Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults

BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.

Cultural Adaptation of the Mental Health Literacy Scale

Background:Mental health literacy(MHL)refers to one’s knowledge and understanding of mental health disorders and their treatments.This literacy may be influenced by cultural norms and values that shape individuals’experiences,beliefs,attitudes,and behaviors regarding mental health.This study focuses on adapting the Mental health literacy scale(MHLS)for use in the multicultural context of Israel.Objectives include validating its construct,assessing its accuracy in measuring MHL in this diverse setting and examining and comparing levels of MHL across different cultural groups.Methods:The data collection included 1057 participants,representing all the ethnic groups of the Israeli population aged 18 and over.The tools included the MHLS and a demographic questionnaire.Confirmatory factor analysis(CFA)was employed to assess the original structure of the MHLS.Results:The results revealed that after evaluating the original MHLS,five items were excluded,leading to the validation of a modified version—Israeli mental health scale(IMHLS)with four factors and 25 items.CFA and reliability analyses supported an established and robust four-factor model.Significant ethnic differences in MHLS scores were identified,with Muslim participants showing the highest familiarity with mental disorders,followed by Druze and Christian participants,while Jewish participants had the lowest familiarity.Conclusion:The study concluded that the IMHLS is a valid and reliable tool for assessing MHL in Israel’s diverse and multicultural population.The revised scale better reflects the cultural nuances of the Israeli context.The significant ethnic differences that the study revealed in IMHLS emphasize the importance of culturally sensitive mental health interventions tailored to different ethnic groups in Israel.

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.

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.

Age- and Sex-Specific Impact of Health Literacy on Healthy Lifestyle Characteristics among Japanese Residents in a Rural Community

The study aimed to examine age- and sex-specific associations between health literacy (HL) and healthy lifestyle characteristics. The cross-sectional study was conducted to examine a total 1348 Japanese participants (613 male and 735 female) who took the health check-up program in April 2013, at Tsumagoi Village, Japan. Information was collected by self-administered questionnaire on three communicative and two critical HL items, and healthy lifestyle characteristics listed in Bres-low’s seven health practices. In multivariate logistic analysis, high HL (≥18) was significantly asso-ciated with healthy lifestyle characteristics in both non-elderly (<65 years old) and elderly (≥65 years old) [Odds ratio (OR) = 1.40, 95% Confidence interval (CI) = 1.13 - 1.75 for non-elderly, OR = 1.34, 95% CI = 1.02 - 1.76 for elderly], as well as female participants (OR = 1.43, 95% CI = 1.06 - 1.94), while the significance was borderline in male participants (OR = 1.34, 95% CI = 0.96 - 1.88). Among 5 HL items, the ability to extract health-related information was significantly associated with healthy lifestyle characteristics (OR = 1.52, 95% CI = 1.11 - 2.07 for non-elderly, OR = 1.55, 95% CI = 1.04 - 2.30 for elderly, OR = 1.95, 95% CI = 1.28 - 2.97 for female participants. HDL-C concentration in the high HL group was significantly higher than that in the low HL group. Among healthy lifestyle characteristics, proportions of smoking behavior (non-smoker), exercise frequency (twice or more per week), and sleep duration (7 - 8 hours) were significantly higher in the high HL group than in the low HL group. The present study revealed a positive association between HL and healthy lifestyle characteristics, which suggests that people are likely to engage in health-promoting behaviours based on access and ability to understand medical information for both age groups and female participants. Significant findings among female participants may be emphasized since it’s important from the entire family's perspective as women are the caretakers of the family. These findings may indicate the importance of comprehensive assessment, including HL, for health promotion in the community.

Understanding the concept of health literacy: A strategy to improve nursing practice

Health literacy(HL)is an effective approach for improved health status and measures the capacity of individuals to engage in health promotion and disease prevention activities as low HL constitutes a global problem in health-care delivery.Nurses play a significant role in providing adequate information to the client and as such it becomes imperative for them to understand the concept of HL.Clinical approach of HL refers to ability to utilize literacy skills in relation to appointments,prescriptions,and instructions for self-management.Public health approach presents HL as means of empowering individuals to take control of their health and factors that influences health.HL is a hierarchy of skills that can be assessed and managed through health education and effective communication.Nurses’understanding of the concept of HL and strategies to reduce HL demands is crucial to delivery of effective nursing practice.This review will provide a clear understanding of the concept of HL which is essential for nurses to effectively educate patients and provide holistic care.More so,nurses will be able to assess literacy level of the patients,plan and develop better educational program tailored to patients’level of literacy.This could invariably improve patients’comprehension and adherence to treatment plans and overall health outcomes.

