Westlake Cheryl, Sethares Kristen, Davidson Patricia
Nursing PhD Program, Azusa Pacific University, 720 E. Foothill Boulevard, P.O. Box 7000, Azusa, CA 91702, USA.
Curr Heart Fail Rep. 2013 Sep;10(3):232-43. doi: 10.1007/s11897-013-0147-7.
Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the home, access care in the community, promote provider-patient interactions, structure self-care, and navigate health care programs both locally and nationally. Further, health literacy is a key determinant of health and a critical dimension for assessing individuals' needs, and, importantly, their capacity for self-care. Poorer health knowledge/status, more medication errors, costs, and higher rates of morbidity, readmissions, emergency room visits, and mortality among patients with health illiteracy have been demonstrated. Individuals at high risk for low health literacy include the elderly, disabled, Blacks, those with a poverty-level income, some or less high school education, either no insurance or Medicare or Medicaid, and those for whom English is a second language. As a consequence, health literacy is a complex, multifaceted, and evolving construct including aspects of social, psychological, cultural and economic circumstances. The purpose of this paper is to describe the mechanisms and consequences of health illiteracy. Specifically, the prevalence, associated demographics, and models of health literacy are described. The mechanism of health illiteracy's influence on outcomes in heart failure is proposed. Tools for health literacy assessment are described and compared. Finally, the health outcomes and general interventions to enhance the health outcomes in heart failure are discussed.
来自25个国家的论文讨论了健康素养问题，研究结果表明，发达国家约三分之一至一半的人口健康素养较低。具体而言，健康素养是个人获取和使用健康信息以做出有关在家中进行个体治疗、在社区获得护理、促进医患互动、组织自我护理以及在地方和国家层面参与医疗保健项目的健康决策的机制。此外，健康素养是健康的关键决定因素，也是评估个人需求以及重要的自我护理能力的关键维度。研究表明，健康素养较低的患者健康知识/状况较差、用药错误更多、成本更高，发病率、再入院率、急诊室就诊率和死亡率也更高。健康素养低风险较高的人群包括老年人、残疾人、黑人、收入处于贫困水平的人、接受过高中以下教育的人、没有保险或参加医疗保险或医疗补助的人以及英语为第二语言的人。因此，健康素养是一个复杂、多层面且不断演变的概念，包括社会、心理、文化和经济环境等方面。本文的目的是描述健康素养低下的机制和后果。具体而言，将描述健康素养的患病率、相关人口统计学特征和模式。提出健康素养低下对心力衰竭结局影响的机制。描述并比较健康素养评估工具。最后，讨论心力衰竭的健康结局以及改善心力衰竭健康结局的一般干预措施。
