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. 2024 Feb;15(1):33-44.
doi: 10.24171/j.phrp.2023.0261. Epub 2024 Feb 19.

Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam

Han Thi Vo  1   2 , Tien Duc Dao  3 , Tuyen Van Duong  1   4 , Tan Thanh Nguyen  5   6 , Binh Nhu Do  7   8 , Tinh Xuan Do  9 , Khue Minh Pham  10 , Vinh Hai Vu  11 , Linh Van Pham  12 , Lien Thi Hong Nguyen  12 , Lan Thi Huong Le  13   14   15 , Hoang Cong Nguyen  13   16 , Nga Hoang Dang  14   17 , Trung Huu Nguyen  18 , Anh The Nguyen  19 , Hoan Van Nguyen  11   20 , Phuoc Ba Nguyen  21 , Hoai Thi Thanh Nguyen  22 , Thu Thi Minh Pham  10   23 , Thuy Thi Le  24   25 , Thao Thi Phuong Nguyen  26 , Cuong Quoc Tran  27 , Kien Trung Nguyen  28
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Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam

Han Thi Vo et al. Osong Public Health Res Perspect. 2024 Feb.

Abstract

Background: The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a "social vaccine" that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association.

Methods: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnam from December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (using the 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions.

Results: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD. Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63-2.12; p<0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97-0.99; p=0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96-0.99; p=0.001).

Conclusion: Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

Keywords: Health literacy; Long COVID-19; Observational study; Posttraumatic stress disorder; Vietnam.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts of interest to declare.

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