Mediating role of inner strength in the relationship between medication literacy and medication adherence among kidney transplant patients

Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.

Relationship between clinical belonging,professional identity,and nursing information ability among nursing interns:Model construction

BACKGROUND Clinical belonging refers to the feeling that clinical medical staff feel recognized and accepted by others or groups.The level of clinical belonging of nursing interns affects students’learning motivation and confidence,which in turn affects their clinical practice behavior.AIM To explore the effects of professional identity and nursing information ability on clinical belonging among nursing interns and establish a relationship model for these factors.METHODS The researchers used the convenience sampling method to select 682 nursing interns from China.The survey was conducted using a general information questionnaire,clinical sense of belonging scale,nursing information ability self-assessment scale,and a nursing student professional identity questionnaire.The mediating effect of nursing information ability between their professional identity and clinical sense of belonging was analyzed using SPSS 21.0 and the path analysis in structural equation modeling.RESULTS The total scores of clinical belonging,professional identity,and nursing information ability of nursing interns were(104.29±13.11)points,(57.89±7.16)points,and(70.29±6.20)points,respectively.Nursing information ability had a direct effect on the clinical sense of belonging(effect value=0.46,P<0.05).Occupational identity had a direct effect(effect value=0.52,P<0.05)and an indirect effect(effect value=0.21,P<0.05)on clinical belonging.CONCLUSION Nursing administrators in nursing colleges and hospitals should take effective measures to improve the professional identity and nursing information ability of nursing interns,as well as the clinical sense of belonging among nursing interns.

Who should be screened for colorectal cancer and how can it be prevented more effectively?

In this editorial,we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol(2024;30:1368-1376).We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer(CRC)screening as a public health strategy to diminish disease burden.Individuals exposed to risk factors for CRC,those with comorbid conditions,and those with limited health literacy should undergo screening.However,we believe that more regular screenings should be accompanied by a greater focus on primary prevention(PP)of CRC.CRC remains a significant global health challenge,and its incidence is strongly linked to age,lifestyle,and socioeconomic factors.It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease,and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC,which significantly impacts the prognosis and imposes a substantial economic burden.This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways.Remarkably,early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings.This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods,health care systems can create a more comprehensive safety net for individuals at risk of CRC.However,before maximizing the health benefits of screening programs,it is essential to make additional efforts prior to screening,such as raising awareness via public education,risk assessment,and personalized recommendations,enhancing the knowledge and skills of health care professionals,optimizing the accessibility and convenience of screening processes,ensuring the quality and safety of screening services,strengthening follow-up and support systems,and providing policy support and financial investment.The establishment of a comprehensive screening system often requires substantial investment in human,material,and financial resources,which can be challenging to achieve in regions with limited health care resources.Strengthening PP strategies can reduce the disease burden by targeting the cause,representing a more cost-effective and impactful approach.Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP,individualized malignant tumor risk assessment,and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies.

Construction and Validity of Chinese Translation of the Universal Mental Health Literacy Scale for Adolescents

Background:In this study,the Universal Mental Health Literacy Scale for Adolescents(UMHL-A)was revised and tested for its reliability and validity in Chinese middle school students,thus establishing a useful tool for assessing the mental health of individuals in this occupation.Methods:Our sample comprised 1208 junior high school students(58.85%male),aged between 11 and 15 years old.The Chinese version of the scale includes a mental health attitude subscale and mental health knowledge subscale,including attitudes towards seeking help,attitudes related to stigma,general mental health knowledge,and knowledge about specific mental illnesses,encapsulated in a total of 17 items.A series of psychometric analyses such as exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and internal consistency reliability estimation were carried out in this study.Results:The results of the CFA indicated that the two-factor model had an acceptable model fit(Attitude(UMHL-A Likert):χ^(2)/df=4.107;RMSEA=0.072;SRMR=0.045;TLI=0.932;CFI=0.954;Knowledge(UMHL-A T/F):χ^(2)/df=3.647;RMSEA=0.066;SRMR=0.044;TLI=0.923;CFI=0.945).The Cronbach’s alpha coefficient of subscales of the Chinese version UMHL-A were 0.80 and 0.78,respectively.Conclusion:In general,the Chinese version of the Universal Mental Health Literacy Scale for adolescents has good reliability and validity and can be used as a tool to measure the mental health literacy of Chinese adolescents.

