Abstracts
Résumé
Le Plan d’action 2015-2020 en santé mentale du Québec vise, chez les personnes présentant des troubles mentaux graves, le développement d’une autonomie optimale dans la société et l’utilisation adéquate des services de santé. Néanmoins, à ce jour, un manque de données est rapporté au Québec, sur la capacité des personnes présentant des troubles mentaux à accéder, à comprendre et à utiliser l’information relative à la santé, ce qui correspond au concept de littératie en santé (LS). Une étude descriptive quantitative a été menée pour décrire la LS chez les personnes présentant des troubles mentaux graves et demeurant dans la communauté de Dolbeau-Mistassini, au Saguenay–Lac-Saint-Jean (Québec). Les données ont été collectées à l’aide de trois questionnaires autorapportés, incluant le Questionnaire sur la littératie en santé (QLS). Ce questionnaire permet de décrire la LS à partir de 9 dimensions, afin de soulever les besoins individuels, organisationnels et sociaux en lien avec la LS des personnes ciblées. Les résultats obtenus auprès des participants (n = 30) ont montré que la LS était plus faible dans la dimension « Comprendre l’information relative à la santé ». Les résultats de cette étude mettent en évidence la nécessité d’adapter les interventions éducatives chez cette population. Cette adaptation pourrait permettre à cette population de mieux intégrer le contenu de l’enseignement reçu, tout en privilégiant l’accompagnement d’un proche lors de la rencontre avec un professionnel de la santé.
Mots-clés :
- littératie en santé,
- troubles mentaux graves,
- maladies chroniques
Abstract
Objectives The Quebec government’s 2015-2020 Ministerial Mental-Health Action Plan aims at developing an optimal autonomy level in society and achieving an adequate use of healthcare services among individuals with severe mental disorders. Individuals presenting with such disorders frequently have other long-term conditions. In order to manage their conditions, these individuals must have access to, understand, and use health-related information. This corresponds to the concept of health literacy (HL). Although some research has been conducted on the HL of individuals with severe mental-health disorders, none has been done in the province of Quebec (Canada) and the measurement questionnaire previously used did not adequately take into account the multiple dimensions of HL. Using a multidimensional questionnaire would thereby be beneficial. Specifically, the objective herein was to describe the HL among individuals with a severe mental disorder residing in the community in the Saguenay–Lac-Saint-Jean region (Québec, Canada).
Methods This quantitative research used a descriptive design. The participants were recruited from the community mental-health program at the Dolbeau–Mistassini CLSC, which is part of the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Saguenay–Lac-Saint-Jean. The participants were selected using a convenience sampling. Three questionnaires were used for data collection: 1) the French version of the Health Literacy Questionnaire (HLQ), a self-report questionnaire with 9 scales; 2) the French version of the Disease Burden Morbidity Assessment to get a portrait of the chronic diseases of participants; and 3) a standard sociodemographic questionnaire. The scores for the dimensions of the HLQ have been described with descriptive statistics. The average values of the nine QLS scales for the different participant subgroups were compared with Student’s t-tests or ANOVA.
Results Based on the overall HLQ results, the dimension Ability to understand health information reflected a lower level of HL. Overall, the averages for the various dimensions for the study population were all slightly lower than those previously described using the same questionnaire but with populations of the elderly or people with chronic conditions.
Conclusion The results highlight the need to continue investigating the HL concept for the population segment with severe mental disorders. This study also brings out the need to adapt the health education delivered to this population so as to help such individuals better understand health-related information.
Keywords:
- health literacy,
- severe mental illness,
- chronic diseases
Appendices
Bibliographie
- American Psychiatric Association (2016). Mini DSM-5 : critères diagnostiques. Paris : Elsevier Masson.
- Bayliss, E. A., Ellis, J. L. et Steiner, J. F. (2005). Subjective assessments of comorbidity correlate with quality of life health outcomes : Initial validation of a comorbidity assessment instrument. Health And Quality Of Life Outcomes, 3(51), 1-8.
