Health Literacy and Anxiety Among Hemodialysis Patients During the Coronavirus Disease Pandemic

Figures & data

Table 1 Demographic and Clinical Characteristics of the Participants (n= 149)

Variables	Category	N (%), M ± SD
Gender	Male	75 (50.3)
	Female	74 (49.7)
Age, years		63.73 ± 10.02
	< 60	12 (8.1)
	60–69	34 (22.8)
	≥ 70	59 (39.6)
Type of household	Single	33 (22.1)
	Cohabitants	116 (77.9)
Education level, years	≤ 6	16 (10.7)
	7–9	20 (13.4)
	10–12	74 (49.7)
	≥13	39 (26.2)
Employment status	Employed	28 (18.8)
	Unemployed	121 (81.2)
Mode of commute to the hospital	Personal	66 (44.3)
	Public	83 (55.7)
COVID-19 related quarantine experience	Yes	12 (8.1)
	No	137 (91.9)
COVID-19 2nd Vaccination Completed	Yes	82 (55.0)
	No	67 (45.0)
Main source of health information	Television, radio	108 (72.5)
	Internet	41 (27.5)
	Print (book, newspapers)	6 (4.0)
	Health care provider	25 (16.8)
Average health information acquiring time, per day	< 1 hour	89 (59.7)
	≥ 1 hour	60 (40.3)
Hemodialysis maintenance period, years		6.22 ± 4.95
	< 3	45 (30.2)
	3–7	48 (32.2))
	≥ 7	56 (37.6)
Comorbidity	Yes	119 (79.9)
	No	30 (20.1)

Abbreviations: M, mean; SD, Standard deviation.

Table 2 Subject’s Health Literacy and Anxiety Level (n= 149)

Variables	Category	N (%)	M ± SD Median, IQR
Health literacy	Functional health literacy		14.03 ± 4.52
	Communicative health literacy		14.01 ± 4.13
	Critical health literacy		9.97 ± 3.77
	FCCHL		38.01 ± 0.61
Anxiety
CAS	Dysfunctional anxiety		0 (0–1.0)
	No (< 9)	147 (98.6)
	Yes (≥ 9)	2 (1.4)
KGAD	Generalized anxiety		0 (0–4.0)
	Normal (0–4)	116 (77.9)
	Mild (5–9)	26 (14.4)
	Moderate (10–14)	7 (4.7)
	Severe (15–21)	0

Abbreviations: CAS, Coronavirus anxiety scale; FCCHL, Functional, communicative and critical health literacy; IQR, Interquartile range; KGAD, The Korean version generalized anxiety disorder; M, mean; SD, Standard deviation.

Figure 1 Comparison of health literacy according to the general characteristics of the participants (n= 149). Boxplot showing the comparison of health literacy between (a) Gender, (b) Age, (c) Household type, (d) Educational year, (e) Employment status, (f) Comorbidity, the main source of information (g) TV or radio, (h) Internet, (i) Prints, (j) healthcare provider, (k) information searching time, and (l) Hemodialysis maintenance period. The p values of independent variables significant in t-test or one-way analysis of variance were shown in the figure. All data points can be seen as scattered dots overlying the boxplot.

Abbreviations: FCCHL, functional, communicative and critical health literacy; HD, hemodialysis.

Table 3 Differences in Coronavirus Anxiety Scale and General Anxiety Disorder According to Generalized Characteristic (n= 149)

