Does health literacy affect the decision to have gestational diabetes screening test?

Year 2024, Volume: 10 Issue: 2, 195 - 203, 04.03.2024

Özlem Özgün Uyanıklar Zeliha Atak Sakine Rahımlı Ocakoglu Hatice Ortaç Gökhan Ocakoğlu

https://doi.org/10.18621/eurj.1291335

Abstract

Objectives: The main objective of this study is to assess the relationship between the level of Health Literacy and the patient's decision to refuse the Gestational diabetes mellitus screening test.

Methods: This cross-sectional study was conducted at a high-volume public hospital from March 2020 to September 2020 with women between 24-28 weeks of gestation. Demographic characteristics and gestational diabetes mellitus screening status were recorded for each woman. The European Health Literacy Survey Questionnaire was used to assess health literacy.

Results: A total of 364 women were included in the study. Two hundred and three (55.7%) women accepted the gestational diabetes mellitus screening test, and 44.2% did not. Health care, disease prevention, health promotion subscales, and the general scale scores were higher in the gestational diabetes mellitus screening group (p = 0.001, p = 0.024, p = 0.01, and p = 0.003, respectively). It was determined that a 1-point increase in the health care score decreased the probability of rejecting the gestational diabetes mellitus screening by 1.03 times (p = 0.003).

Conclusions: Lower health literacy levels were associated with higher rates of gestational diabetes mellitus screening test rejection.

Keywords

Gestational diabetes, health literacy, surveys and questionnaires

References

• 1. Saravanan P; Diabetes in Pregnancy Working Group; Maternal Medicine Clinical Study Group; Royal College of Obstetricians and Gynaecologists, UK. Gestational diabetes: opportunities for improving maternal and child health. Lancet Diabetes Endocrinol. 2020;8(9):793-800. doi: 10.1016/S2213-8587(20)30161-3.
• 2. Deputy NP, Kim SY, Conrey EJ, Bullard KM. Prevalence and Changes in Preexisting Diabetes and Gestational Diabetes Among Women Who Had a Live Birth - United States, 2012-2016. MMWR Morb Mortal Wkly Rep. 2018;67(43):1201-1207. doi: 10.15585/mmwr.mm6743a2.
• 3. Karaçam Z, Çelİk D. The prevalence and risk factors of gestational diabetes mellitus in Turkey: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2021;34(8):1331-1341. doi: 10.1080/14767058.2019.1635109.
• 4. Dodd JM, Crowther CA, Antoniou G, Baghurst P, Robinson JS. Screening for gestational diabetes: the effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes. Aust N Z J Obstet Gynaecol. 2007;47(4):307-312. doi: 10.1111/j.1479-828X.2007.00743.x.
• 5. Scholtens DM, Kuang A, Lowe LP, et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care. 2019;42(3):381-392. doi: 10.2337/dc18-2021.
• 6. Carolan-Olah M, Vasilevski V. Development and validation of the 'Knowledge of Gestational Diabetes (GDM)' questionnaire among a sample of women with GDM in Australia. Patient Educ Couns. 2021;104(8):2112-2118. doi: 10.1016/j.pec.2021.01.029.
• 7. Hillier TA, Pedula KL, Ogasawara KK, et al. A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening. N Engl J Med. 2021;384(10):895-904. doi: 10.1056/NEJMoa2026028.
• 8. Caughey AB. Gestational diabetes mellitus. Obstet Gynecol. 2017;130:E17-31.
• 9. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43:S14-S31. doi: 10.2337/dc20-S002.
• 10. IDF Atlas 9th edition and other resources. Available at: https://www.diabetesatlas.org/en/resources/. Accessed 4 October 2021.
• 11. Health Literacy: A Prescription to End Confusion. Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Washington (DC): National Academies Press (US). 2004. doi: 10.17226/10883.
• 12. Committee Opinion No. 676: Health Literacy to Promote Quality of Care. Obstet Gynecol. 2016;128(4):e183-e186. doi: 10.1097/AOG.0000000000001714.
• 13. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107. doi: 10.7326/0003-4819-155-2-201107190-00005.
• 14. Emiral GÖ, Atalay B, Aygar H, Işıktekin B, Göktaş S, Dağtekin G, et al. Health literacy scale-European union-Q16: a validity and reliability study in Turkey. Int Res J Med Sci. 2018;6:1-7.
• 15. Hocaoglu M, Turgut A, Guzin K, et al. Why some pregnant women refuse glucose challenge test? Turkish pregnant women's perspectives for gestational diabetes mellitus screening. North Clin Istanb. 2018;6(1):7-12. doi: 10.14744/nci.2018.37167.
• 16. Sella T, Shalev V, Elchalal U, Chovel-Sella A, Chodick G. Screening for gestational diabetes in the 21st century: a population-based cohort study in Israel. J Matern Fetal Neonatal Med. 2013;26(4):412-416. doi: 10.3109/14767058.2012.733761.
• 17. Blatt AJ, Nakamoto JM, Kaufman HW. Gaps in diabetes screening during pregnancy and postpartum. Obstet Gynecol. 2011;117(1):61-68. doi: 10.1097/AOG.0b013e3181fe424b.
• 18. Nicotra F, Molinari C, Dozio N, et al. Screening for gestational diabetes in the Lombardy region: A population-based study. Diabetes Metab. 2015;41(4):319-325. doi: 10.1016/j.diabet.2014.11.008.
• 19. van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J, Uiters E. The relationship between health, education, and health literacy: results from the Dutch Adult Literacy and Life Skills Survey. J Health Commun. 2013;18:172-184. doi: 10.1080/10810730.2013.825668.
• 20. Sørensen K, Pelikan JM, Röthlin F, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health. 2015;25(6):1053-1058. doi: 10.1093/eurpub/ckv043.
• 21. Weiss BD. Removing barriers to better, safer care. Health literacy and patient safety: help patients understand. Manual for clinicians. 2nd ed. Chicago (IL): American Medical Association Foundation and American Medical Association. 2007.
• 22. Stafford JD, Goggins ER, Lathrop E, Haddad LB. Health Literacy and Associated Outcomes in the Postpartum Period at Grady Memorial Hospital. Matern Child Health J. 2021;25(4):599-605. doi: 10.1007/s10995-020-03030-1.
• 23. Endres LK, Sharp LK, Haney E, Dooley SL. Health literacy and pregnancy preparedness in pregestational diabetes. Diabetes Care. 2004;27(2):331-334. doi: 10.2337/diacare.27.2.331.
• 24. Pirdehghan A, Eslahchi M, Esna-Ashari F, Borzouei S. Health literacy and diabetes control in pregnant women. J Family Med Prim Care. 2020;9(2):1048-1052. doi: 10.4103/jfmpc.jfmpc_891_19.