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.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Latent Categories of Mental Health Literacy in Patients with Coronary Artery Disease and Their Relationship with Quality of Life

Objectives: This study aims to explore the latent categories of mental health literacy among patients with coronary artery disease and examine their associations with quality of life. Design: A cross-sectional quantitative design was used. Methods: The study sample consisted of 208 patients with coronary artery disease from five wards in the Department of Cardiology at a tertiary hospital. Data were collected using a general information questionnaire, the Chinese version of the Multiple Mental Health Literacy Scale and the Chinese Cardiovascular Patient Quality of Life Assessment Questionnaire. The data were analysed with Mplus (v.8.3) and SPSS (v.25.0). Results: The mental health literacy of the 208 patients was categorised into four latent categories: low literacy (n = 28, 13.5%), high knowledge-low resources (n = 53, 25.5%), low knowledge-high resources (n = 63, 30.2%) and high literacy (n = 64, 30.8%). A significant difference in quality of life was observed according to mental health literacy category (P Conclusion: The quality of life of patients with coronary artery disease is significantly influenced by their levels of mental health literacy. Targeted interventions addressing the various profiles of mental health literacy should be implemented to improve the quality of life for patients with coronary artery disease.

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.

Improving health literacy and stakeholder-directed knowledge of One Health through analysis of readability:a cross sectional infodemiology study

Background:The One Health approach involves collaboration across several sectors,including public health,veterinary and environmental sectors in an integrated manner.These sectors may be disparate and unrelated,however to succeed,all stakeholders need to understand what the other stakeholders are communicating.Likewise,it is important that there is public acceptance and support of One Health approaches,which requires effective communication between professional and institutional organisations and the public.To help aid and facilitate such communication,written materials need to be readable by all stakeholders,in order to communicate effectively.There has been an exponential increase in the publication of papers involving One Health,with<5 per year,in the 2000s,to nearly 500 published in 2023.To date,readability of One Health information has not been scrutinised,nor has it been considered as an integral intervention of One Health policy communication.The aim of this study was therefore to examine readability of public-facing One Health information prepared by 24 global organisations.Methods:Readability was calculated using Readable software,to obtain four readability scores[(i)Flesch Reading Ease(FRE),(ii)Flesch-Kincaid Grade Level(FKGL),(iii)Gunning Fog Index and(iv)SMOG Index]and two text metrics[words/sentence,syllables/word]for 100 sources of One Health information,from four categories[One Health public information;PubMed abstracts;Science in One Health(SOH)abstracts(articles);SOH abstracts(reviews)].Results:Readability of One Health information for the public is poor,not reaching readability reference standards.No information was found that had a readability of less than 9th grade(around 14 years old).Mean values for the FRE and FKGL were(19.4±1.4)(target>60)and(15.6±0.3)(target<8),respectively,with mean words per sentence and syllables per word of 20.5 and 2.0,respectively.Abstracts with“One Health”in the title were more difficult to read than those without“One Health”in the title(FRE:P=0.0337;FKGL:P=0.0087).Comparison of FRE and FKGL readability scores for the four categories of One Health information[One Health public information;PubMed abstracts;SOH abstracts(articles);SOH abstracts(reviews)]showed that SOH abstracts from articles were easier to read than those from SOH reviews.No One Health public-facing information from the 100 sources examined met the FKGL target of8.The most easily read One Health information required a Grade Level of 9th grade(14-15 years old),with a mean Grade Level of 15.5(university/college level).Conclusion:Considerable work is required in making One Health written materials more readable,particularly for children and adolescents(<14 years of age).It is important that any interventions or mitigations taken to support better public understanding of the One Health approach are not ephemeral,but have longer lasting and legacy value.Authors of One Health information should consider using readability calculators when preparing One Health information for their stakeholders,to check the readability of their work,so that the final material is within recommended readability reference parameters,to support the health literacy and stakeholder-directed knowledge of their readers.

The prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015： findings from a meta-analysis

Objective： To systematically investigate the prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015. Methods： The eligible studies were identified by searching China National Knowledge Infrastructure （CNKI）, Wanfang database and Chinese Scientific and Technical Periodicals Database. After abstracted in- formation and appraised the risk of bias of all eligible studies, Stata software versionl2.0 was used to perform statistical analysis. Results： A total of 35 cross-sectional studies, including 94631 residents, were finally included in the present study. All eligible studies were appraised as to have the quality of more than 14 grades. Meta-analysis revealed that the prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015 was 20.00% （95% CI, 18% to 23%）. Conclusion： The prevalence of health literacy of Chinese resident for infectious disease be- tween 2011 and 2015 are extremely low. And thus, it is essential to take targeted health education program depending on the characteristics of diverse group of people in order to improve the overall health of Chinese resident.

