Health-related quality of life (HRQoL) is an important health indicator in chronic diseases like kidney diseases. Health literacy (HL) may strongly affect HRQoL, but evidence is scarce. Therefore, we assessed the associations of HL with HRQoL in dialysed patients. We performed a cross-sectional study in 20 dialysis clinics across Slovakia (n = 542 patients, mean age = 63.6 years, males = 60.7%). We assessed the association of categorised HL (low, moderate, high) with the SF36 physical component score (PCS) and mental component score (MCS) using generalised linear models adjusted for age, gender, education, and comorbidity (Charlson Comorbidity Index, CCI). We found significant associations of HL with PCS and MCS in dialysed patients, adjusted for age, gender, education, and CCI. Low-HL patients had a lower PCS (B = -3.27, 95%-confidence interval, CI: -5.76/-0.79) and MCS (B = -6.05, 95%-CI: -8.82/-3.29) than high-HL patients. Moderate-HL patients had a lower MCS (B = -4.26, 95%-CI: -6.83/-1.69) than high-HL patients. HL is associated with physical and mental HRQoL; this indicates that dialysed patients with lower HL deserve specific attention and tailored care to have their HRQoL increased.

• Klíčová slova
• dialysed patients, health literacy, health-related quality of life, mental component score, physical component score,
• MeSH
• chronická nemoc MeSH
• komorbidita MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• zdravotní gramotnost * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Health-related quality of life (HRQoL) is likely to deteriorate with the progression of chronic kidney disease (CKD). This change may be worsened by low health literacy (HL). We performed a longitudinal study at over 20 dialysis clinics in Slovakia (n = 413; mean age = 64.8 years; males = 58.4%). We assessed the association of three HL groups with a change in HRQoL over two years using binary logistic regression adjusted for type of vascular access, dialysis effectiveness, comorbidity, age and gender. We found that patients with low HL had poorer HRQoL at baseline in comparison to high-HL patients. We did not find significant associations of lower HL with the deterioration of mental or physical HRQoL after two years. In the adjusted model, patients with lower HL were not more likely to have deteriorated physical (low-HL patients: odds ratio/95% confidence interval: 0.99/0.53-1.84; moderate-HL patients: 0.97/0.55-1.73) or mental HRQoL (low-HL patients: 1.00/0.53-1.87; moderate-HL patients: 0.95/0.53-1.70) in comparison to high-HL patients. The HRQoL of lower-HL patients is worse at baseline but develops similarly to that of high-HL patients during dialysis treatment. Their relative HRQoL, thus, does not worsen further, but it does not improve either. Tailoring care to their needs may help to decrease the burden of low HL in dialysed patients.

• Klíčová slova
• change in quality of life, dialysed patients, health literacy, health-related quality of life,
• MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• zdravotní gramotnost * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Objectives: Chronic kidney disease (CKD) strongly affects patients' health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL. Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life - Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test. Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001. Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.

• Klíčová slova
• CKD-5, chronic kidney disease, dialyzed patients, health literacy, health-related quality of life,
• MeSH
• dialýza ledvin * MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• zdravotní gramotnost * statistika a číselné údaje   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21-3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26-2.98) or anxiety (OR/95% CI: 1.81/1.22-2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients' psychological distress to ensure adequate adherence with recommended diet.

• Klíčová slova
• anxiety, depression, dialyzed patients, diet non-adherence, health literacy, stage 5 CKD,
• MeSH
• adherence pacienta statistika a číselné údaje   MeSH
• deprese epidemiologie   MeSH
• dieta * MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• úzkost epidemiologie   MeSH
• zdravé chování MeSH
• zdravotní gramotnost * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Slovenská republika MeSH

(1) Background: There is a need for studies on population-level health literacy (HL) to identify the current state of HL within and between countries. We report comparative findings from 10 European countries (Austria, Belgium (Fl), Czechia, England, Estonia, Finland, Germany, Macedonia, Poland, and Slovakia) on adolescents' HL and its associations with gender, family affluence (FAS), and self-rated health (SRH). (2) Methods: Representative data (N = 14,590; age 15) were drawn from the HBSC (Health Behavior in School-Aged Children) study. The associations between HL, gender, FAS, and SRH were examined via path models. (3) Results: The countries exhibited differences in HL means and in the range of scores within countries. Positive associations were found between FAS and HL, and between HL and SRH in each country. Gender was associated with differences in HL in only three countries. HL acted as a mediator between gender and SRH in four countries, and between FAS and SRH in each country. (4) Conclusions: The findings confirm that there are differences in HL levels within and between European countries, and that HL does contribute to differences in SRH. HL should be taken into account when devising evidence-informed policies and interventions to promote the health of adolescents.

