Sudore Rebecca L, Schillinger Dean
Division of Geriatrics (Dr. Sudore), and the Division of General Internal Medicine (Dr. Schillinger), University of California, San Francisco, CA.
J Clin Outcomes Manag. 2009 Jan 1;16(1):20-29.
To propose a framework and describe best practices for improving care for patients with limited health literacy (LHL). METHODS: Review of the literature. RESULTS: Approximately half of the U.S. adult population has LHL. Because LHL is associated with poor health outcomes and contributes to health disparities, the adoption of evidence-based best practices is imperative. Feasible interventions at the clinician-patient level (eg, patient-centered communication, clear communication techniques, teach-to-goal methods, and reinforcement), at the system-patient level (eg, clear health education materials, visual aids, clear medication labeling, self-management support programs, and shame-free clinical environments), and at the community-patient level (eg, adult education referrals, lay health educators, and harnessing the mass media) can improve health outcomes for patients with LHL. CONCLUSION: Because LHL is prevalent, and because the recommended communication strategies can benefit patients of all literacy levels, clinicians, health system planners, and health policy leaders should promote the uptake of these strategies into routine care.
提出一个框架并描述改善健康素养有限（LHL）患者护理的最佳实践。方法：文献综述。结果：约一半的美国成年人口健康素养有限。由于健康素养有限与不良健康结果相关并导致健康差距，因此采用循证最佳实践势在必行。在临床医生-患者层面（如以患者为中心的沟通、清晰的沟通技巧、目标导向教学方法和强化）、系统-患者层面（如清晰的健康教育材料、视觉辅助工具、清晰的药物标签、自我管理支持项目和无羞辱感的临床环境）以及社区-患者层面（如成人教育转诊、非专业健康教育工作者和利用大众媒体）的可行干预措施可改善健康素养有限患者的健康结果。结论：由于健康素养有限情况普遍，且推荐的沟通策略可使所有素养水平的患者受益，临床医生、卫生系统规划者和卫生政策领导者应推动将这些策略纳入常规护理。
