Morgan Erin E, Iudicello Jennifer E, Cattie Jordan E, Blackstone Kaitlin, Grant Igor, Woods Steven Paul
Department of Psychiatry (8231), University of California, San Diego, 220 Dickinson St., Suite B, San Diego, CA, 92103, USA.
AIDS Behav. 2015 Jan;19(1):166-77. doi: 10.1007/s10461-014-0851-7.
This study sought to determine the effects of HIV-associated neurocognitive disorders (HAND) on health literacy, which encompasses the ability to access, understand, appraise, and apply health-related information. Participants included 56 HIV seropositive individuals, 24 of whom met Frascati criteria for HAND, and 24 seronegative subjects who were comparable on age, education, ethnicity, and oral word reading. Each participant was administered a brief battery of well-validated measures of health literacy, including the Expanded Numeracy Scale (ENS), Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy in Medicine (REALM), and Brief Health Literacy Screen (BHLS). Results revealed significant omnibus differences on the ENS and NVS, which were driven by poorer performance in the HAND group. There were no significant differences on the REALM or the BHLS by HAND status. Among individuals with HAND, lower scores on the NVS were associated with greater severity of neurocognitive dysfunction (e.g., working memory and verbal fluency) and self-reported dependence in activities of daily living. These preliminary findings suggest that HAND hinders both fundamental (i.e., basic knowledge, such as numeracy) and critical (i.e., comprehension and application of healthcare information) health literacy capacities, and therefore may be an important factor in the prevalence of health illiteracy. Health literacy-focused intervention may play an important role in the treatment and health trajectories among persons living with HIV infection.
本研究旨在确定与艾滋病病毒相关的神经认知障碍(HAND)对健康素养的影响,健康素养包括获取、理解、评估和应用与健康相关信息的能力。研究对象包括56名艾滋病毒血清阳性个体,其中24人符合HAND的弗拉斯卡蒂标准,以及24名在年龄、教育程度、种族和口头单词阅读方面具有可比性的血清阴性受试者。对每位参与者进行了一系列经过充分验证的健康素养简短测量,包括扩展算术量表(ENS)、最新生命体征(NVS)、医学成人识字率快速评估(REALM)和简短健康素养筛查(BHLS)。结果显示,ENS和NVS存在显著的总体差异,这是由HAND组较差的表现所致。HAND状态在REALM或BHLS上没有显著差异。在患有HAND的个体中,NVS得分较低与神经认知功能障碍(如工作记忆和语言流畅性)的严重程度较高以及自我报告的日常生活活动依赖程度较高相关。这些初步研究结果表明,HAND会阻碍基本(即基础知识,如算术)和关键(即医疗保健信息的理解和应用)健康素养能力,因此可能是健康素养普遍存在的一个重要因素。以健康素养为重点的干预措施可能在艾滋病毒感染者的治疗和健康轨迹中发挥重要作用。