{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:25:13Z","timestamp":1790018713923,"version":"4.0.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"The National Institute of Hospital Administration","award":["YLZLXZ23G014"],"award-info":[{"award-number":["YLZLXZ23G014"]}]},{"name":"The National Institute of Hospital Administration","award":["YLZLXZ23G014"],"award-info":[{"award-number":["YLZLXZ23G014"]}]},{"name":"The National Institute of Hospital Administration","award":["YLZLXZ23G014"],"award-info":[{"award-number":["YLZLXZ23G014"]}]},{"name":"The National Institute of Hospital Administration","award":["YLZLXZ23G014"],"award-info":[{"award-number":["YLZLXZ23G014"]}]},{"name":"Medical Supplies Management Center","award":["ZDC202201"],"award-info":[{"award-number":["ZDC202201"]}]},{"name":"Medical Supplies Management Center","award":["ZDC202201"],"award-info":[{"award-number":["ZDC202201"]}]},{"name":"Medical Supplies Management Center","award":["ZDC202201"],"award-info":[{"award-number":["ZDC202201"]}]},{"name":"Medical Supplies Management Center","award":["ZDC202201"],"award-info":[{"award-number":["ZDC202201"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"DOI":"10.1186\/s12877-026-07171-w","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T04:45:10Z","timestamp":1775882710000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A medication literacy instrument for older chronic disease patients in China: development and validation"],"prefix":"10.1186","volume":"26","author":[{"given":"Boya","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xixi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"7171_CR1","unstructured":"National Health Commission of the People\u2019s Republic of China. Report of the State Council on the progress of strengthening and promoting the work on Aging\u2014\u2014At the 36th meeting of the Standing Committee of the 13th National People\u2019s Congress on August 30, 2022[EB\/OL].(2022-08-31)[2025-02-06]. http:\/\/www.npc.gov.cn\/npc\/c2\/c30834\/202208\/t20220831_319086.html."},{"key":"7171_CR2","unstructured":"General Administrative Office of the Ministry of Civil Affairs of the People\u2019s Republic of China. Statistical bulletin of civil affairs development in 2023 [EB\/OL].(2024-08-06)[2025-02-06]. https:\/\/www.mca.gov.cn\/n156\/n2679\/c1662004999980001204\/attr\/355717.pdf."},{"key":"7171_CR3","doi-asserted-by":"publisher","first-page":"1184701","DOI":"10.3389\/fphar.2023.1184701","volume":"14","author":"T Lu","year":"2023","unstructured":"Lu T, Yang Z, Chen P, Li J, Zheng C, Kong L, Zhang H. Influencing factors of medication literacy among community-dwelling older adult patients with hypertension: a study based on social learning theory. Front Pharmacol. 2023;14:1184701. https:\/\/doi.org\/10.3389\/fphar.2023.1184701. PMID: 37332350; PMCID: PMC10272614.","journal-title":"Front Pharmacol"},{"key":"7171_CR4","doi-asserted-by":"publisher","unstructured":"Dimmitt SB, Stampfer HG. Low drug doses may improve outcomes in chronic disease. Med J Aust. 2009;191(9):511-3. https:\/\/doi.org\/10.5694\/j.1326-5377.2009.tb02916.x. PMID: 19883348.","DOI":"10.5694\/j.1326-5377.2009.tb02916.x"},{"issue":"1","key":"7171_CR5","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/s12939-022-01772-8","volume":"21","author":"A Di Filippo","year":"2022","unstructured":"Di Filippo A, Perna S, Pierantozzi A, Milozzi F, Fortinguerra F, Caranci N, Moro L, Agabiti N, Belleudi V, Cesaroni G, Nardi A, Spadea T, Gnavi R, Trotta F. Socioeconomic inequalities in the use of drugs for the treatment of chronic diseases in Italy. Int J Equity Health. 2022;21(1):157. https:\/\/doi.org\/10.1186\/s12939-022-01772-8. PMID: 36352409; PMCID: PMC9644599.","journal-title":"Int J Equity Health"},{"key":"7171_CR6","unstructured":"Publicity Department of National Health Commission of the People\u2019s Republic of China. Notice on carrying out the three-year action to improve the health literacy of the whole people (2024\u20132027) [EB\/OL].