Ginde Adit A, Weiner Scott G, Pallin Daniel J, Camargo Carlos A
Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA.
Acad Emerg Med. 2008 Jun;15(6):577-80. doi: 10.1111/j.1553-2712.2008.00116.x.
The objective was to evaluate the prevalence of limited health literacy and its association with sociodemographic variables in emergency department (ED) patients.
This was a cross-sectional survey in three Boston EDs. The authors enrolled consecutive adult patients during two 24-hour periods at each site. They measured health literacy by the short version of the Test of Functional Health Literacy in Adults (S-TOFHLA). Using multivariate logistic regression, the authors evaluated associations between sociodemographic variables and limited health literacy, as classified by S-TOFHLA scores.
The authors enrolled 300 patients (77% of eligible). Overall, 75 (25%; 95% confidence interval [CI] = 20% to 30%) of participants had limited health literacy. Limited health literacy was independently associated with older age (compared to 18-44 years, odds ratio [OR] 4.3 [95% CI = 2.0 to 9.2] for 45-64 years and OR 3.4 [95% CI = 1.4 to 8.5] for >or=65 years), less education (compared to high school graduates, OR 2.7 [95% CI = 1.1 to 7.3] for some high school or lower and OR 0.43 [95% CI = 0.21 to 0.88] for some college or higher), and lower income (OR 2.8 [95% CI = 1.2 to 6.6] for <or=$40,000 compared to >$40,000). Although ethnicity, race, and language were associated with limited health literacy in unadjusted analyses, the associations were not significant on multivariate analysis.
In this sample, one-quarter of ED patients would be expected to have difficulty understanding health materials and following prescribed treatment regimens. Advanced age and low socioeconomic status were independently associated with limited health literacy. The ability of a significant subgroup of ED patients to understand health information, especially during illness or injury, requires further study.
评估急诊科（ED）患者健康素养有限的患病率及其与社会人口统计学变量的关联。
这是一项在波士顿三家急诊科进行的横断面调查。作者在每个地点的两个24小时时间段内纳入连续的成年患者。他们使用成人功能性健康素养测试简版（S-TOFHLA）来测量健康素养。作者通过多变量逻辑回归评估社会人口统计学变量与健康素养有限之间的关联，健康素养有限根据S-TOFHLA分数进行分类。
作者纳入了300名患者（符合条件者的77%）。总体而言，75名（25%；95%置信区间[CI]=20%至30%）参与者健康素养有限。健康素养有限与年龄较大独立相关（与18-44岁相比，45-64岁的优势比[OR]为4.3[95%CI=2.0至9.2]，65岁及以上的OR为3.4[95%CI=1.4至8.5]），教育程度较低（与高中毕业生相比，高中及以下学历的OR为2.7[95%CI=1.1至7.3]，大专及以上学历的OR为0.43[95%CI=0.21至0.88]），以及收入较低（与收入超过40,000美元相比，收入低于或等于40,000美元的OR为2.8[95%CI=1.2至6.6]）。尽管在未调整分析中种族、民族和语言与健康素养有限相关，但在多变量分析中这些关联并不显著。
在该样本中，预计四分之一的急诊科患者在理解健康资料和遵循规定治疗方案方面会有困难。高龄和低社会经济地位与健康素养有限独立相关。急诊科患者中相当一部分人理解健康信息的能力，尤其是在患病或受伤期间，需要进一步研究。