Association between Mental Health Literacy and Workplace Well-Being of Chinese Grassroots Civil Servants:The Chain Mediating Effects of Regulatory Emotional Self-Efficacy and Resilience

This study aimed to investigate the relationship between mental health literacy(MHL)and workplace well-being(WWB)of Chinese grassroots civil servants,with regulatory emotional self-efficacy(RESE)and resilience as mediating variables.A questionnaire survey was conducted among Chinese grassroots civil servants,with a valid sample size of 2673 after excluding missing values and conducting relevant data processing.The PROCESS was used to examine the relationship between MHL,RESE,resilience,and WWB.The study found that MHL among grassroots civil servants was positively and significantly correlated with WWB(r=0.73,p<0.01).RESE partially mediated the relationship between MHL and WWB(β=0.25,95%CI[0.22,0.28]).Resilience partially mediated the relationship between MHL and WWB(β=0.22,95%CI[0.19,0.26]).MHL had a positive effect on WWB through the chain mediating effect of RESE and resilience(β=0.05,95%CI[0.03,0.07]).There is a close relationship between MHL and WWB,where Chinese grassroots civil servants with higher levels of MHL can develop stronger RESE and resilience,leading to higher WWB.The results of this study remind organizational institutions of Chinese grassroots civil servants that enhancing MHL,RESE,and resilience is an important pathway to promoting their WWB.

An Experimental Study on the Effectiveness of Individualized Online Intervention for Mental Health Literacy of Community Residents

Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily depend on traditional education and contact interventions,which have limitations with regard to pertinence and individualization.Artificial intelligence(AI)and big data technology have influenced mental health services to be more intellectual and digital,and they also provide greater technical convenience for individualized interventions for promoting mental health literacy.However,there is relatively little research on the effectiveness of individualized online intervention for mental health literacy in the literature.This study aims to fill this void.To verify whether individualized online intervention can improve the level of mental health literacy.Methods:We conducted a pretest–post-test control experiment.The participants were recruited from a large community located in central China.A total of 152 participants completed the research.We use mixed linear model estimation and paired t-tests to analyze the data.Results:Individualized online intervention can effectively improve the mental health literacy level of participants.Specifically,we found that compared with the control group,the mental health literacy in the experimental group was significantly improved after receiving individualized online intervention.Likewise,the mental health literacy of the control group has also improved after receiving individualized online intervention.In addition,we compared the mental health literacy level of the experimental group at Time 3 to those at Time 2 and found that the mental health literacy level at Time 3 had not decreased one month later.This shows that individualized online intervention was not only momentarily effective,but also had long-term efficacy.Conclusion:This study illustrates that the individualized online intervention has both great momentary and long-term effectiveness in improving community residents’mental health literacy.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Digital Literacy in the Rural Environment of Rivers State, Nigeria

While literacy can generally be defined as the basic ability to read,write,and also count,digital literacy can be described as the ability to perform all these tasks using electronic means.These means would include modern electronic gadgets,such as mobile phones,tablets,computers,kindle books,and the like.To be digitally literate would therefore require the existence of modern technologies such as internet facilities that would make it possible to access online reading and writing.The rural environment,particularly in developing areas,is usually characterised by a seeming lack of modern amenities and even worse,digital internet networks.Yet,those who live in the rural areas of Rivers State belong to the modern digital era and deserve to be digitally literate.This paper examines the prerequisites for digital literacy and explores how these can be achieved for citizens who inhabit the rural areas of an industrially-nascent state like Rivers State.

College English Teaching Based on the Theory of Core Competencies

The core competencies of college students can influence their further learning,employment,and personal development.This paper explores college English teaching from the three aspects of core competencies:cultural foundation,self-development,and social participation.Adapting to the challenges posed by the new era for the cultivation of foreign language talents,the paper aims to improve students’cultural literacy,independent learning,the ability of problem discovery and problem solving,and critical cultural thinking,so as to make them more competitive in employment and entrepreneurship.