• Klíčová slova
• adolescent, comparative study, health literacy, self-rated health,
• MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• sexuální faktory MeSH
• zdravotní gramotnost * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Periodontal disease is inflammation of the gums and without good oral hygiene, it can progress to periodontitis. Oral hygiene might be related to a patient's health literacy (HL), defined as ability to gain access, understand, and use information to promote and maintain good health. The aim of our study is to examine the associations of HL with indicators of periodontal disease. A cross-sectional study on 1117 adults (36.2% males; mean age = 36.4, SD = 14.2) attending dental hygiene treatment was conducted. Data on demographics, socioeconomic status, and nine domains of HL (Health Literacy Questionnaire, HLQ) were collected by questionnaire, and Community Periodontal Index of Treatment Needs (CPITN) was established by the dental hygienist. Data were analysed using t-tests and logistic regression. Respondents with periodontal disease (N = 152) had statistically significantly lower levels of HL in seven out of nine HLQ domains compared to intact patients (N = 818) (t from 3.03 to 4.75, p < 0.01). Association of higher HL in seven domains with lower chance of diagnosed periodontal disease remain significant even after adjustment for age, gender and educational attainment (adjusted ORs 0.55-0.67, p < 0.05). Our findings confirm that an individual's lower HL is significantly associated with higher chance of periodontal disease incidence, specifically among Slovak adults attending oral hygiene clinics. HL might be a promising factor in the improvement of oral health in this population, worthy of consideration in intervention and preventive activities.

• Klíčová slova
• Community Periodontal Index of Treatment Needs (CPITN), Health Literacy Questionnaire (HLQ), dental hygiene, health literacy, oral health,
• MeSH
• dospělí MeSH
• lidé MeSH
• nemoci parodontu * MeSH
• orální hygiena MeSH
• orální zdraví MeSH
• průřezové studie MeSH
• zdravotní gramotnost * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Slovenská republika MeSH

Effective vascular access (VA) is an essential condition for providing hemodialysis, affecting patients' health outcomes. We aim to explore how health literacy (HL) as a non-clinical factor is associated with the decision-making process regarding VA type selection. Using data from 20 dialysis centers across Slovakia (n = 542, mean age = 63.6, males = 60.7%), the association of HL with type of VA (arteriovenous fistula (AVF) vs. central venous catheter (CVC)) was analyzed using a logistic regression model adjusted for sociodemographic characteristics and comorbidity. Sociodemographic data and data on nine domains of HL were collected by questionnaire. Data on VA and comorbidity were obtained from a medical records. Patients with a greater ability to engage with healthcare providers (odds ratio (OR): 1.34; 95% confidence interval (CI): 1.00-1.78), those with a better ability to navigate the healthcare system (OR: 1.41; 95% CI: 1.08-1.85), those more able to find good health information (OR: 1.52; 95% CI: 1.15-2.03), and those who understand it well enough to know what to do (OR: 1.52; 95% CI: 1.12-2.06) are more likely to have AVF. Patients' HL is associated with the type of VA; therefore, it should be considered in the decision-making process regarding the selection of the type of VA, thereby informing strategies for improving patients' HL and doctor-patient communication.

• Klíčová slova
• arteriovenous fistula, central venous catheter, chronic kidney disease (CKD-5), dialyzed patients, health literacy, vascular access,
• MeSH
• arteriovenózní píštěl * MeSH
• centrální žilní katétry * MeSH
• chronické selhání ledvin terapie   MeSH
• dialýza ledvin * MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• odds ratio MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rozhodování MeSH
• senioři MeSH
• zdravotní gramotnost * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Slovenská republika MeSH

Non-adherence to dietary and fluid intake recommendations (NADFIR) is an important factor for the effective treatment of dialyzed patients and may be hindered by low health literacy (HL). Therefore, we assessed whether low HL of dialyzed patients is associated with their NADFIR. We performed a multicentric cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; response rate: 70.1%; mean age = 63.6 years; males: 60.7%). We assessed the association between nine domains of HL and non-adherence (high serum potassium, high serum phosphate, relative overhydration, and self-reported NADFIR) using general linear models adjusted for age and gender. Moreover, we assessed the moderation by socioeconomic status (SES). We found higher NADFIR among patients with less sufficient information for health management (high serum phosphate level; odds ratio (OR): 0.77; 95% confidence interval (CI): 0.63-0.94), with a lower ability to actively manage their health (self-reported diet non-adherence; OR: 0.74; 95% CI: 0.62-0.89), and those less able to actively engage with healthcare providers (overhydrated; OR: 0.78; 95% CI: 0.65-0.94). Moreover, SES modified this relation. Low HL affects the adherence of dialyzed patients. This shows a need to support patients with low HL and to train healthcare providers to work with these patients, taking into account their SES.

