Negative Impact of Fear of COVID-19 on Health-Related Quality of Life Was Modified by Health Literacy, eHealth Literacy, and Digital Healthy Diet Literacy: A Multi-Hospital Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Settings
2.2. Study Sample and Data Collection
2.3. Instruments and Measurements
2.3.1. Health-Related Quality of Life
2.3.2. Fear of COVID-19
2.3.3. Health Literacy and Digital Healthy Diet Literacy
2.3.4. eHealth Literacy
2.3.5. Participants’ Characteristics
2.3.6. Lifestyle Changes
2.4. Statistical Analysis
3. Results
3.1. Demographic Characteristics
3.2. Associations of HL, eHEALS, DDL, and FCoV-19S with HRQoL
3.3. Effect Modification by eHEALS and DDL on the Association between FCoV-19S and HRQoL
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
B | Unstandardized regression coefficient |
DDL | Digital healthy diet literacy |
eHEALS | eHealth Literacy Scale |
FCoV-19S | Fear of COVID-19 Scale |
HL | Health literacy |
HLS-SF12 | 12-item short-form health literacy questionnaire |
HRQoL | Health-related quality of life |
OPD | Outpatient departments |
S-COVID-19-S | Suspected COVID-19 symptoms |
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Geographic Location | Hospitals | Studied Participants |
---|---|---|
Northern area | ||
Ha Noi city | ||
1. Military Hospital 103 | 501 | |
2. E Hospital | 183 | |
3. General Hospital of Agricultural | 300 | |
Hai Phong city | ||
4. Hai Phong University of Medicine and Pharmacy Hospital | 490 | |
5. Kien An Hospital | 492 | |
Quang Ninh province | ||
6. Bai Chay Hospital | 364 | |
7. Quang Ninh Obstetrics and Pediatrics Hospital | 280 | |
8. Quang Ninh General Hospital | 309 | |
Bac Ninh city | ||
9. Bac Ninh Obstetrics and Pediatrics Hospital | 500 | |
Central area | ||
Da Nang city | ||
10. Da Nang Oncology Hospital | 421 | |
Southern area | ||
Can Tho city | ||
11. Can Tho University of Medicine and Pharmacy Hospital | 508 | |
Total | 4348 |
Variables | Total (N = 4348) | HRQoL | |
---|---|---|---|
n (%) | Mean (SD) | p * | |
Age (years), mean (SD) | 42.8 (16.7) | ||
Age groups | <0.001 | ||
<60 | 3412(78.5) | 65.8 (17.6) | |
≥60 | 936 (21.5) | 53.8 (15.6) | |
Gender | 0.454 | ||
Women | 2694 (62.0) | 63.0 (18.1) | |
Men | 1654 (38.0) | 63.5 (17.5) | |
Marital status | <0.001 | ||
Never married | 772 (17.8) | 69.7 (15.6) | |
Ever married | 3560 (82.2) | 61.8 (18.1) | |
Education attainment | <0.001 | ||
Secondary school or below | 1007 (23.2) | 58.2 (18.3) | |
High school | 1196 (27.5) | 61.1 (18.2) | |
College/university or higher | 2139 (49.3) | 66.8 (16.7) | |
Occupation | <0.001 | ||
Unemployed | 474 (10.9) | 56.5 (19.5) | |
Employed | 3874 (89.1) | 64.0 (17.5) | |
Ability to pay for treatments | <0.001 | ||
Very or fairly difficult | 2712 (62.5) | 60.9 (17.7) | |
Very or fairly easy | 1626 (37.5) | 67.1 (17.5) | |
Social status | <0.001 | ||
Low | 921 (21.2) | 59.6 (20.6) | |
Middle or high | 3419 (78.8) | 64.2 (16.9) | |
BMI, kg/m2 | 0.156 | ||
Normal weight (BMI < 25.0) | 3791 (87.4) | 63.3 (18.0) | |
Overweight/obese (BMI ≥ 25.0) | 546 (12.6) | 62.2 (17.2) | |
Suspected COVID-19 symptoms ** | <0.001 | ||
No | 2595 (59.7) | 65.5 (17.2) | |
Yes | 1753 (40.3) | 59.7 (18.3) | |
Comorbidity | <0.001 | ||
No | 3094 (71.2) | 64.6 (17.8) | |
Yes | 1254 (28.8) | 59.6 (17.6) | |
Smoking tobacco *** | 0.329 | ||
Never, stopped, or smoke less | 3994 (91.9) | 63.1 (18.0) | |
Unchanged or smoke more | 354 (8.1) | 64.1 (16.4) | |
Drinking alcohol *** | 0.918 | ||