Comparative Study of the Socioeconomic Characteristics and Digital Literacy Level of Agricultural Extension Personnel in Imo and Ebonyi States, South-East, Nigeria

The study comparatively analysed the socioeconomic characteristics and digital literacy level of Agricultural Extension personnel (AEP) in Ebonyi and Imo States, South-East, Nigeria. The specific objectives were to describe the socioeconomic characteristics of agricultural extension personnel in Ebonyi and Imo States, and to ascertain the digital literacy level of AEP in the studied states. Purposive sampling technique was used to select 312 Agricultural Extension personnel (132 from Ebonyi State Agricultural Development Program and 180 from Imo State Agricultural Development Program) for the study. Data were collected through the use of validated and structured questionnaire, and administered through the help of well-trained enumerators. Data were analysed using simple descriptive statistical tools such as percentages mean score, standard deviation and weighted mean. Findings indicated that they were more male in the both States (55.3% and 57.8%) for Ebonyi and Imo State respectively and that the average age of AEP in Ebonyi and Imo States were 44.7 years and 49.2 years respectively. It was further revealed that the majority (77.3% and 82.8%) had B.Sc./HND as their highest academic qualifications, belonged to professional organisations (62.1% and 75%), and were earning an average monthly income of N58,798 and N62,648 for Ebonyi and Imo State respectively. Also, it was revealed that their mean years of service were 12.4 years and 13.4 years for Ebonyi and Imo State respectively. Almost all of them (87.9% and 95.0%) own a smartphone, had access to the internet (80.3% and 90.0%), but do not own a laptop/ipad (82.6% and 72.8%) for Ebon-yi and Imo State respectively. Results further revealed that Agricultural extension personnel in both Ebonyi and Imo State respectively had low digital literacy level ( = 2.41 and 2.32). The study concluded that AEP in Ebonyi and Imo State respectively had similar socioeconomic characteristics and low level of digital literacy. The study recommended that the management of ADPs in both Ebonyi and Imo State should ensure the training of AEP in digital skills to enhance their digital literacy level to enable them use digital technologies in their work.

A Study on the Values and Strategies of English Picture Book Reading for Improving Pupils’ English Reading Literacy

Reading is one of the core skills in English learning.It is indispensable for EFL learners to develop good English reading literacy in primary schools.English picture books are consistent with pupils’cognitive and thinking modes,which is valuable to improve their English reading literacy.However,at present,most Chinese pupils have some problems in English reading.The paper aims at analyzing the current problems in Chinese pupils’English reading and digging out the values and strategies of English picture book reading,so as to stimulate their reading interests,cultivate their intercultural awareness,and improve their English reading literacy.

Paths to Enhance Teacher Digital Literacy Under Educational Digital Transformation in China

In the context of the digital transformation of education in the new era,digital literacy for teachers is a new requirement for professional development.Teacher digital literacy encompasses four main aspects:attitudinal literacy,knowledge and skills literacy,instructional application literacy,and innovation and development literacy.Currently,there are several issues with teacher digital literacy,such as a lack of digital responsibility,insufficient digital knowledge and skills,weak digital application skills,and low digital innovation capability.Enhancing teachers’digital literacy is a complex and critical task.Based on the current state of teachers’digital literacy,this paper proposes the following approaches:(1)adherence to digital norms;(2)development of a robust training mechanism;(3)improvement of the evaluation system;(4)strengthening of digital innovation.

Exploring International Media and Information Literacy Initiatives: Insights From DW Akademie’s MIL Model

Media and Information Literacy(MIL)is one of the most important topics in today’s mediatized world.Under the leadership of United Nations Educational,Scientific and Cultural Organization(UNESCO),many international organizations in the world,as foreign donors,annually announce many projects and grants for the promotion and development of the field of MIL in the countries of the world.One of the main actors of this movement is DW Akademie with different media and MIL projects several countries of the world.This research paper delves into the role of DW Akademie’s MIL model in shaping a media-savvy generation.The study explores the theoretical underpinnings and practical applications of Deutsche Welle(DW)Akademie’s MIL model,analysing its effectiveness in fostering media literacy skills.The research employs a multi-faceted approach,incorporating case studies to assess the model’s impact across diverse demographics.The paper also considers the model’s alignment with global educational policies and proposes recommendations for its integration into broader frameworks.By investigating DW Akademie’s MIL model,this research contributes to the ongoing discourse on media literacy education,providing valuable insights for educators,policymakers,and researchers.The findings offer a nuanced understanding of the model’s position in cultivating a media-savvy generation poised to navigate the complexities of the information age.