- Beauchamp, A., Buchbinder, R., Dodson, S., Batterham, R. W., Elsworth, G. R., McPhee, C., . . . Osborne, R. H. (2015). Distribution of health literacy strengths and weaknesses across socio-demographic groups : A cross-sectional survey using the Health Literacy Questionnaire (HLQ). BMC Public Health, 15, 678-678. doi: 10.1186/s12889-015-2056-z
- Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., Viera A., C. K. et coll. (2011). Health Literacy Interventions and Outcomes : An Updated Systematic Review
- Clausen, W., Watanabe-Galloway, S., Bill Baerentzen, M. et Britigan, D. H. (2016). Health literacy among people with serious mental illness. Community Mental Health Journal, 52(4), 399-405. doi: 10.1007/s10597-015-9951-8
- Conseil canadien sur l’apprentissage. (2008). La littératie en santé au Canada : Une question de bien-être 2008.
- de Jordy, L. C. (2018). Traduction et validation françaises canadiennes du questionnaire de la littératie en santé (QLS) (Mémoire de maîtrise). (Université du Québec à Chicoutimi, Québec).
- Doucette, E., Chevrier, A., Gauthier, M., Bellemare, M., Ghersi, I., Olmstead, D.,… Selby, S. (2014). Mental health : Is it critical ? Evidence-based practice for patients with mental illness in a critical care setting. Dynamics, 25(2), 25-25.
- Dufour, I., Lacasse, A., Chouinard, M.-C., Chiu, Y. et Lafontaine, S. (2019). Health literacy and use of healthcare services among community-dwelling older adults living with chronic conditions. Clinical Nursing Studies, 7(2).
- Flaskerud, J. H. (2012). Mental health care and health literacy. Issues in Mental Health Nursing, 33(3), 196-198. doi: 10.3109/01612840.2011.610563
- Fortin, M. F. et Gagnon, J. (2016). Fondements et étapes du processus de recherche : méthodes quantitatives et qualitatives. (3e éd.). Montréal, Canada : Chenelière éducation.
- Galletly, C., Neaves, A., Burton, C., Liu, D. et Denson, L. A. (2012). Evaluating health literacy in people with mental illness using the Test of Functional Health Literacy in Adults. Nursing Outlook, 60(5), 316-321. doi: 10.1016/j.outlook.2012.01.003
- Government of Canada. (2018). Social determinants of health and health inequalities. Repéré le 2019-11-12 à https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.htm
- Graham, H. L., Maslin, J., Copello, A., Birchwood, M., Mueser, K., McGovern, D. et Georgiou, G.. (2001). Drug and alcohol problems amongst individuals with severe mental health problems in an inner-city area of the UK. Social Psychiatry and Psychiatric Epidemiology, 36(9), 448-455.
- Haun, J. N., Valerio, M. A., McCormack, L. A., Sørensen, K. et Paasche-Orlow, M. K. (2014). Health literacy measurement : An inventory and descriptive summary of 51 instruments. Journal of Health Communication, 19(2), 302-333. doi: 10.1080/10810730.2014.936571
- Hudon, C., Chouinard, M. C., Dubois, M. F., Roberge, P., Loignon, C., Tchouaket, E., . . . Bouliane, D. (2018). Case management in primary care for frequent users of health care services with chronic disease and complex care needs (V1SAGES) : A mixed methods study. Annals of family medicine, 16(3), 232-239.
- Institute of Medicine (2009). Measures of Health Literacy : Workshop Summary. Washington, D.C. : National Academies Press.
- Institute of Medicine (2012). Facilitating state health exchange communication through the use of health literate practices. Washington, D.C.).
- Jayasinghe, U. W., Harris, M. F., Parker, S. M., Litt, J., van Driel, M., Mazza, D., . . . Taylor, R. (2016). The impact of health literacy and lifestyle risk factors on health-related quality of life of Australian patients. Health And Quality Of Life Outcomes, 14, 68-68. doi: 10.1186/s12955-016-0471-1
- Jessup, R. L., Osborne, R. H., Beauchamp, A., Bourne, A. et Buchbinder, R. (2017). Health literacy of recently hospitalised patients : A cross-sectional survey using the Health Literacy Questionnaire (HLQ). BMC Health Services Research, 17, 1-12. doi: 10.1186/s12913-016-1973-6
- Jordan, J. E., Osborne, R. H. et Buchbinder, R. (2011). Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesses. Journal of clinical epidemiology(64), 366-379.
- Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. et Pollitt, P. (1997). Mental health literacy : A survey of the public’s ability to recognize mental disorders and their belief about the effectiveness of treatment. Medical Journal of Australia (166), 182-186.
- Krishan, S., Von Esenwein, S. A., Druss, B. G., Krishan, S. et Druss, B. G. (2012). The health literacy of adults with severe mental illness. Psychiatric Services, 63(4), 397-397.
- Lean, M., Fornells-Ambrojo, M., Milton, A., Lloyd-Evans, B., Harrison-Stewart, B., Yesufu-Udechuku, A., … Johnson, S. (2019). Self-management interventions for people with severe mental illness : systematic review and meta-analysis. British Journal of Psychiatry, 214(5), 260-268. doi: 10.1192/bjp.2019.54
- Lincoln, Espejo, D., Johnson, P., Paasche-Orlow, M., Speckman, J. L., Webber, T. L. et White, R. F. (2008). Limited literacy and psychiatric disorders among users of an urban safety-net hospital’s mental health outpatient clinic. Journal of Nervous & Mental Disease, 196(9), 687-693.
- Ministère de la Santé et des Services sociaux (2005). Plan d’action en santé mentale 2005-2010 : la force des liens. Québec, Canada : Les éditions de la Direction des communications du ministère de la Santé et des Services sociaux du Québec.
- Ministère de la Santé et des Services sociaux (2015). Plan d’action en santé mentale 2015-2020 : faire ensemble et autrement. Québec, Canada : Les éditions de la Direction des communications du ministère de la Santé et des Services sociaux du Québec.
- O’Brien, S., McFarland, J., Kealy, B., Pullela, A., Saunders, J., Cullen, W. et Meagher, D. (2012). A randomized-controlled trial of intensive case management emphasizing the recovery model among patients with severe and enduring mental illness. Irish Journal Of Medical Science, 181(3), 301-308. doi: 10.1007/s11845-011-0795-0
- O’Connor, M. et Casey, L. (2015). The mental health literacy scale (MHLS) : A new scale-based measure of mental health literacy. Psychiaty Research, p. 511-516.
- Osborne, R. H., Batterham, R. W., Elsworth, G. R., Hawkins, M. et Buchbinder, R. (2013). The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ). BMC Public Health, 13(1), 658-658. doi: 10.1186/1471-2458-13-658
- Pampalon, R., Hamel, D., Alix, C. et Landry, M. (2013). Une stratégie et des indicateurs pour la surveillance des inégalités sociales de santé au Québec. Québec : Institut national de santé publique du Québec.
- Photharos, N., Wacharasin, C. et Duongpaeng, S. (2018). Model of Self-management Behavior in People Experiencing Early Stage Chronic Kidney Disease. Pacific Rim International Journal of Nursing Research, 22(4), 360-371.
- Poitras, M. E., Fortin, M., Hudon, C., Haggerty, J. et Almirall, J. (2012). Validation of the disease burden morbidity assessment by self-report in a French-speaking population. BMC Health Services Research, 12(35).
- Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L. et Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA, 264(19), 2511-2518.
- Rose, L., Sawyer, A. et Everett, A. (2014). Cardiovascular health literacy and treatment adherence in persons with serious mental illness. Issues in Mental Health Nursing, 35(2), 88-99. doi: 10.3109/01612840.2013.843622
- Rowlands, G., Shaw, A., Jaswal, S., Smith, S. et Harpam, T. (2017). Health literaty and the social determinants of health : a qualitative model from adult learners. Health promotion international, (32), 130-138.
- Salisbury, C., Johnson, L., Purdy, S., Valderas, J. M., Montgomery, A. A., Salisbury, C., . . . Montgomery, A. A. (2011). Epidemiology and impact of multimorbidity in primary care : A retrospective cohort study. British Journal of General Practice, 61(582), 12-21.
- World Health Organization (2013). Health literacy : The solid facts. Geneva (CH) : WHO Regional Office for Europe.