(2024-06-06)[2025-02-06]. http:\/\/www.nhc.gov.cn\/xcs\/s7852\/202406\/2ce2c00ea62f4672b63b7dcd6eee955f.shtml."},{"issue":"4","key":"7171_CR7","doi-asserted-by":"publisher","first-page":"2675","DOI":"10.1016\/j.sapharm.2021.06.003","volume":"18","author":"LL Neiva Pantuzza","year":"2022","unstructured":"Neiva Pantuzza LL, Nascimento ED, Crepalde-Ribeiro K, Botelho SF, Parreiras Martins MA, Camila de Souza Groia, Veloso R, Gonzaga do Nascimento MM, Vieira LB, Moreira Reis AM. Medication literacy: A conceptual model. Res Social Adm Pharm. 2022;18(4):2675\u201382. Epub 2021 Jun 7. PMID: 34134939.","journal-title":"Res Social Adm Pharm"},{"issue":"19","key":"7171_CR8","doi-asserted-by":"publisher","first-page":"6951","DOI":"10.3390\/ijerph17196951","volume":"17","author":"HW Lin","year":"2020","unstructured":"Lin HW, Chang EH, Ko Y, Wang CY, Wang YS, Mafruhah OR, Wu SH, Chen YC, Huang YM. Conceptualization, Development and Psychometric Evaluations of a New Medication-Related Health Literacy Instrument: The Chinese Medication Literacy Measurement. Int J Environ Res Public Health. 2020;17(19):6951. https:\/\/doi.org\/10.3390\/ijerph17196951. PMID: 32977520; PMCID: PMC7579017.","journal-title":"Int J Environ Res Public Health"},{"key":"7171_CR9","doi-asserted-by":"publisher","first-page":"691983","DOI":"10.3389\/fphar.2021.691983","volume":"12","author":"J Qu","year":"2021","unstructured":"Qu J, Zhou T, Xue M, Sun H, Shen Y, Liu Y. Relationship Between Medication Literacy and Frailty in Elderly Inpatients With Coronary Heart Disease: A Cross-Sectional Study in China. Front Pharmacol. 2021;12:691983. PMID: 34305601; PMCID: PMC8295746.","journal-title":"Front Pharmacol"},{"key":"7171_CR10","doi-asserted-by":"publisher","first-page":"822","DOI":"10.3389\/fphar.2019.00822","volume":"10","author":"S Shi","year":"2019","unstructured":"Shi S, Shen Z, Duan Y, Ding S, Zhong Z. Association Between Medication Literacy and Medication Adherence Among Patients With Hypertension. Front Pharmacol. 2019;10:822. https:\/\/doi.org\/10.3389\/fphar.2019.00822. PMID: 31396088; PMCID: PMC6664237.","journal-title":"Front Pharmacol"},{"issue":"3","key":"7171_CR11","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1093\/heapro\/15.3.259","volume":"15","author":"D Nutbeam","year":"2000","unstructured":"Nutbeam D. Health literacy as a public goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15(3):259\u201367. https:\/\/doi.org\/10.1093\/heapro\/15.3.259.","journal-title":"Health Promot Int"},{"key":"7171_CR12","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2458-12-80","volume":"12","author":"K S\u00f8rensen","year":"2012","unstructured":"S\u00f8rensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H, (HLS-EU). Consortium Health Literacy Project European. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. https:\/\/doi.org\/10.1186\/1471-2458-12-80. PMID: 22276600; PMCID: PMC3292515.","journal-title":"BMC Public Health"},{"key":"7171_CR13","doi-asserted-by":"publisher","unstructured":"Mokkink LB, Elsman EBM, Terwee CB. COSMIN guideline for systematic reviews of patient-reported outcome measures version 2.0. Qual Life Res. 2024;33(11):2929\u201339. https:\/\/doi.org\/10.1007\/s11136-024-03761-6. Epub 2024 Aug 28. PMID: 39198348; PMCID: PMC11541334.","DOI":"10.1007\/s11136-024-03761-6"},{"key":"7171_CR14","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1037\/1040-3590.7.3.286","volume":"7","author":"FJ Floyd","year":"1995","unstructured":"Floyd FJ, Widaman KF. Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess. 1995;7:286\u201399. https:\/\/doi.org\/10.1037\/1040-3590.7.3.286.","journal-title":"Psychol Assess"},{"key":"7171_CR15","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.jbmt.2021.10.009","volume":"29","author":"R Hedayati","year":"2021","unstructured":"Hedayati R, Amjadian F, Ebadi A, Ehsani F. Cross-cultural adaptation, validity and reliability of the Persian version of Fremantle knee awareness questionnaire. J Bodyw Mov Ther. 2021;29:257\u201363. https:\/\/doi.org\/10.1016\/j.jbmt.2021.10.009.","journal-title":"J Bodyw Mov Ther"},{"key":"7171_CR16","unstructured":"Nunnally JC, Bernstein IH. Psychometric Theory. 4. New, York. McGraw-Hill; 1994. [Google Scholar]Harrington D. Confirmatory factor analysis. New York: Oxford University Press; 2009."},{"issue":"1","key":"7171_CR17","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12961-017-0232-6","volume":"15","author":"MH Imani-Nasab","year":"2017","unstructured":"Imani-Nasab MH, Yazdizadeh B, Salehi M, Seyedin H, Majdzadeh R. Validity and reliability of the Evidence Utilization in Policymaking Measurement Tool (EUPMT). Health Res Policy Syst. 2017;15(1):66. https:\/\/doi.org\/10.1186\/s12961-017-0232-6. PMID: 28778204; PMCID: PMC5545013.","journal-title":"Health Res Policy Syst"},{"key":"7171_CR18","doi-asserted-by":"publisher","unstructured":"Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. 1999;6(1):1\u201355. https:\/\/doi.org\/10.1080\/10705519909540118.","DOI":"10.1080\/10705519909540118"},{"key":"7171_CR19","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1057\/s41599-023-01995-2","volume":"10","author":"D Deng","year":"2023","unstructured":"Deng D, Ye C, Wu F, et al. Effect of organizational ethical self-interest climate on unethical accounting behavior with two different motivations in China: the moderating effect of Confucian ShiZhong Thinking. Humanit Soc Sci Commun. 2023;10:525. https:\/\/doi.org\/10.1057\/s41599-023-01995-2.","journal-title":"Humanit Soc Sci Commun"},{"issue":"3","key":"7171_CR20","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1177\/002224378101800312","volume":"18","author":"RPE Bagozzi","year":"1981","unstructured":"Bagozzi RPE. Structural Equation Models with Unobservable Variables and Measurement Error: A Comment[J]. J Mark Res. 1981;18(3):375\u201381. https:\/\/doi.org\/10.1177\/002224378101800312.","journal-title":"J Mark Res"},{"key":"7171_CR21","doi-asserted-by":"publisher","unstructured":"Jing cheng SHI. MO Xian kun,SUN Zhen qiu. Content validity index in scale development. Journal of Central South University(Medical Science),2012,37(2):152\u20135. https:\/\/doi.org\/10.3969\/j.issn.1672-7347.2012.02.007.","DOI":"10.3969\/j.issn.1672-7347.2012.02.007"},{"key":"7171_CR22","doi-asserted-by":"crossref","unstructured":"Polit DF, Beck CT. Owen SV.Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4): 459\u201367.","DOI":"10.1002\/nur.20199"},{"key":"7171_CR23","unstructured":"Waltz CF, Strickland O, Lenz ER. Measurement in nursing and health research. 3rd ed. New York: Springer Publishing; 2005. p. 157."},{"key":"7171_CR24","doi-asserted-by":"publisher","unstructured":"Qin J, Du M, Zhang Z. Influencing Factors of Drug-Resistant Bacterial Infection in Elderly Patients with Community Acquired Pneumonia. Chin Community Doctors. 2024;40(23):44\u20136. https:\/\/doi.org\/10.3969\/j.issn.1007-614x.2024.23.014.","DOI":"10.3969\/j.issn.1007-614x.2024.23.014"},{"issue":"1","key":"7171_CR25","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s12877-023-03743-2","volume":"23","author":"J Tang","year":"2023","unstructured":"Tang J, Wang K, Yang K, Jiang D, Fang X, Su S, Lin Y, Chen S, Gu H, Li P, Yan S. A combination of Beers and STOPP criteria better detects potentially inappropriate medications use among older hospitalized patients with chronic diseases and polypharmacy: a multicenter cross-sectional study. BMC Geriatr. 