Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, USA.
J Gen Intern Med. 2012 May;27(5):534-40. doi: 10.1007/s11606-011-1927-y. Epub 2011 Nov 18.
Knowing a patient's health literacy can help clinicians and researchers anticipate a patient's ability to understand complex health regimens and deliver better patient-centered instructions and information. Poor health literacy has been linked with lower ability to function adequately in health care systems.
We evaluated and compared three measures of health literacy and performance among older patients with diabetes.
Cross-sectional study utilizing in-person interviews conducted in participants' homes.
A tri-ethnic sample (n = 563) of African American, American Indian, and white older adults with diabetes from eight counties in south-central North Carolina.
Participants completed interviews and health literacy assessments using the Short-Form Test of Functional Health Literacy in Adults (S-TOFHLA), the Rapid Estimates of Adult Literacy in Medicine Short-Form (REALM-SF), or the Newest Vital Signs (NVS). Scores for reading comprehension and numeracy were calculated.
Over 90% completed the S-TOFHLA numeracy and approximately 85% completed the S-TOFHLA reading and REALM-SF. Only 73% completed the NVS. The correlation of S-TOFHLA total scores with REALM-SF and NVS were 0.48 and 0.54, respectively. Age, gender, ethnic, educational and income differences in health literacy emerged for several instruments, but the pattern of results across the instruments was highly variable.
A large segment of older adults is unable to complete short-form assessments of health literacy. Among those who were able to complete assessments, the REALM-SF and NVS performed comparably, but their relatively low convergence with the S-TOFHLA raises questions about instrument selection when studying health literacy of older adults.
了解患者的健康素养可以帮助临床医生和研究人员预测患者理解复杂健康方案的能力，并提供更好的以患者为中心的指导和信息。健康素养差与在医疗保健系统中充分发挥作用的能力较低有关。
我们评估并比较了三种衡量 8 个南卡罗来纳州中南部县的糖尿病老年患者健康素养和表现的方法。
在参与者家中进行的横断面研究，使用面对面访谈。
来自南卡罗来纳州中南部 8 个县的、具有不同族裔的、年龄在 65 岁及以上的、患有糖尿病的非裔美国人、美洲印第安人和白人的三族样本（n = 563）。
参与者使用成人简易健康素养测试（S-TOFHLA）、成人医学简易阅读量表（REALM-SF）或最新生命体征（NVS）完成访谈和健康素养评估。计算阅读理解和算术的分数。
超过 90%的人完成了 S-TOFHLA 的算术部分，大约 85%的人完成了 S-TOFHLA 的阅读部分和 REALM-SF。只有 73%的人完成了 NVS。S-TOFHLA 总分与 REALM-SF 和 NVS 的相关性分别为 0.48 和 0.54。在几个工具中，年龄、性别、族裔、教育和收入的健康素养差异都出现了，但结果模式在各个工具之间变化很大。
很大一部分老年人无法完成简短的健康素养评估。在能够完成评估的人群中，REALM-SF 和 NVS 的表现相当，但它们与 S-TOFHLA 的相对低收敛性引起了关于在研究老年人群健康素养时选择工具的问题。