Never, stopped, or drink less | 4015 (92.6) | 63.2 (18.1) | |
Unchanged or drink more | 321 (7.4) | 63.3 (15.6) | |
Physical activity *** | <0.001 | ||
Never, stopped, or exercise less | 2515 (57.8) | 58.5 (17.5) | |
Unchanged or exercise more | 1833 (42.2) | 69.7 (16.3) | |
Healthy eating *** | <0.001 | ||
Less healthy | 325 (7.5) | 55.6 (12.8) | |
Unchanged or healthier | 4002 (92.5) | 63.8 (18.1) | |
Health literacy, mean (SD) | 26.5 (10.5) | ||
eHealth Literacy Scale, mean (SD) | 27.9 (6.9) | ||
Digital healthy diet literacy, mean (SD) | 25.9 (12.2) | ||
Fear of COVID-19 Scale, mean (SD) | 20.6 (5.4) |
Variables | HRQoL | |||
---|---|---|---|---|
Model 1 ** | Model 2 *** | |||
B (95% CI) | p | B (95% CI) | p | |
Fear of COVID-19 Scale, 1-score increment * | −0.83 (−0.93, −0.74) | <0.001 | −0.78 (−0.87, −0.70) | <0.001 |
Health literacy, 1-score increment * | 0.41 (0.36, 0.46) | <0.001 | 0.20 (0.15, 0.25) | <0.001 |
eHealth Literacy Scale, 1-score increment * | 0.50 (0.42, 0.57) | <0.001 | 0.24 (0.17, 0.32) | <0.001 |
Digital healthy diet literacy, 1-score increment * | 0.38 (0.33, 0.42) | <0.001 | 0.18 (0.14, 0.22) | <0.001 |
Interactions | HRQoL | |||
---|---|---|---|---|
Model 1 * | Model 2 ** | |||
B (95% CI) | p | B (95% CI) | p | |
Interaction between FCoV-19S and HL | ||||
FCoV-19S, 1-score increment | −1.16 (−1.39, −0.92) | <0.001 | −1.00 (−1.21, −0.78) | <0.001 |
HL, 1-score increment | 0.22 (0.05, 0.38) | 0.008 | 0.11 (−0.05, 0.26) | 0.177 |
FCoV-19S × HL | 0.01 (0.00, 0.02) | 0.017 | 0.01 (−0.01, 0.02) | 0.079 |
Interaction between FCoV-19S and eHEALS | ||||
FCoV-19S, 1-score increment | −1.51 (−1.86, −1.17) | <0.001 | −1.18 (−1.51, −0.85) | <0.001 |
eHEALS, 1-score increment | 0.14 (−1.11, 0.38) | 0.273 | 0.09 (−0.14, 0.32) | 0.451 |
FCoV-19S × eHEALS | 0.02 (0.01, 0.03) | <0.001 | 0.01 (0.01, 0.02) | 0.034 |
Interaction between FCoV-19S and DDL | ||||
FCoV-19S, 1-score increment | −1.12 (−1.33, −0.91) | <0.001 | −1.02 (−1.22, −0.82) | <0.001 |
DDL, 1-score increment | 0.17 (0.02, 0.32) | 0.026 | 0.03 (−0.11, 0.17) | 0.652 |
FCoV-19S × DDL | 0.01 (0.00, 0.02) | 0.003 | 0.01 (0.00, 0.02) | 0.016 |
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Nguyen, M.H.; Pham, T.T.M.; Nguyen, K.T.; Nguyen, Y.H.; Tran, T.V.; Do, B.N.; Dao, H.K.; Nguyen, H.C.; Do, N.T.; Ha, T.H.; et al. Negative Impact of Fear of COVID-19 on Health-Related Quality of Life Was Modified by Health Literacy, eHealth Literacy, and Digital Healthy Diet Literacy: A Multi-Hospital Survey. Int. J. Environ. Res. Public Health 2021, 18, 4929. https://doi.org/10.3390/ijerph18094929
Nguyen MH, Pham TTM, Nguyen KT, Nguyen YH, Tran TV, Do BN, Dao HK, Nguyen HC, Do NT, Ha TH, et al. Negative Impact of Fear of COVID-19 on Health-Related Quality of Life Was Modified by Health Literacy, eHealth Literacy, and Digital Healthy Diet Literacy: A Multi-Hospital Survey. International Journal of Environmental Research and Public Health. 2021; 18(9):4929. https://doi.org/10.3390/ijerph18094929
Chicago/Turabian StyleNguyen, Minh H., Thu T. M. Pham, Kien T. Nguyen, Yen H. Nguyen, Tien V. Tran, Binh N. Do, Hung K. Dao, Huu C. Nguyen, Ngoc T. Do, Tung H. Ha, and et al. 2021. "Negative Impact of Fear of COVID-19 on Health-Related Quality of Life Was Modified by Health Literacy, eHealth Literacy, and Digital Healthy Diet Literacy: A Multi-Hospital Survey" International Journal of Environmental Research and Public Health 18, no. 9: 4929. https://doi.org/10.3390/ijerph18094929