School of Nursing, University of California-Los Angeles, Los Angeles, California, USA.
J Card Fail. 2010 Jan;16(1):9-16. doi: 10.1016/j.cardfail.2009.10.026. Epub 2009 Dec 11.
Low health literacy compromises patient safety, quality health care, and desired health outcomes. Specifically, low health literacy is associated with decreased knowledge of one's medical condition, poor medication recall, nonadherence to treatment plans, poor self-care behaviors, compromised physical and mental health, greater risk of hospitalization, and increased mortality.
The health literacy literature was reviewed for: definitions, scope, risk factors, assessment, impact on health outcomes (cardiovascular disease and heart failure), and interventions. Implications for future research and for clinical practice to address health literacy in heart failure patients were summarized.
General health literacy principles should be applied to patients with heart failure, similar to others with chronic conditions. Clinicians treating patients with heart failure should address health literacy using five steps: recognize the consequences of low health literacy, screen patients at risk, document literacy levels and learning preferences, and integrate effective strategies to enhance patients' understanding into practice.
Although the literature specifically addressing low health literacy in patients with heart failure is limited, it is consistent with the larger body of health literacy evidence. Timely recognition of low health literacy combined with tailored interventions should be integrated into clinical practice.
健康素养低会危及患者安全、医疗质量和预期健康结果。具体而言,健康素养低与以下方面相关:对自身病情的了解减少、药物记忆差、不遵守治疗计划、自我护理行为差、身心健康受损、住院风险增加和死亡率升高。
综述了健康素养文献,包括定义、范围、风险因素、评估、对健康结果(心血管疾病和心力衰竭)的影响,以及干预措施。总结了对未来研究和临床实践的启示,以解决心力衰竭患者的健康素养问题。
应将一般健康素养原则应用于心力衰竭患者,与其他慢性病患者类似。治疗心力衰竭患者的临床医生应采用以下五个步骤来解决健康素养问题:认识到低健康素养的后果、对有风险的患者进行筛查、记录患者的读写能力水平和学习偏好,并将增强患者理解的有效策略整合到实践中。
尽管针对心力衰竭患者的低健康素养的文献有限,但与更广泛的健康素养证据一致。及时识别低健康素养并结合针对性干预措施应整合到临床实践中。