Graduate Institute of Medical Sciences, National Defense Medical Center; Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan.
Br J Gen Pract. 2013 May;63(610):e354-60. doi: 10.3399/bjgp13X667222.
In Taiwan, older veterans typically match the characteristics of a high prevalence of inadequate health literacy, which is a major barrier to effective communication in delivering proper health care. A good physician-patient relationship increases patients' trust and willingness to communicate, so an awareness of the factors that influence this relationship could improve it over time and enhance patients' health.
To explore factors related to the physician-patient relationship among older veterans with inadequate health literacy in Taiwan.
Observational study in veterans' homes.
Data were collected using self-report questionnaires in face-to-face interviews. Patients with a Test of Functional Health Literacy in Adults score <60 (defined as inadequate health literacy) were recruited. Demographic characteristics, the Geriatric Depression Scale-Short Form, Multidimensional Health Locus of Control, and Perceived Involvement in Care Scales were used to identify related factors. Multiple regression and bootstrapping were used for data analyses.
A total of 256 older individuals were defined as having inadequate health literacy. Patients' perceived involvement in health care partially mediated the relationship between Health Locus of Control and the physician-patient relationship. Perceived Involvement in Care, depression score, and Health Locus of Control were predictors of the physician-patient relationship.
Older patients with inadequate health literacy had difficulty becoming actively involved in health care. The GP is in an ideal position to become a key person in helping such patients become involved in health care, and appropriately treating their depression may improve the physician-patient relationship.
在台湾,老年退伍军人通常具有健康素养不足的特点,这是有效沟通提供适当医疗保健的主要障碍。良好的医患关系增加了患者的信任和沟通意愿,因此,了解影响这种关系的因素可以随着时间的推移改善这种关系,并增强患者的健康。
探讨台湾健康素养不足的老年退伍军人医患关系的相关因素。
退伍军人之家的观察性研究。
采用面对面访谈的自我报告问卷收集数据。招募成年人功能性健康素养测试得分<60 分(定义为健康素养不足)的患者。使用一般健康问卷-抑郁量表短表、多维健康控制感量表和感知参与护理量表来确定相关因素。采用多元回归和自举法进行数据分析。
共有 256 名老年人被定义为健康素养不足。患者对健康护理的感知参与部分中介了健康控制感与医患关系之间的关系。感知参与护理、抑郁评分和健康控制感是医患关系的预测因素。
健康素养不足的老年患者在积极参与医疗保健方面存在困难。全科医生处于帮助此类患者参与医疗保健的理想位置,适当治疗他们的抑郁可能会改善医患关系。