Ishikawa Hirono, Takeuchi Takeaki, Yano Eiji
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
Diabetes Care. 2008 May;31(5):874-9. doi: 10.2337/dc07-1932. Epub 2008 Feb 25.
Health literacy (HL), the capacity of individuals to access, understand, and use health information to make informed and appropriate health-related decisions, has been recognized as an important concept in patient education and disease management. This study examined the psychometric properties of newly developed scales for measuring three different levels of HL (i.e., functional, communicative, and critical) in patients with diabetes.
The reliability and validity of the three HL scales were evaluated in a sample of 138 outpatients with type 2 diabetes. In addition, sociodemographic and clinical characteristics, knowledge of diabetes, information-seeking behaviors, and self-efficacy were assessed for each patient through a self-report questionnaire and review of electronic medical records.
Scale items were constructed to directly reflect the definition of HL. Internal consistency of functional, communicative, and critical HL scales was adequately high (alpha = 0.84, alpha = 0.77, and alpha = 0.65, respectively). Three interpretable factors were identified in exploratory factor analysis. Correlations between HL scales and other measures supported the construct validity of the scales. The three HL scales were only moderately correlated with each other, suggesting that each represents a different domain of HL abilities and skills.
Our newly developed HL scales are reliable and valid measures of three types of HL in diabetic patients. Exploring a patient's HL levels may provide a better understanding of the patient's potential barriers to self-management of disease and health-promoting behaviors.
健康素养（HL）是指个人获取、理解和使用健康信息以做出明智且恰当的健康相关决策的能力，已被公认为患者教育和疾病管理中的一个重要概念。本研究检验了新开发的用于测量糖尿病患者三种不同水平健康素养（即功能型、沟通型和批判性）量表的心理测量特性。
在138例2型糖尿病门诊患者样本中评估了这三种健康素养量表的信度和效度。此外，通过自我报告问卷和电子病历回顾，对每位患者的社会人口统计学和临床特征、糖尿病知识、信息寻求行为及自我效能进行了评估。
量表项目的构建直接反映了健康素养的定义。功能型、沟通型和批判性健康素养量表的内部一致性足够高（分别为α = 0.84、α = 0.77和α = 0.65）。探索性因子分析确定了三个可解释的因子。健康素养量表与其他测量指标之间的相关性支持了量表的结构效度。这三个健康素养量表彼此之间仅呈中度相关，表明每个量表代表了健康素养能力和技能的不同领域。
我们新开发的健康素养量表是糖尿病患者三种类型健康素养的可靠且有效的测量工具。探索患者的健康素养水平可能有助于更好地理解患者在疾病自我管理和健康促进行为方面的潜在障碍。
