Wang Kwua-Yun, Chu Nain-Feng, Lin Sieh-Hwa, Chiang I-Chyun, Perng Wann-Cherng, Lai Hsiang-Ru
Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan; School of Nursing, National Defense Medical Center, Taipei, Taiwan.
J Clin Nurs. 2014 Jul;23(13-14):2031-42. doi: 10.1111/jocn.12434. Epub 2013 Dec 14.
To explore health literacy status in asthma patients and to examine the causal model linking health literacy to health outcome-related factors via mediator and moderator variables.
Understanding how low health literacy may influence health outcomes is important.
This is a cross-sectional survey study.
A total of 326 asthma patients aged 20 years and older (average: 51 ± 18·3 years) were recruited by purposive sampling from pulmonary medicine outpatient departments at three medical centres and a regional teaching hospital in northern Taiwan. Data were collected via structured questionnaires, including measures of socio-demographic and disease characteristics; medical decision-making; asthma knowledge, attitudes and self-efficacy; healthcare experience and health outcome-related factors (metered-dose inhaler/dry-powder inhaler usage proficiency, medical use, self-management behaviour). Three hundred patients who met the inclusion criteria and completed the questionnaire survey were analysed.
Overall, 217 subjects (72·3%) had adequate functional health literacy, 42 (14%) had inadequate functional health literacy, and 41 (13·7%) had marginal functional health literacy. Subjects' average asthma knowledge, attitudes and self-efficacy scores were 7·23 ± 2·69, 51·46 ± 6·18 and 58·31 ± 8·10, respectively. Health literacy correlated positively with asthma knowledge (r = 0·605), attitudes (r = 0·192) and medical decision-making (r = 0·413).
Health literacy is positively associated with proficiency in metered-dose inhaler usage, asthma knowledge, attitudes and medical decision-making, but is not significantly associated with medical care use and self-management behaviour. Health literacy had an indirect effect on self-management behaviour through the mediation effect of asthma attitudes. No moderator was found for the effect of health literacy on health outcome-related factors.
Results of this study may help to develop adequate intervention strategies to improve the health outcomes of asthma patients.
探讨哮喘患者的健康素养状况，并通过中介变量和调节变量检验将健康素养与健康结局相关因素联系起来的因果模型。
了解低健康素养如何影响健康结局很重要。
这是一项横断面调查研究。
通过目的抽样法，从台湾北部三个医疗中心和一家地区教学医院的肺病门诊招募了326名年龄在20岁及以上（平均年龄：51±18.3岁）的哮喘患者。通过结构化问卷收集数据，包括社会人口统计学和疾病特征、医疗决策、哮喘知识、态度和自我效能感、医疗保健经历以及健康结局相关因素（定量吸入器/干粉吸入器使用熟练度、医疗用途、自我管理行为）。对300名符合纳入标准并完成问卷调查的患者进行了分析。
总体而言，217名受试者（72.3%）具备足够的功能性健康素养，42名（14%）功能性健康素养不足，41名（13.7%）功能性健康素养处于边缘水平。受试者的平均哮喘知识、态度和自我效能感得分分别为7.23±2.69、51.46±6.18和58.31±8.10。健康素养与哮喘知识（r = 0.605）、态度（r = 0.192）和医疗决策（r = 0.413）呈正相关。
健康素养与定量吸入器使用熟练度、哮喘知识、态度和医疗决策呈正相关，但与医疗保健使用和自我管理行为无显著关联。健康素养通过哮喘态度的中介作用对自我管理行为产生间接影响。未发现健康素养对健康结局相关因素的影响存在调节变量。
本研究结果可能有助于制定适当的干预策略，以改善哮喘患者的健康结局。