Variables	N (%)	CAS	Z	KGAD Score	Z
		Median (IQR)	(p)	Median (IQR)	(p)
Gender			−2.149		−1.895
Male	75 (50.3)	0.0 (0.0–0.0)	(0.032)	0.0 (0.0–3.0)	(0.058)
Female	74 (49.7)	0.0 (0.0–2.0)		1.0 (0.0–5.0)
Age, years			2.702		0.458
< 60		0.0 (0.0–0.0)	(0.259)	0.0 (0.0–5.3)	(0.795)
60–69		0.0 (0.0–1.0)		0.0 (0.0–3.5)
≥ 70		0.0 (0.0–2.0)		0.0 (0.0–4.0)
Cohabitant			−0.092		−0.869
Yes	112 (75.2)	0.0 (0.0–1.0)	(0.927)	0.0 (0.0–5.0)	(0.385)
No	37 (24.8)	0.0 (0.0–1.0)		0.0 (0.0–3.75)
Education level, years			4.996		2.328
≤ 6	16 (10.7)	0.0 (0.0–2.75)	(0.172)	1.0 (0.0–5.0)	(0.507)
7–9	20 (13.4)	0.0 (0.0–2.75)		0.50 (0.0–6.0)
10–12	74 (49.7)	0.0 (0.0–1.0)		0.0 (0.0–4.0)
≥13	39 (26.2)	0.0 (0.0–0.0)		0.0 (0.0–2.0)
Employment status			−0.236		−0.847
Employed	27 (18.1)	0.0 (0.0–1.0)	(0.814)	0.0 (0.0–4.0)	(0.397)
Unemployed	122 (81.9)	0.0 (0.0–1.0)		2.0 (0.0–4.0)
Transport to hospital			−0.012		−0.019
Personal	66 (44.3)	0.0 (0.0–1.0)	(0.990)	0.0 (0.0–4.0)	(0.985)
Public	83 (55.7)	0.0 (0.0–0.75)		2.0 (0.0–4.0)
COVID-19 related quarantine experience			−1.403		−0.259
Yes	12 (8.1)	0.50 (0.0–2.50)	(0.161)	0.50 (0.0–2.75)	(0.796)
No	137 (91.9)	0.0 (0.0–1.0)		0.0 (0.0–4.0)
COVID-19 2nd Vaccination Completed			−0.760		−1.092
Yes	82 (55.0)	0.0 (0.0–1.0)	(0.447)	0.0 (0.0–3.0)	(0.275)
No	67 (45.0)	0.0 (0.0–1.0)		0.0 (0.0–5.0)
Sources of health information
Television, radio			−0.855		−0.866
Yes	108 (72.5)	0.0 (0.0–1.0)	(0.393)	0.0 (0.0–5.0)	(0.386)
No	41 (27.5)	0.0 (0.0–0.50)		0.0 (0.0–3.0)
Internet			−1.162		−0.757
Yes	41 (27.5)	0.0 (0.0–0.0)	(0.245)	1.0 (0.0–5.0)	(0.449)
No	108 (72.5)	0.0 (0.0–1.0)		0. 0 (0.0–4.0)
Print (book, newspapers)			−0.189		−1.139
Yes	6 (4.0)	0.0 (0.0–1.75)	(0.850)	3.5 (0.0–6.25)	(0.255)
No	143 (96.0)	0.0 (0.0–1.0)		0.0 (0.0–4.0)
Health care provider			−0.253		−0.166
Yes	25 (16.8)	0.0 (0.0–1.0)	(0.800)	0.0 (0.0–5.0)	(0.868)
No	124 (83.2)	0.0 (0.0–1.0)		0. 0 (0.0–4.0)
Average daily health information search time			−2.472		−1.891
< 1 hour	89 (59.7)	0.0 (0.0–0.0)	(0.013)	0.0 (0.0–3.75)	(0.059)
≥ 1 hour	60 (40.3)	1.5 (0.0–2.25)		1.5 (0.0–5.0)
Duration on hemodialysis, years			2.651		1.883
< 3	28 (18.8)	0.0 (0.0–0.0)	(0.266)	1.0 (0.0–5.25)	(0.390)
3–7	49 (32.9)	0.0 (0.0–1.0)		0.0 (0.0–4.0)
≥ 7	30 (20.1)	0.0 (0.0–2.0)		0.0 (0.0–4.0)
Comorbidity			−1.367		−2.384
Yes	119 (79.9)	0.0 (0.0–0.0)	(0.172)	0.0 (0.0–0.0)	(0.017)
No	30 (20.1)	0.0 (0.0–1.0)		1.0 (0.0–1.0)

Abbreviations: CAS, Coronavirus anxiety scale; IQR, Interquartile range; KGAD, The Korean version generalized anxiety disorder.

Table 4 Spearman Correlation Between Subject’s Health Literacy (Domain; Functional, Communicative and Critical Literacy) and Anxiety (Coronavirus Anxiety Scale, Generalized Anxiety Disorder)

	FHL	CmHL	CHL	FCCHL	CAS	KGAD
FHL	1
CmHL	0.504**	1
CHL	0.454**	0.806**	1
FCCHL	0.791**	0.886**	0.885**	1
CAS	−0.188*	−0.238*	−0.192*	−0.242*	1
KGAD	−0.186*	−0.215*	−0.141	−0.215*	0.400**	1

Notes: *p <0.05, **p <0.01.

Abbreviations: CAS, Coronavirus anxiety scale; CmHL, communicative literacy; CHL, critical health literacy; FCCHL, functional, communicative and critical health literacy; FHL, functional health literacy; KGAD, The Korean version generalized anxiety disorder.