{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:09:11Z","timestamp":1787785751916,"version":"build-2784847793"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Understanding the health literacy status of patients with gout diagnosis is essential for improving the health of this population. Our study aimed to investigate the latent profiles of health literacy in patients with gout and to analyze differences in characteristics across potential profiles.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a cross-sectional study. Eligible participants attended the Shandong Gout Medical Center, from March 2023 to May 2023 and self-reported gout diagnosis. We used the Health Literacy Scale for Patients with Gout designed and validated by our team. The scale had good reliability and validity among patients with gout. 243 patients completed the Demographic Information Questionnaire and the Health Literacy Scale for Patients with Gout. We used latent profile analysis to identify the latent profiles of gout patients\u2019 health literacy. We used Chi-square tests with Bonferroni correction to analyze differences in demographics and illness characteristics across identified profiles.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Three profiles of patients with gout emerged (prevalence): the <jats:italic>low literacy-low critical<\/jats:italic> group (21.81%), the <jats:italic>moderate literacy<\/jats:italic> group (42.79%), and the <jats:italic>high literacy-stable<\/jats:italic> group (35.39%). The three groups differed in age, education level, monthly income, disease duration, and place of residence (<jats:italic>P<\/jats:italic>&lt;0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The health literacy of patients with gout was heterogeneous. Healthcare professionals should adopt targeted interventions based on the characteristics of each latent health literacy profile to improve the health literacy level of patients with gout.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0300983","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T17:53:09Z","timestamp":1715277189000},"page":"e0300983","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Health literacy in patients with gout: A latent profile analysis"],"prefix":"10.1371","volume":"19","author":[{"given":"Shuo","family":"Cai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danqing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9229-452X","authenticated-orcid":true,"given":"Jianchun","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haowei","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1427-0004","authenticated-orcid":true,"given":"Aimin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"issue":"5","key":"pone.0300983.ref001","first-page":"400","article-title":"[Gout].","volume":"81","author":"AK Tausche","year":"2022","journal-title":"Zeitschrift fur Rheumatologie"},{"issue":"7","key":"pone.0300983.ref002","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1038\/s41584-020-0441-1","article-title":"Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors","volume":"16","author":"M Dehlin","year":"2020","journal-title":"Nature reviews Rheumatology"},{"issue":"4","key":"pone.0300983.ref003","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/1756-185X.13266","article-title":"Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan.","volume":"21","author":"KH Yu","year":"2018","journal-title":"International journal of rheumatic diseases"},{"issue":"12","key":"pone.0300983.ref004","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1080\/03007995.2020.1840341","article-title":"Health-related quality of life assessed by Gout Impact Scale (GIS) in Chinese patients with gout.","volume":"36","author":"W Zhou","year":"2020","journal-title":"Current medical research and opinion."},{"key":"pone.0300983.ref005","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.2147\/PPA.S310689","article-title":"Potential Development of a Mobile Application for Gout Self-Management: What Support Do Patients Need?","volume":"15","author":"Y Yin","year":"2021","journal-title":"Patient preference and adherence."},{"issue":"6","key":"pone.0300983.ref006","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1016\/j.semarthrit.2021.09.003","article-title":"Allopurinol adherence, persistence and patterns of use in individuals with diabetes and gout: A retrospective, population-based cohort analysis","volume":"51","author":"A Weisman","year":"2021","journal-title":"Seminars in arthritis and rheumatism"},{"key":"pone.0300983.ref007","article-title":"Incident gout and chronic Kidney Disease: healthcare utilization and survival.","volume":"311","author":"DH Jaffe","year":"2019","journal-title":"BMC rheumatology."},{"key":"pone.0300983.ref008","first-page":"49","article-title":"A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors.","volume":"13","author":"J Taggart","year":"2012"},{"issue":"1","key":"pone.0300983.ref009","doi-asserted-by":"crossref","first-page":"101419","DOI":"10.1016\/j.respe.2022.101419","article-title":"Association of health literacy with physical and mental health in people with chronic diseases.","volume":"71","author":"S Arsenovi\u0107","year":"2023","journal-title":"Revue d\u2019epidemiologie et de sante publique."},{"issue":"3","key":"pone.0300983.ref010","first-page":"e279","article-title":"The Effect of Health Literacy on Health-Related Quality of Life Among Saudi Women With Chronic Diseases. The journal of nursing research","volume":"31","author":"E Alhalal","year":"2023","journal-title":"JNR"},{"issue":"12","key":"pone.0300983.ref011","doi-asserted-by":"crossref","first-page":"3769","DOI":"10.1007\/s10067-020-05161-w","article-title":"Comparison of persistence rates between allopurinol and febuxostat as first-line urate-lowering therapy in patients with gout: an 8-year retrospective cohort study.","volume":"39","author":"A Kim","year":"2020","journal-title":"Clinical rheumatology."},{"issue":"11","key":"pone.0300983.ref012","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1016\/j.pec.2017.05.023","article-title":"Low health literacy and healthcare utilization among immigrants and non-immigrants in Switzerland.","volume":"100","author":"S Mantwill","year":"2017","journal-title":"Patient education and counseling."},{"issue":"2","key":"pone.0300983.ref013","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/17423953211035472","article-title":"The importance of health literacy for self-management: A scoping review of reviews.","volume":"18","author":"M van der Gaag","year":"2022","journal-title":"Chronic illness."},{"issue":"5","key":"pone.0300983.ref014","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1093\/heapro\/dax015","article-title":"Improving health literacy in community populations: a review of progress.","volume":"33","author":"D Nutbeam","year":"2017","journal-title":"Health promotion international"},{"issue":"4","key":"pone.0300983.ref015","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1002\/nop2.1468","article-title":"Development of the health literacy assessment instrument for chronic pain patients: A Delphi study","volume":"10","author":"S Chen","year":"2023","journal-title":"Nursing open"},{"issue":"3","key":"pone.0300983.ref016","first-page":"259","article-title":"Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century Health promotion international.","volume":"15","author":"D. Nutbeam","year":"2000"},{"key":"pone.0300983.ref017","article-title":"Gout management and outcomes during established COVID-19 pandemic in 2020\u20132021: a cross-sectional","volume":"14","author":"JA Singh","year":"2022","journal-title":"Internet survey. 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Zimmer","year":"2023"},{"issue":"9","key":"pone.0300983.ref032","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1007\/s10067-014-2838-1","article-title":"Health literacy in patients dealing with gout: a qualitative study.","volume":"34","author":"M van Onna","year":"2015","journal-title":"Clinical rheumatology."},{"key":"pone.0300983.ref033","article-title":"Dietary Guide for Hyperuricemia and Gout Patients (WS\/T 560\u20132017). 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