Morris Nancy S, MacLean Charles D, Littenberg Benjamin
College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA.
BMC Fam Pract. 2006 Aug 14;7:49. doi: 10.1186/1471-2296-7-49.
Inconsistent findings reported in the literature contribute to the lack of complete understanding of the association of literacy with health outcomes. We evaluated the association between literacy, physiologic control and diabetes complications among adults with diabetes.
A cross-sectional study of 1,002 English speaking adults with diabetes, randomly selected from the Vermont Diabetes Information System, a cluster-randomized trial of a diabetes decision support system in a region-wide sample of primary care practices was conducted between July 2003 and March 2005. Literacy was assessed by the Short-Test of Functional Health Literacy in Adults. Outcome measures included glycated hemoglobin, low density lipoprotein, blood pressure and self-reported complications.
After adjusting for sociodemographic characteristics, duration of diabetes, diabetes education, depression, alcohol use, and medication use we did not find a significant association between literacy and glycemic control (beta coefficent,+ 0.001; 95% confidence interval [CI], -0.01 to +0.01; P = .88), systolic blood pressure (beta coefficent, +0.08; 95% CI, -0.10 to +0.26; P = .39), diastolic blood pressure (beta coefficent, -0.03; 95% CI, -0.12 to +0.07, P = .59), or low density lipoprotein (beta coefficent, +0.04; 95% CI, -0.27 to +0.36, P = .77. We found no association between literacy and report of diabetes complications.
These findings suggest that literacy, as measured by the S-TOFHLA, is not associated with glycated hemoglobin, blood pressure, lipid levels or self-reported diabetes complications in a cross-sectional study of older adults with diabetes under relatively good glycemic control. Additional studies to examine the optimal measurement of health literacy and its relationship to health outcomes over time are needed.
文献中报道的结果不一致，这导致人们对识字能力与健康结果之间的关联缺乏全面了解。我们评估了糖尿病成年人的识字能力、生理控制与糖尿病并发症之间的关联。
2003年7月至2005年3月间，对从佛蒙特糖尿病信息系统中随机选取的1002名讲英语的糖尿病成年人进行了一项横断面研究。该系统是一项在全地区初级保健实践样本中进行的糖尿病决策支持系统的整群随机试验。通过成人功能性健康识字简短测试来评估识字能力。结果指标包括糖化血红蛋白、低密度脂蛋白、血压和自我报告的并发症。
在对社会人口学特征、糖尿病病程、糖尿病教育、抑郁、饮酒和药物使用进行调整后，我们发现识字能力与血糖控制（β系数，+0.001；95%置信区间[CI]，-0.01至+0.01；P = 0.88）、收缩压（β系数，+0.08；95%CI，-0.10至+0.26；P = 0.39）、舒张压（β系数，-0.03；95%CI，-0.12至+0.07，P = 0.59）或低密度脂蛋白（β系数，+0.04；95%CI，-0.27至+0.36，P = 0.77）之间无显著关联。我们发现识字能力与糖尿病并发症报告之间无关联。
这些发现表明，在血糖控制相对良好的老年糖尿病成年人横断面研究中，用成人功能性健康识字简短测试衡量的识字能力与糖化血红蛋白、血压、血脂水平或自我报告的糖尿病并发症无关。需要进一步研究以探讨健康识字能力的最佳测量方法及其与健康结果随时间的关系。
