Fatores associados ao conhecimento e letramento em saúde de indivíduos com diagnóstico de hepatite C crônica em acompanhamento ambulatorial

Abstract

Among the challenges for eliminating hepatitis C (HC), there are deficits in knowledge and low health literacy (LS) regarding preventive measures, control and treatment. LS involves the individual's ability to obtain, access, understand basic information and services needed to make health decisions. This study aimed to analyze the factors associated with health knowledge and literacy of individuals diagnosed with chronic Hepatitis C in outpatient follow-up. The cross-sectional analytical study was carried out between January and August 2020. One hundred five patients were interviewed. Information was collected from sociodemographic, clinical; a knowledge assessment instrument was applied through a self-report instrument on the causes and transmission of hepatitis C infection; and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Continuous and categorical variables that showed a significant association was included in the multivariate analysis. The associations between the variables were analyzed using the F test. The quality of the fit of the final model through the adjusted R-square. Four variables were associated with knowledge about HC: age (p <0.001), having a partner (p = 0.009), high school education and higher education (p <0.001) and smoking (p = 0.009). The knowledge items that had the worst performance were related to the nature of the disease and transmission. The dimensions of the LS with the lowest scores were enough information to take care of health; and understand health information and know what to do. The multivariate analysis showed R2 elevated in three dimensions of the LS "health information assessment" (R2: 0.35), "finding good health information" (R2: 0.32) and "understanding health information" (R2: 0.48). The independent variables that showed a negative association with the HLQ-Br scores were age ("having enough information; finding good health information and understanding health information", p <0.001); treatment ("health information assessment", p <0.001); hypertension ("navigating the health system", p <0.05), "understanding health information", p <0.005) and type of transmission ("understanding health information" p <0.05). Knowledge about the disease was a predictor of better scores in LS dimensions. The results showed that chronic hepatitis C is a challenge for health systems in terms of developing strategies that promote the effective engagement of the patient with the therapeutic process. The analysis of the knowledge and literacy of patients in outpatient follow-up at Brazilian health service showed advances and challenges to be faced so that Brazil reaches the goal, set by the World Health Organization, of eliminating Viral Hepatitis by 2030. Especially in terms of the need for strategies that improve the ability to understand disease and treatment, as well as the skills of health professionals to communicate with patients with chronic hepatitis C.