• Klíčová slova
• dialyzed patients, diet adherence, fluid intake adherence, health literacy, non-adherence,
• MeSH
• adherence pacienta statistika a číselné údaje   MeSH
• dialýza ledvin statistika a číselné údaje   MeSH
• dieta * MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• pití MeSH
• přijímání potravy * MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• společenská třída MeSH
• zdravotní gramotnost statistika a číselné údaje   MeSH
• zpráva o sobě MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Slovenská republika MeSH

BACKGROUND: Intradialytic resistance training (IRT) protects patients' muscle mass and functions against protein-energy wasting, malnutrition and cachexia. However, the evidence of the effects of such an intervention in haemodialysis patients is limited and not conclusive. To improve the applicability of such interventions, we need a better understanding of molecular, functional and psycho-social adaptation in dialysed patients following a physical training. Therefore, the aim of this study is to investigate the effects of IRT on lower extremity muscle functions, quality of life, and anxiety and depression, clinical outcomes and circulatory micro-ribonucleic acid (miRNA) profiles in patients on chronic haemodialysis therapy. METHODS: We will perform a quasi-experimental study in 3 dialysis centres. Patients will be recruited via their nephrologists and will be allocated to an experimental and a control group based on the location of the patients' dialysis centre. Patients allocated to the experimental group will undergo a 12-week IRT, while the control group will remain physically inactive during dialysis. The primary outcome is the change in the maximal force produced during an isometric contraction of lower extremity muscles. Secondary outcomes regard quality of life, anxiety and depression, clinical outcomes and circulatory miRNA profiles. Patients' level of health literacy defined as the ability to get and understand health information will be also measured in the study as a potential modifier of effects. DISCUSSION: This quasi-experimental study can add in an important way to our understanding of the effects of resistance training on dialysis patients' muscle strength, quality of life and disease-specific outcomes.

• MeSH
• chronické selhání ledvin patofyziologie   psychologie   terapie   MeSH
• deprese terapie   MeSH
• dialýza ledvin * MeSH
• isometrická kontrakce MeSH
• klinická studie jako téma * MeSH
• kvalita života MeSH
• lidé MeSH
• mikro RNA krev   MeSH
• multicentrické studie jako téma MeSH
• odporový trénink * metody   MeSH
• svalová síla MeSH
• úzkost terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• protokol klinické studie MeSH
• Názvy látek
• mikro RNA MeSH

BACKGROUND: Guidelines on modifiable risk factors regarding cardiological patients are poorly implemented in clinical practice perhaps due to low health literacy. Several digital tools for improving lifestyle and behavioural intervention were developed. Our primary aim is to evaluate the effectiveness of a digital exercise prescription tool on the adherence to physical activity recommendations among patients with cardiovascular diseases. METHODS: A randomized controlled trial will be realized in cooperation with Cardiovascular Health Centres in Eastern Slovakia. Patients recruited through their cardiologists, will be randomised at 1:1 ratio to the three-months' experimental condition or control condition. The experimental group will receive standard lifestyle consultation leading to individually optimized prescription of physical activity. The control group will receive standard, usual-cardio-care lifestyle counselling, also in the domain of physical activity. The digital system will be used for optimized exercise prescription. The primary outcome is a change in the patient's adherence to exercise recommendations. Data will be collected in both groups prior to consultation and after 3 months. DISCUSSION: This study protocol presents background and design of a randomized control trial to investigate the effectiveness of a digital system-provide exercise prescription tool on the adherence to physical activity recommendations. An optimized exercise prescription that better reflects patient's diagnosis, comorbidities and medication can have a significant impact on secondary prevention of cardiovascular disease. This trial can provide important evidence about the effectiveness of digital exercise guidance in everyday practice of cardiovascular healthcare. TRIAL REGISTRATION: The study was registered on 1st November, 2017 and is available online at ClinicalTrials.gov (ID: NCT03329053 ).

• Klíčová slova
• Cardiovascular disease, Digital exercise prescription tool, Exercise prescription,
• MeSH
• adherence pacienta statistika a číselné údaje   MeSH
• dospělí MeSH
• kardiovaskulární nemoci terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• terapie cvičením * MeSH
• výzkumný projekt MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Slovenská republika MeSH