基于美国健康素养(Health Literacy Tool Shed)数据库的健康素养量表分析

针对健康素养测评量表在应用方面存在适用条件差异大、数量多且分散、查找不方便等问题,美国建立了健康素养测评工具屋(Health Literacy Tool Shed,HLTS)数据库。在介绍该库功能与特点的基础上,采用内容分析法分析健康素养测评量表研究现状的结果表明,测评方式多样化、开发方法现代化、测评内容简洁化、填写方式网络化、语言版本多元化、主客观相结合的评估方法是健康素养评估工具研究的发展趋势。

Translation and psychometric evaluation of the Chinese version of the Heart Failure-Specific Health Literacy Scale

Objective:Health literacy is closely associated with self-care behaviors in heart-failure patient.A reliable,valid,and practical measuring tool would evaluated the level of health literacy in Chinese patients with heart failure,and provide evidence for individualized education.Aim of this study was to translate Heart Failure-Specific Health Literacy Scale(HF-Specific HL Scale)into Chinese and test the reliability and validity of the Chinese version.Methods:The original HF-specific HL scale was translated into Chinese and modified for cultural adaption.Totally 164 HF inpatients were investigated with the Chinese version of HF-specific HL scale.To test the reliability and validity of the scale,item analysis,exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and correlation analysis were conducted.Result:Cronbach's a value for the scale is 0.87;the correlation coefficients between each item and the total score ranged from 0.61 to 0.91.Three factors was extracted by EFA,which could explain 64.62%of the total variance.The result of CFA also showed that the scale demonstrated an acceptable model fit.The scale was significantly correlated with the Chinese version of the Heart Failure Knowledge Test(C-HFKT).Conclusion:The Chinese version of HF-specific HL scale is reliable and valid,and is suitable for assessment of HL in Chinese HF patients.

Health literacy and health outcomes in hypertension: An integrative review

Objective:The aim of this study was to summarize the evidence of health literacy and health outcomes in hypertensive patients.Methods:Articles published in English were searched from six databases:MEDLINE,CINAHL,Embase,ERIC,psycINFO,and SCOPUS.The articles published up to September 2017 were included.Results:Nineteen publications were included in the review.There was quality and consistent evidence that hypertensive patients with lower literacy had poorer knowledge.There was inconsistent evidence to show the relationship between health literacy and clinical outcomes,of systolic and diastolic blood pressure,and blood pressure control;behavioral outcomes,of self-care,self-efficacy,adherence;patientphysician interactions outcomes,of patient-physician communication,patient trust,involvement in decision making and other outcomes.Conclusion:The person with low health literacy is likely to have poor knowledge of hypertension.However,there is insufficient evidence to suggest that health literacy is associated with outcomes of hypertension independently.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

The effect of health literacy level on health outcomes in patients with diabetes at a type v health centre in Western Jamaica

Objective:To identify the effects of health literacy levels on health outcomes in patients with diabetes in a type V health center in Western Jamaica.Method:A correlational survey design with a random sampling technique was used.An 18-item questionnaire and the Newest Vital Sign tool were administered to 88 consenting adults with diabetes to assess their health literacy levels.Their health outcomes were evaluated with docket review.Data were analyzed using SPSS version 18.Results:The participants were predominantly female(77.3%),aged 51-70 years,married(44%),employed(46%),and diagnosed with diabetes>10 years(42%).Only 13.6%of the study population was adequately health literate.The health literacy scores for gender were not significant(P=0.84).The health literacy scores of the patients with different ages and educational levels were significant(P<0.001).Pearson's correlations revealed no linear relationship between health literacy scores and health outcome(r=0.185,P=0.084).Conclusion:Limited health literacy and high likelihood of limited health literacy are predominant in the study population.Age and educational level are significantly associated with health literacy levels.However,these findings suggest no association between health literacy level and diabetic health outcomes.

Health literacy in kidney disease: Review of the literature and implications for clinical practice

Health literacy is the capacity of an individual to understand information related to a disease in order to make an informed decision. In patients with kidney diseases, studies have reported increasing impact of limited health literacy on health outcomes. Our paper discusses current literature on health literacy in kidney diseases.

Development of Health Literacy for Regular Hemodialysis Patients in Menoufia Governorate: A Cross-Sectional Study

Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, p < 0.001), of increasing age (OR = 0.12 CI 95%: 0.07_0.19, p < 0.001), low education (OR = 1.08, CI 95%: 1.04_1.11, p < 0.001) and the patient did not undergo kidney transplant (OR = 4.19 CI 95%: 1.12_15.62, p = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.

Cross-sectional Study on Their Reproductive Health Status of 604 Fem ale Floating Residents in Beijing

This study on the reproductive health statusw asbased on the data from a survey and an exam ination of severalhundredsof fem ale floating residentsin Beijing. The results w ere compared w ith those from fem ale perm anent residents in Beijing. The study revealed thatm ostof theinvestigated fem alefloating residentshad lived in Bei- jing w ith their fam ily for threeyearson an average. They had a harderlifethan that of Beijing perm anentresidents. Also they did notreceiveadequateprenatalcaresdur- ing their pregnanciesin Beijing and a quarter of thesem othersdid notreceiveany pre- natal exam ination during their pregnancies at all. Again the fem ales had a great prevalence of reproductive tractinfections, reaching 29.3of thoseexam ined, high- er than the w om en perm anently residing in Beijing.