2023;23(1):44. https:\/\/doi.org\/10.1186\/s12877-023-03743-2. PMID: 36694126; PMCID: PMC9875512.","journal-title":"BMC Geriatr"},{"key":"7171_CR26","first-page":"1853","volume":"23","author":"Y Wang","year":"2020","unstructured":"Wang Y, Zhang Z, Fu B. Recent advances in burden of multiple medications in older adults patients with multimorbidity. Chin Gen Pract. 2020;23:1853\u20138.","journal-title":"Chin Gen Pract"},{"issue":"12","key":"7171_CR27","doi-asserted-by":"publisher","first-page":"4210","DOI":"10.1111\/jan.15429","volume":"78","author":"R Gn\u00e4gi","year":"2022","unstructured":"Gn\u00e4gi R, Z\u00fa\u00f1iga F, Brunkert T, Meyer-Massetti C. Development of a medication literacy assessment instrument (MELIA) for older people receiving home care. J Adv Nurs. 2022;78(12):4210\u201320. https:\/\/doi.org\/10.1111\/jan.15429. Epub 2022 Sep 2. PMID: 36052608; PMCID: PMC9826207.","journal-title":"J Adv Nurs"},{"issue":"1","key":"7171_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11096-016-0409-z","volume":"39","author":"AM Advinha","year":"2017","unstructured":"Advinha AM, Lopes MJ, de Oliveira-Martins S. Assessment of the Elderly\u2019s Functional Ability to Manage Their Medication: A Systematic Literature Review. Int J Clin Pharm. 2017;39(1):1\u201315. https:\/\/doi.org\/10.1007\/s11096-016-0409-z.","journal-title":"Int J Clin Pharm"},{"issue":"7","key":"7171_CR29","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s40266-020-00764-z","volume":"37","author":"AM Badawoud","year":"2020","unstructured":"Badawoud AM, Salgado TM, Lu J, Parsons P, Peron EP, Slattum PW. Measuring Medication Self-Management Capacity: A Scoping Review of Available Instruments. Drugs Aging. 2020;37(7):483\u2013501. https:\/\/doi.org\/10.1007\/s40266-020-00764-z.","journal-title":"Drugs Aging"},{"key":"7171_CR30","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","volume":"143","author":"JA Hanley","year":"1982","unstructured":"Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982;143:29\u201336. https:\/\/doi.org\/10.1148\/radiology.143.1.7063747.","journal-title":"Radiology"},{"issue":"4","key":"7171_CR31","doi-asserted-by":"publisher","first-page":"195","DOI":"10.4103\/tjem.tjem_182_23","volume":"23","author":"\u015eK \u00c7orbac\u0131o\u011flu","year":"2023","unstructured":"\u00c7orbac\u0131o\u011flu \u015eK, Aksel G. Receiver operating characteristic curve analysis in diagnostic accuracy studies: A guide to interpreting the area under the curve value. Turk J Emerg Med. 2023;23(4):195\u20138. https:\/\/doi.org\/10.4103\/tjem.tjem_182_23. PMID: 38024184; PMCID: PMC10664195.","journal-title":"Turk J Emerg Med"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-026-07171-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07171-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07171-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T03:05:06Z","timestamp":1779159906000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12877-026-07171-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,11]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7171"],"URL":"https:\/\/doi.org\/10.1186\/s12877-026-07171-w","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,11]]},"assertion":[{"value":"11 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Review Committee of Beijing Tiantan Hospital, Capital Medical University (Ethical Batch Number: KY2022-228-01). Informed consent to participate was obtained from all of the participants in the study. This study adhered to the Declaration of Helsinki to this effect.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This manuscript has not been published or presented elsewhere in part or in entirety and is not under consideration by another journal. All the authors have approved the manuscript and agree with its submission to your esteemed journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"685"}}