Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon

Rationale & Objective Chronic kidney disease is projected to become the fifth most prevalent chronic condition globally by 2040, with a current prevalence of 10%-15%. This study aimed to assess treatment adherence in relation to health literacy (HL) and digital healthy diet literacy (DDL) levels...

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Main Author: Boueri, Myriam (author)
Other Authors: Abdelkhalik, Mohamad (author), Al Maaz, Fatima (author), Chehade, Houssein (author), Bouclaous, Carmel (author)
Format: article
Published: 2025
Online Access:http://hdl.handle.net/10725/17342
https://doi.org/10.1016/j.xkme.2025.101081
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://www.sciencedirect.com/science/article/pii/S2590059525001177
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author Boueri, Myriam
author2 Abdelkhalik, Mohamad
Al Maaz, Fatima
Chehade, Houssein
Bouclaous, Carmel
author2_role author
author
author
author
author_facet Boueri, Myriam
Abdelkhalik, Mohamad
Al Maaz, Fatima
Chehade, Houssein
Bouclaous, Carmel
author_role author
dc.creator.none.fl_str_mv Boueri, Myriam
Abdelkhalik, Mohamad
Al Maaz, Fatima
Chehade, Houssein
Bouclaous, Carmel
dc.date.none.fl_str_mv 2025-10-08T09:15:58Z
2025-10-08T09:15:58Z
2025
2025-10
dc.identifier.none.fl_str_mv 2590-0595
http://hdl.handle.net/10725/17342
https://doi.org/10.1016/j.xkme.2025.101081
Boueri, M., Abdelkhalik, M., Al Maaz, F., Chehade, H., & Bouclaous, C. (2025). Navigating Health Care in Crises: Evaluating Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon. Kidney Medicine, 101081.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://www.sciencedirect.com/science/article/pii/S2590059525001177
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Kidney Medicine
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Rationale & Objective Chronic kidney disease is projected to become the fifth most prevalent chronic condition globally by 2040, with a current prevalence of 10%-15%. This study aimed to assess treatment adherence in relation to health literacy (HL) and digital healthy diet literacy (DDL) levels of patients receiving hemodialysis in Lebanon. Study Design A multicenter, cross-sectional study was conducted during 2021-2023. Setting & Participants It included patients in 18 dialysis centers based on nonprobability sampling. Patients were eligible if they were aged 18+ years and Arabic speakers. Severe illness, dementia, and confusion were exclusion criteria. Exposure(s) Sociodemographic factors (marital status, education, governorate, employment, financial means, and fear of coronavirus disease 2019 [COVID-19]) were assessed as predictors of adherence and HL. Outcomes The primary outcomes were HL scores (Health Literacy Scale- Short Form 12), DDL scores (Digital Healthy Diet Literacy Scale), and adherence to treatment scores (treatment adherence questionnaire). Analytical Approach Bivariate analysis identified associations between patient characteristics and scores on scales. Simple linear regression was used to evaluate the relationship between scores and independent variables. Results Participants (N = 699, 64.5% male patients) showed below-average HL levels (18.96 ± 11.79) and DDL (15.95 ± 14.58), and moderate adherence behavior (995.82 ± 178.99). Single patients and those with higher educational and employment statuses had higher levels of HL. Regional disparities were observed. Individuals who did not experience financial difficulty in covering their treatment cost, and those who had less fear from COVID-19, showed higher DDL scores. Single individuals displayed lower treatment adherence. Limitations This study is limited by its cross-sectional design, and by contextual factors that affected patient attendance and researcher access to hemodialysis centers, along with overrepresentation of private facilities. Conclusions There is a need for educational programs and targeted interventions to enhance health literacy and adherence in this patient population, especially among those with lower education, financial instability, and higher fear of COVID-19.
eu_rights_str_mv openAccess
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id LAURepo_197ec22d35c2c1684b52e7e0c4889a32
identifier_str_mv 2590-0595
Boueri, M., Abdelkhalik, M., Al Maaz, F., Chehade, H., & Bouclaous, C. (2025). Navigating Health Care in Crises: Evaluating Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon. Kidney Medicine, 101081.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/17342
publishDate 2025
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repository.name.fl_str_mv
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spelling Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in LebanonBoueri, MyriamAbdelkhalik, MohamadAl Maaz, FatimaChehade, HousseinBouclaous, CarmelRationale & Objective Chronic kidney disease is projected to become the fifth most prevalent chronic condition globally by 2040, with a current prevalence of 10%-15%. This study aimed to assess treatment adherence in relation to health literacy (HL) and digital healthy diet literacy (DDL) levels of patients receiving hemodialysis in Lebanon. Study Design A multicenter, cross-sectional study was conducted during 2021-2023. Setting & Participants It included patients in 18 dialysis centers based on nonprobability sampling. Patients were eligible if they were aged 18+ years and Arabic speakers. Severe illness, dementia, and confusion were exclusion criteria. Exposure(s) Sociodemographic factors (marital status, education, governorate, employment, financial means, and fear of coronavirus disease 2019 [COVID-19]) were assessed as predictors of adherence and HL. Outcomes The primary outcomes were HL scores (Health Literacy Scale- Short Form 12), DDL scores (Digital Healthy Diet Literacy Scale), and adherence to treatment scores (treatment adherence questionnaire). Analytical Approach Bivariate analysis identified associations between patient characteristics and scores on scales. Simple linear regression was used to evaluate the relationship between scores and independent variables. Results Participants (N = 699, 64.5% male patients) showed below-average HL levels (18.96 ± 11.79) and DDL (15.95 ± 14.58), and moderate adherence behavior (995.82 ± 178.99). Single patients and those with higher educational and employment statuses had higher levels of HL. Regional disparities were observed. Individuals who did not experience financial difficulty in covering their treatment cost, and those who had less fear from COVID-19, showed higher DDL scores. Single individuals displayed lower treatment adherence. Limitations This study is limited by its cross-sectional design, and by contextual factors that affected patient attendance and researcher access to hemodialysis centers, along with overrepresentation of private facilities. Conclusions There is a need for educational programs and targeted interventions to enhance health literacy and adherence in this patient population, especially among those with lower education, financial instability, and higher fear of COVID-19.Published2025-10-08T09:15:58Z2025-10-08T09:15:58Z20252025-10Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2590-0595http://hdl.handle.net/10725/17342https://doi.org/10.1016/j.xkme.2025.101081Boueri, M., Abdelkhalik, M., Al Maaz, F., Chehade, H., & Bouclaous, C. (2025). Navigating Health Care in Crises: Evaluating Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon. Kidney Medicine, 101081.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttps://www.sciencedirect.com/science/article/pii/S2590059525001177enKidney Medicineinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/173422025-10-08T09:15:58Z
spellingShingle Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
Boueri, Myriam
status_str publishedVersion
title Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
title_full Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
title_fullStr Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
title_full_unstemmed Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
title_short Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
title_sort Navigating Health Care in Crises: Health Literacy and Treatment Adherence Among Hemodialysis Patients in Lebanon
url http://hdl.handle.net/10725/17342
https://doi.org/10.1016/j.xkme.2025.101081
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://www.sciencedirect.com/science/article/pii/S2590059525001177