Department of Health Outcomes and Policy and Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Ann Emerg Med. 2011 Apr;57(4):334-45. doi: 10.1016/j.annemergmed.2010.08.035. Epub 2010 Oct 29.
We assess emergency department (ED) patients' health literacy, the readability of ED patient materials, and the relationship between health literacy and ED outcomes through a systematic literature review.
PubMed, PsychInfo, CINAHL, Web of Knowledge, and ERIC were searched for studies published January 1, 1980, to July 15, 2010, conducted in the United States, reporting original data, and measuring ED patients' health literacy, the readability of ED materials, or the association between health literacy and ED-related outcomes. Two reviewers evaluated each study and abstracted information from included studies into evidence tables.
We identified 413 articles, and 31 met inclusion criteria. Collectively, health literacy skills were assessed at or below the eighth-grade level for approximately 40% of ED patients. In contrast, ED patient materials were typically assessed at or above the ninth-grade level. Studies of adults aged 65 years and older found that those with lower health literacy were more likely to use the ED and incur higher ED costs. Studies of pediatric ED patients did not find direct effects of caregiver literacy on ED outcomes.
A substantial proportion of ED patients have limited health literacy, and ED materials are typically too complex for these patients. It is important for EDs to evaluate the accessibility and patient understanding of information presented. The evidence linking health literacy to ED outcomes is limited. Additional research is needed to better understand the relationship between health literacy and ED outcomes.
通过系统文献回顾，评估急诊科（ED）患者的健康素养、ED 患者材料的可读性，以及健康素养与 ED 结局之间的关系。
检索 1980 年 1 月 1 日至 2010 年 7 月 15 日期间在美国发表的、报告原始数据且测量 ED 患者健康素养、ED 材料可读性或健康素养与 ED 相关结局之间关联的研究，使用 PubMed、PsychInfo、CINAHL、Web of Knowledge 和 ERIC 进行检索。两名评审员评估了每一项研究，并将纳入研究的信息摘要到证据表中。
我们共确定了 413 篇文章，其中 31 篇符合纳入标准。大约 40%的 ED 患者的健康素养技能评估处于或低于八年级水平，而 ED 患者材料通常评估处于或高于九年级水平。对 65 岁及以上成年人的研究发现，健康素养较低的患者更有可能使用 ED，并产生更高的 ED 费用。对儿科 ED 患者的研究未发现看护者的文化程度对 ED 结局有直接影响。
相当一部分 ED 患者的健康素养有限，而 ED 材料通常对这些患者来说过于复杂。ED 必须评估所提供信息的可及性和患者的理解程度。将健康素养与 ED 结局联系起来的证据有限。需要进一步研究以更好地了解健康素养与 ED 结局之间的关系。
