{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:15:12Z","timestamp":1773098112638,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Health literacy (HL) can influence self\u2010management and outcomes in chronic diseases, but it remains poorly characterized in the context of rare diseases, including myasthenia gravis (MG). This study aimed to explore general HL levels and specific HL domains and competencies in adults with MG and their associations with sociodemographic, clinical, and organizational factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicentre, observational, cross\u2010sectional study was conducted between April and October 2024 in 22 neurology centres located in 11 regions of northern, central, and southern Italy. Eligible participants were adult patients (\u2265\u200918\u2009years) with a confirmed diagnosis of MG. Comparisons across patient groups were explored with non\u2010parametric tests; multivariable linear models were used to estimate adjusted associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 113 participants were enrolled. The median HLS\n                      <jats:sub>19<\/jats:sub>\n                      \u2010Q12 total score was 58.3 (IQR: 41.7\u201375.0), indicating problematic HL. In adjusted models, higher education was significantly associated with lower appraisal competence (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u221211.1, 95% CI: \u221220.2, \u22122.0). Not meeting the Patient Acceptable Symptom State (PASS) was significantly associated with lower scores across multiple domains and competencies, while follow\u2010up in centres with nurses specialized in MG was significantly associated with higher scores in access (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20098.2, 95% CI: 0.9, 15.6), understanding (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200910.8, 95% CI: 2.1, 19.4), application (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200910.6, 95% CI: 2.6, 18.7), health care (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200911.5, 95% CI: 2.9, 20.0), and health promotion (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200911.9, 95% CI: 3.5, 20.2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Symptom\u2010burdened patients and centres without specialized nursing support appear to be priority targets for HL\u2010oriented interventions and organizational redesign.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70148","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:15:52Z","timestamp":1768295752000},"page":"598-607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Literacy in Patients With Myasthenia Gravis: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-2759","authenticated-orcid":false,"given":"Francesco","family":"Pastore","sequence":"first","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Jonian Area \u2010 (DiMePRe\u2010J) University of Bari Aldo Moro  Bari Italy"},{"name":"Center of Innovation in Nursing Research (CINR)\u2010Center for Advanced Studies and Technology (CAST) \u201cG. D'annunzio\u201d University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7185-4850","authenticated-orcid":false,"given":"Valentina","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Center of Innovation in Nursing Research (CINR)\u2010Center for Advanced Studies and Technology (CAST) \u201cG. D'annunzio\u201d University of Chieti\u2010Pescara  Chieti Italy"},{"name":"Department of Innovative Technologies in Medicine and Dentistry \u201cG.D'annunzio\u201d University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7612-382X","authenticated-orcid":false,"given":"Giammarco","family":"Milella","sequence":"additional","affiliation":[{"name":"Neurology Unit, AOU Consorziale Policlinico University of Bari  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5462-8209","authenticated-orcid":false,"given":"Barbara","family":"Forastefano","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention \u201cTorVergata\u201d University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Domenicone","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties \u2010 Neurology Unit San Filippo Neri Hospital \u2010 Asl Rome 1  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8150-7476","authenticated-orcid":false,"given":"Davide","family":"Ferorelli","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine \u201cAldo Moro\u201d University of Bari  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6567-5373","authenticated-orcid":false,"given":"Marina","family":"DeTommaso","sequence":"additional","affiliation":[{"name":"DiBraiN \u2010 Department of Translational Biomedicine and Neuroscience University of Bari Aldo Moro  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-1792","authenticated-orcid":false,"given":"Giancarlo","family":"Cicolini","sequence":"additional","affiliation":[{"name":"Center of Innovation in Nursing Research (CINR)\u2010Center for Advanced Studies and Technology (CAST) \u201cG. D'annunzio\u201d University of Chieti\u2010Pescara  Chieti Italy"},{"name":"Department of Innovative Technologies in Medicine and Dentistry \u201cG.D'annunzio\u201d University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3622-6370","authenticated-orcid":false,"given":"Dania","family":"Comparcini","sequence":"additional","affiliation":[{"name":"Center of Innovation in Nursing Research (CINR)\u2010Center for Advanced Studies and Technology (CAST) \u201cG. 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