Wright Nunes Julie A, Osborn Chandra Y, Ikizler T Alp, Cavanaugh Kerri L
Department of Internal Medicine, Division of Nephrology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Hemodial Int. 2015 Apr;19(2):287-95. doi: 10.1111/hdi.12239. Epub 2014 Oct 30.
Health numeracy is linked to important clinical outcomes. Kidney disease management relies heavily on patient numeracy skills across the continuum of kidney disease care. Little data are available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Using focus groups, we asked patients receiving hemodialysis open-ended questions to identify facilitators and barriers to their understanding, interpretation, and application of numeric information in kidney care. Transcripts were analyzed using content analysis. Twelve patients participated with a mean (standard deviation) age of 56 (12) years. All were African American, 50% were women, and 83% had an annual income <$20,000/year. Although patients felt numbers were critical to every aspect in life, they noted several barriers to understanding, interpreting and applying quantitative information specifically to manage their health. Low patient self-efficacy related to health numeracy and limited patient-provider communication about quantitatively based feedback, were emphasized as key barriers. Through focus groups of key patient stakeholders we identified important modifiable barriers to effective kidney care. Additional research is needed to develop tools that support numeracy-sensitive education and communication interventions in dialysis.
健康数字素养与重要的临床结果相关。在整个肾脏疾病护理过程中，肾脏疾病管理严重依赖患者的数字素养技能。关于健康数字素养这一概念，从接受透析治疗的患者那里获取利益相关者观点的数据很少。通过焦点小组，我们向接受血液透析的患者提出开放式问题，以确定在肾脏护理中他们理解、解读和应用数字信息的促进因素和障碍。使用内容分析法对访谈记录进行分析。12名患者参与其中，平均（标准差）年龄为56（12）岁。所有患者均为非裔美国人，50%为女性，83%的年收入低于20,000美元/年。尽管患者认为数字对生活的方方面面都至关重要，但他们指出在理解、解读和应用定量信息以管理自身健康方面存在一些障碍。强调了与健康数字素养相关的患者自我效能低下以及患者与医护人员之间关于基于定量的反馈的沟通有限，是关键障碍。通过关键患者利益相关者的焦点小组，我们确定了有效肾脏护理中重要的可改变障碍。需要进一步开展研究来开发支持透析中数字素养敏感教育和沟通干预的工具。