Competencies in Computer Security and Resolution of Technological Problems in Higher Education Students

Starting from the importance of preserving our information and protecting our devices against attacks on their vulnerabilities, this article aims to establish the level of knowledge in computer security and problem-solving of students at a university in northwest Mexico. This research has a quantitative approach where the European Framework of Digital Competencies for Citizenship was used as a reference to identify and establish the level of the competencies that were evaluated. The IKANOS Test was used as a data collection tool. The results show that students know the importance of keeping their devices safe and how valuable the information found on them is. On the other hand, the results also show a considerable percentage of students who do not have the knowledge and are at a basic level of knowledge to solve technical problems with their devices.

The Application of Analytic Hierarchy Process Method in the Evaluation of Educational Quality in Colleges and Universities

Talent quality is the lifeline of colleges and universities.Based on employment guidance,this paper establishes a student quality evaluation and control system including knowledge,moral character,and ability,and uses the Analytic Hierarchy Process(AHP)method to analyze the factors affecting the quality of education in colleges and universities.In addition,some suggestions are provided to improve the quality of students.

Research on the Cultivation of Aesthetics among Art Students under the New Era Background

Through understanding the history and current situation of aesthetic education in China,this paper explains some misunderstandings in the aesthetics of contemporary university art students,such as the insufficiency of aesthetic value and ability,as well as the inadequacy of students’creativity due to traditional art education.It is also pointed out that the cultivation of core literacy of art students is a multidimensional and comprehensive process,and these problems need to be solved by schools,teachers,and students,so as to strengthen the inner aesthetic education of students and improve their aesthetic awareness and ability.Aesthetic education is not only an important part of the art classroom but also a key part of fostering students’all-round development and enhancing their humanistic literacy.It is necessary to cultivate students’observation,imagination,image-thinking ability,and creativity,so that they can become artistic talents with independent thinking and innovation.

A Study on Extracurricular Literary Classics Reading in High School English Based on Core Literacy

Reading teaching is the core content of high school English teaching,and extracurricular literary classics reading is a supplement to in-class reading,which can deepen students’understanding and memorization of English-related knowledge,and cultivate students’core literacy.This paper outlines the problems in high school English reading teaching,analyzes the significance of extracurricular literary classics reading in high school English,and explores the teaching strategies of extracurricular literary classics reading in high school English based on core literacy,with a view to providing valuable reference information for teachers.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Improving Statistical Literacy through Evidence-Based Strategies Among First-Year Education Students in a State University

Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.

China’s Perspectives on the Modern Educational Value of Critical Information Literacy

Critical information literacy is a new and important direction of information literacy education for university students in the new media era.By comparing critical information literacy between China and the West,combining with the research on information literacy education in China in the past 20 years,and based on the three major relationships that Chinese philosophy is concerned about that people need to face in the world of life,i.e.,the individual and the self,the individual and nature,and the individual and the society,this paper defines critical information literacy as that individuals,as information subjects,discover,select,confirm,and evaluate the information they are exposed to by obtaining and discriminating the content elements of the information world(information sources,information,and information assets)and using critical thinking skills and methods,creatively interpret or solve the relevant problems arising from the interaction between individuals and self,individuals and nature,individuals and society,and form the literacy that represents the knowledge,ability,attitude,habit,and level of the information subject through continuous reflection and practice.In order for human beings to better understand the world and construct it responsibly,critical information literacy can play a greater role and educational value.It not only helps contemporary college students build knowledge of“good questioning”and enhance their“reasoning”skills,but also encourages them to maintain a“firm standpoint,”cultivate a habit of“healthy skepticism,”and enhance their“decision-making”skills.