a Section of Hospital Medicine, Department of Medicine , University of Chicago Medicine , Chicago , Illinois , USA.
J Health Commun. 2013;18 Suppl 1(Suppl 1):197-204. doi: 10.1080/10810730.2013.830346.
Patient-centered care includes involving patients and their families in self-management of chronic diseases. Identifying and addressing barriers to self-management, including those related to health literacy and vision limitations, may enhance one's ability to self-manage. A set of brief verbal screening questions (BVSQ) that does not rely on sufficient vision to assess health literacy was developed by Chew and colleagues in the outpatient setting. The authors aimed to evaluate the usefulness of this tool for hospitalized patients and to determine the prevalence of poor vision among inpatients. In a prospective study, the BVSQ and the Rapid Estimate of Adult Learning in Medicine-Revised (REALM-R; among participants with sufficient vision, ≥ 20/50 Snellen) were administered to general medicine inpatients. Of 893 participants, 79% were African American, and 57% were female; the mean age was 53 years. Among 668 participants who completed both tools, the proportion with low health literacy was 38% with the BVSQ versus 47% with the REALM-R (p = .0001). Almost one fourth of participants had insufficient vision; participants with insufficient vision were more likely to be identified as having low health literacy by the BVSQ, compared with those with sufficient vision (59% vs. 38%, p < .001).
以患者为中心的护理包括让患者及其家属参与慢性病的自我管理。确定并解决自我管理的障碍，包括与健康素养和视力限制相关的障碍，可能会增强自我管理的能力。Chew 及其同事在门诊环境中开发了一套不依赖于足够视力来评估健康素养的简短口头筛查问题 (BVSQ)。作者旨在评估该工具在住院患者中的有用性，并确定住院患者中视力不佳的患病率。在一项前瞻性研究中，BVSQ 和成人医学简易学习评估修订版 (REALM-R; 在有足够视力的参与者中，≥20/50 Snellen) 被用于普通内科住院患者。在 893 名参与者中，79%为非裔美国人，57%为女性；平均年龄为 53 岁。在完成这两种工具的 668 名参与者中，BVSQ 评估的低健康素养比例为 38%，REALM-R 为 47%（p =.0001）。近四分之一的参与者视力不足；与有足够视力的参与者相比，视力不足的参与者更有可能被 BVSQ 识别为低健康素养（59%比 38%，p <.001）。
