Health literacy profiles in kidney transplanted patients: A cluster analysis.

The analysis used baseline data only and did not follow patients or test health outcomes, so it cannot show that tailored support improves transplant care. The sample was from one transplant centre in Norway, and most patients who could not complete questionnaires in Norwegian were excluded. The final number of clusters was chosen by senior researchers, and no fixed rule governed how many participants are needed for cluster analysis. Recruitment occurred during the COVID-19 pandemic, when 37% of recipients had a living donor kidney, higher than normal. All health literacy, distress and health status measures were self-reported, and clinical variables were also self-reported. 241 patients were invited, 41 declined, and five were excluded before baseline questionnaires, so the analysed group was 195. All patients completed a satisfactory number of Health Literacy Questionnaire items, but only three had missing answers in the HSCL-5 and EQ-5D visual analogue scale questionnaires.

The authors declared no conflict of interest. Funding was from the South-Eastern Norway Regional Health Authority.

Do not conclude that kidney school harmed health literacy. Cluster 1 had the highest kidney school attendance and the lowest scores, but attendance was optional, the data were collected once, and the study did not test whether kidney school affected the scores.