Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001). The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001). The elderly with higher health literacy scores were significantly less likely to have risky behaviors (smoking, regular drinking, and lack of physical exercise), and in turn significantly more likely to undergo health examinations regularly, report good self-rated health, and significantly more likely to access sufficient health information from multiple sources (p < 0.001). No differences were noted between the health literacy score and BMI (p > 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p < 0.001). Conclusions: Health literacy was significantly associated with health-related behaviors in elderly Chinese. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health-related behaviors. To reduce risky habits, educational interventions to improve health literacy should be simultaneously conducted in health promotion work.

Background: Narrative medicine has become a solution to cultivate medical students’ ability of empathy and humanistic care. However, the role of narrative medicine is lacking in the study of professionalism. The aim of this study was to analyze the effects of narrative medical theory learning and narrative writing on professionalism, empathy and humanistic care ability of nursing students.Methods: This cluster randomized controlled trial was conducted between June 2021 and June 2022 in two universities in Jiangsu, China. The participants of this study were 85 nursing students who were randomly divided into the intervention group (n = 43) or the control group (n = 42). Participants in the intervention group were trained in narrative medical theory learning and narrative writing based on a Web-based platform, while those in the control group were not. Self-report questionnaires of professionalism, empathy and humanistic care ability were used before and after intervention.Results: The results showed that the professionalism score of the intervention group was (68.7 ± 6.8 vs. 64.5 ± 7.5;P = 0.005), empathy (99.4 ± 15.7 vs. 92.2 ± 14.6;P = 0.014) and humanistic care ability (127.6 ± 20.0 vs. 113.3 ± 18.8;P = 0.004) were better than the control group.Conclusion: The results of this quantitative study suggest that narrative medical theory education and narrative writing based on the network platform can promote the development of professionalism, empathy and humanistic care ability of nursing undergraduates.

Background:Coronary heart disease (CHD) is a common chronic disease in the elderly. Frailty can accelerate the development of CHD and lead to adverse health outcomes. Risk prediction and decision-making for frailty are crucial. The peripheral hemoglobin-to-red blood cell distribution width ratio (HRR) is a novel biomarker of inflammation. Our purpose was to explore the correlation between HRR and frailty in elderly patients with CHD.Methods:This cross-sectional study evaluated 245 Chinese hospitalized patients with CHD. Blood parameters measured upon admission were obtainedviathe hospital electronic information medical record system. The Fried Frailty Phenotype Scale was used to evaluate the frailty status of the participants. The Receiver operating characteristic curve was used to determine the optimal cut-off values of HRR. We used univariate analysis to examine the potential factors affecting frailty. Kendall's tau-b grade correlation was used to analyze the correlation between HRR and frailty. The ordered logistic regression model was used to analyze the relationship between HRR and frailty.Results:A total of 233 elderly patients with CHD were included in our study. Among the patients, 33.48% (78) were in a state of frailty. The optimal cut-off values of HRR was 9.76. The area under the curve (AUC) for HRR in the frailty patients was 0.652, exceed Hb (AUC = 0.618) and RDW (AUC = 0.650). Kendall's tau-b grade correlation analysis showed that HRR (K = −0.296,P< 0.001) was negatively correlated with frailty. The ordered logistic regression analysis determined that lower HRR was associated with frailty (P< 0.05) after adjusted for age, body mass index, number of drugs, comorbidity index, heart failure, red blood cells, albumin, total cholesterol, triglyceride, high density lipoprotein cholesterol, and low density lipoprotein cholesterol.Conclusion:Lower HRR is an independent risk factor for frailty in elderly hospitalized patients with CHD. HRR was a more powerful prognostic indicator for frailty than either Hb or RDW alone. Clinicians should focus on timely identification of the risk of frailty in order to improve patient quality of life and to reduce the risk of complications.