LETRAMENTO EM SAÚDE EM PESSOAS IDOSAS: REVISÃO SISTEMÁTICA E RELAÇÃO COM A PROBABILIDADE DE ÓBITO

Abstract

ABSTRACT Introduction: Health literacy is an important variable to be evaluated in older adults, as it is related to several health outcomes and also to specific personal characteristics, such as increasing age. Identifying the possible relationship between health literacy and the probability of death in older adultos can help in planning interventions before adverse outcomes occur. Objective: To identify in the literature the factors associated with low health literacy in older adults; and to evaluate the relationship between health literacy and the probability of death in older adults registered in Primary Health Care centers. Two studies were carried out. Article 1. Methods: A systematic literature review was conducted in the Pubmed, Web of Science, Scopus, PsycInfo, Embase, and LILACS databases. The descriptors used were “Aged” and “Health Literacy”, with the Boolean operator “AND”. Articles published in English, Portuguese or Spanish were selected, with no time limit. This review was registered in PROSPERO - CRD: 42022350140. Results: 23,500 articles were identified in the databases and 176 were selected to compose the review. Several factors are associated with low health literacy in older people, such as sociodemographic aspects (i.e., older age, low educational level, not being white and others); social (i.e. lack of social/family support, loneliness, social isolation, few social activities, few social contacts and others); economic (i.e., lower income and/or lower socioeconomic level) and health (i.e., worse health, chronic conditions, worse mental health, hospitalizations, frailty, physical inactivity, worse cognition, low adherence to treatment and others). Article 2. Methods: Cross-sectional and quantitative study, carried out with 200 older adults registered in Family Health Units in the city of Naviraí, Mato Grosso do Sul, Brazil. A sociodemographic and health characterization was carried out and the Test of Functional Health Literacy in Adults (TOFHLA) and the Suemoto Index were applied. For the analyses, correlation tests and linear regression models were used. All ethical precautions were observed. Results: The majority of participants were male, aged between 60-69 years, with a partner, with more than four years of education, retired, using medication, had not been hospitalized or suffered a fall in the last year and declared themselves very satisfied with life. The average TOFHLA score was 47.7 points, with 2.5% of participants classified as having adequate literacy, 25.0% with limited literacy and 72.5% with inadequate literacy. The older the age, the worse the health literacy. The average probability of death in 10 years was 35.4%, being higher for men, with higher age, who use medication, were hospitalized and fell in the last year. A weak and inversely proportional correlation was identified between health literacy and probability of death. Health literacy was associated with the probability of death, regardless of age, sex, number of medications and recent hospitalization. Conclusions: It was possible to identify factors related to low health literacy, which are sociodemographic, social, economic and health. There is a relationship between health literacy and the probability of death. Health literacy, as well as demographic and health variables, influence the probability of death. The results can support health education interventions aimed at improving the literacy of older adults, especially in Primary Health Care, where the bond with patients is greater. The nurse, as a member of the team, plays a fundamental role in this process that can reduce the probability of death in older adults and improve their quality of life. Keywords: Geriatric Nursing; Aged; Health Literacy; Death; Systematic Review