Main Article Content
Purpose: To determine the level of health literacy on sodium restriction and factors associated with health literacy on sodium restriction among patients with hypertension in Phnom Penh, Cambodia.
Designs: A cross-sectional descriptive design was conducted among 317 outpatients with hypertension at the Khmer-Soviet Friendship hospital. Data were collected with the self-report questionnaire comprising demographic characteristics, literacy skills, knowledge about hypertension and sodium restriction, health literacy on sodium restriction, and health professional communication. Descriptive statistic and linear regression were performed.
Main findings: The average health literacy on sodium restriction among patients with hypertension in this study was35.38 (SD = 9.60). Four factors including educational level (β = .159, p = .003), literacy skills (β = .125, p = .019), knowledge about hypertension and sodium restriction (β = .266, p < .001), and health professional communication (β = .359, p < .001) were significantly associated with the level of health literacy on sodium restriction.
Conclusion and recommendations: Patients with hypertension in Phnom Penh, Cambodia had limited health literacy on sodium restriction. Education level, literacy skills, knowledge about hypertension and sodium restriction, and health professional communication were positively associated with health literacy on sodium restriction.Consequently,healthcare provider should promote health literacy on sodium restriction by improving patients’ literacy skills and knowledge about hypertension and sodium restriction through supportive communication especially among patients with low education level.
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2. Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE, et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014;371(7):624-34. doi: 10.1056/NEJMoa1304127.
3. U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2010. 7th ed. Washington, DC: U.S. Goverment Printing Office; 2010. 95 p.
4. Frisoli TM, Schmieder RE, Grodzicki T, Messerli FH. Salt and hypertension: is salt dietary reduction worth the effort? Am J Med. 2012;125(5):433-9. doi: 10.1016/j.amjmed.2011.10.023.
5. Ministry of Health of Cambodia. Health report 2018. Phnom Penh, Cambodia: Ministry of Health of Cambodia; 2018. p.89-103.
6. Ramsay LC. A cross-sectional evaluation of sodium consumption by people in Cambodia [master’s thesis]. Guelph, Ontario: University of Guelph; 2014. 105 p.
7. Grimes CA, Riddell LJ, Nowson CA. Consumer knowledge and attitudes to salt intake and labelled salt information. Appetite. 2009;53(2):189-94. doi: 10.1016/j.appet.2009.06.007.
8. Hutchison J, Warren-Findlow J, Dulin M, Tapp H, Kuhn L. The association between health literacy and diet adherence among primary care patients with hypertension. Journal Health Disparities Research Practice. 2014;7(2):109-26.
9. Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion Int. 2000;15(3):259-67. doi: 10.1093/heapro/15.3.259.
10. Nutbeam D. Defining, measuring and improving health literacy. Health Evaluation and Promotion. 2015;42(4):450-5. doi: 10.7143/jhep.42.450.
11. Adeseun GA, Bonney CC, Rosas SE. Health literacy associated with blood pressure but not other cardiovascular disease risk factors among dialysis patients. Am J Hypertens. 2012;25(3):348-53. doi: 10.1038/ajh.2011.252.
12. Schaeffer D, Berens EM, Vogt D. Health literacy in the German population. Dtsch Arztebl Int. 2017;114(4):53-60. doi: 10.3238/arztebl.2017.0053.
13. Liu YB, Liu L, Li YF, Chen YL. Relationship between health literacy, health-related behaviors and health status: a survey of elderly Chinese. Int J Environ Res Public Health. 2015;12(8):9714-25. doi: 10.3390/ijerph120809714.
14. 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.
15. Zheng Y, Lamoureux EL, Chiang PP, Cheng CY, Anuar AR, Saw SM, et al. Literacy is an independent risk factor for vision impairment and poor visual functioning. Invest Opthalmol Vis Sci. 2011;52(10):7634-9. doi: 10.1167/iovs.11-7725.
16. Du S, Zhou Y, Fu C, Wang Y, Du X, Xie R. Health literacy and health outcomes in hypertension: an integrative review. Int J Nurs Sci. 2018;5(3):301-9. doi: 10.1016/j.ijnss.2018.06.001.
17. DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A, Rudd R, et al. Health literacy universal precautions toolkit. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; 2010. 219 p.
18. Daniel WW, Cross CL. Biostatistic: a foundation for analysis in the health sicence. 10th ed. Hoboken, NJ: Wiley; 2013. p.189-91.
19. Bhattacharya S, Thakur JS, Singh A. Knowledge attitude, and practice regarding dietary salt intake among urban slum population of North India. J Family Med Prim Care. 2018;7(3):526-30. doi: 10.4103/jfmpc.jfmpc_60_17.
20. Temple NJ, Fraser J. Food labels: a critical assessment. Nutrition. 2014;30(3):257-60. doi: 10.1016/j.nut.2013.06.012.
21. Ministry of Industry, Mines and Energy. Cambodian Standard CS 001-2000 Labelling of Food Product [Internet]. Phnom Penh: Ministry of Industry, Mines and Energy; 2000 [cited 2019 Jul 15]. Available from: https://www.wipo.int/edocs/lexdocs/laws/en/kh/kh025en.pdf.
22. Sweet L, Pereira C, Ford R, Feeley AB, Badham J, Mengkheang K, et al. Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania. Matern Child Nutr. 2016;12 Suppl 2:106-25. doi: 10.1111/mcn.12268.
23. Kuczmarski MF, Adams EL, Cotugna N, Pohlig RT, Beydoun MA, Zonderman AB, et al. Health literacy and education predict nutrient quality of diet of socioeconomically diverse, urban adults. J Epidemiol Prev Med. 2016;2(1): pii: 13000115. doi: 10.19104/jepm.2016.115.
24. Jessen N, Santos A, Damasceno A, Silva-Matos C, Severo M, Padrão P, et al. Knowledge and behaviors regarding salt intake in Mozambique. Eur J Clin Nutr. 2018;72(12):1690-9. doi: 10.1038/s41430-018-0125-y.
25. Jackson SL, Coleman King SM, Park S, Fang J, Odom EC, Cogswell ME. Health professional advice and adult action to reduce sodium intake. Am J Prev Med. 2016;50(1):30-9. doi: 10.1016/j.amepre.2015.04.034.
26. Fang J, Cogswell ME, Merritt NLKRK. Primary health care providers’ attitudes and counseling behaviors related to dietary sodium reduction. Arch Intern Med. 2012;172(1):76-8. doi: 10.1001/archinternmed.2011.620.