment of Iranian women in Mashhad Electronic Physician 2017;9(11):5764-5769, DOI: http://dx.doi.org/10.19082/5764.

24. Kendir C , Akkaya K, Arslantaş İ, Kartal M. Dokuz Eylül Üniversitesi, Tıp ve Hemşirelik Fakültelerine Başvuran Öğrencilerin, Sağlık Okuryazarlık Düzeyi. TJFMPC 2017;11(3) DOI: 10.21763/tjfmpc.336167.

25. Miller TA. Health literacy and adherence to medical treatment in chronic and acute illness: ameta-analysis. Patient Educ Couns 2016; 99:1079–86.

26. Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, et al. Functional health literacy and the risk of hospital admission among medicare managed care enrollees. Am J Public Health 2002; 92:1278–83.

27. Stewart DW, Vidrine JI, Shete S, Spears CA, Cano MA, Correa-Fernández V, et al. Health literacy, smoking, and health indicators in African American adults. J Health Commun 2015;20(suppl 2):24–33.

28. Stewart DW, Cano MA, Correa-Fernández V, Spears CA, Li Y, Waters AJ, et al. Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status. BMC Public Health 2014;14:716. doi: 10.1186/1471-2458-14-716.

29. Braun RT, Hanoch Y, Barnes AJ. Tobacco use and health insurance literacy among vulnerable populations: implications for health reform. BMC Health Serv Res. 2017;17(1):729. doi: 10.1186/s12913-017-2680-7.

30. Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, et al. Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc. 2006;54(5):770–776.

31. Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007;167(14):1503–1509.

32. Stewart DW, Adams CE, Cano M, CorreaFernandez V, Li Y, Waters AJ, et al. Associations between health literacy and established predictors of smoking cessation. Am J Public Health. 2013;103:e43–e49.

33. Mancusa MJ. Health Literacy: A concept/ dimensional analysis. Nursing and Health Sciences 2008; 10: 248-255.

34. Entwistle V, Williams B. Health literacy: The need to consider images as well as words. Health Expectations 2008;11(2): 99–101.

35. Eichler K, Wieser S, Brugger U. The costs of limited health literacy: A systematic review. Int J Public Health 2009;54(5): 313–324.