{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:26:32Z","timestamp":1790871992968,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify and describe health literacy profiles of patients with rheumatic diseases and explore whether the identified health literacy profiles can be generalized to a broader rheumatology context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with rheumatoid arthritis, spondyloarthritis, and gout from 3 hospitals in different regions in The Netherlands completed the Health Literacy Questionnaire (HLQ). Hierarchical cluster analysis was used to identify patients\u2019 health literacy profiles based on 9 HLQ domains. A multinomial regression model with the identified health literacy profiles as the dependent variable was fitted to assess whether patients with a given disease type or attending a given hospital were more likely to belong to a specific profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 895 participating patients, the lowest mean HLQ domain scores (indicating most difficulty) were found for \u201ccritical appraisal,\u201d \u201cnavigating the health system,\u201d and \u201cfinding good health information.\u201d The 10 identified profiles revealed substantial diversity in combinations of strengths and weaknesses. While 42% of patients scored moderate to high on all 9 domains (profiles 1 and 3), another 42% of patients (profiles 2, 4, 5, and 6) clearly struggled with 1 or several aspects of health literacy. Notably, 16% (profiles 7\u201310) exhibited difficulty across a majority of health literacy domains. The probability of belonging to one of the profiles was independent of the hospital where the patient was treated or the type of rheumatic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ten distinct health literacy profiles were identified among patients with rheumatic diseases, independent of disease type and treating hospital. These profiles can be used to facilitate the development of health literacy interventions in rheumatology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24480","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T14:24:28Z","timestamp":1602080668000},"page":"100-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Addressing Health Literacy Needs in Rheumatology: Which Patient Health Literacy Profiles Need the Attention of Health Professionals?"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-1300","authenticated-orcid":false,"given":"Mark M.","family":"Bakker","sequence":"first","affiliation":[{"name":"Maastricht UMC+ and Care and Public Health Research Institute Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-1861","authenticated-orcid":false,"given":"Polina","family":"Putrik","sequence":"additional","affiliation":[{"name":"Maastricht UMC+ and Care and Public Health Research Institute Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jany","family":"Rademakers","sequence":"additional","affiliation":[{"name":"Nivel Netherlands Institute for Health Services Research Utrecht, and Care and Public Health Research Institute Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart","family":"van de Laar","sequence":"additional","affiliation":[{"name":"Medisch Spectrum Twente Arthritis Center Twente and University of Twente  Enschede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3792-7718","authenticated-orcid":false,"given":"Harald","family":"Vonkeman","sequence":"additional","affiliation":[{"name":"Medisch Spectrum Twente Arthritis Center Twente and University of Twente  Enschede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2394-6926","authenticated-orcid":false,"given":"Marc R.","family":"Kok","sequence":"additional","affiliation":[{"name":"Maasstad Hospital  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke","family":"Voorneveld\u2010Nieuwenhuis","sequence":"additional","affiliation":[{"name":"Maasstad Hospital  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8899-9087","authenticated-orcid":false,"given":"Sofia","family":"Ramiro","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Leiden, and Zuyderland Medical Center  Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8428-6354","authenticated-orcid":false,"given":"Maarten","family":"de Wit","sequence":"additional","affiliation":[{"name":"Tools2use patient association  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0597-0933","authenticated-orcid":false,"given":"Rachelle","family":"Buchbinder","sequence":"additional","affiliation":[{"name":"Monash University and Cabrini Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5273-1011","authenticated-orcid":false,"given":"Roy","family":"Batterham","sequence":"additional","affiliation":[{"name":"Swinburne University of Technology Centre for Global Health and Equity, Melbourne, Victoria, Australia, and Thammasat University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9081-2699","authenticated-orcid":false,"given":"Richard H.","family":"Osborne","sequence":"additional","affiliation":[{"name":"Swinburne University of Technology Centre for Global Health and Equity  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-9533","authenticated-orcid":false,"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[{"name":"Maastricht UMC+ and Care and Public Health Research Institute Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daw103"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1026"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckv043"},{"key":"e_1_2_7_5_1","unstructured":"World Health Organization.Health literacy: the solid facts.2013. 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