Malloy-Weir Leslie J, Charles Cathy, Gafni Amiram, Entwistle Vikki A
Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada.
Health Services Research Unit, University of Aberdeen, Fosterhill, Scotland, UK.
Patient Educ Couns. 2015 Mar;98(3):296-309. doi: 10.1016/j.pec.2014.11.004. Epub 2014 Dec 8.
This study asked: What is known from the existing literature about the empirical relationships between health literacy (HL) and the three stages of the treatment decision making (TDM) process: information exchange, deliberation, and deciding on the treatment to implement?
A scoping review of the literature was conducted. Four databases were searched and a total of 2772 records were returned. After de-duplication and three levels of relevance screening, 41 primary studies were included.
Relationships between HL and information exchange were studied more often than relationships between HL and deliberation and deciding on the treatment to implement. Across the 41 studies, there was little overlap in terms the measure(s) of HL adopted, the aspect of TDM considered, and the characteristics of the study populations--making comparisons of the findings difficult. Multiple knowledge gaps and measurement-related problems were identified; including, the possibility that the process of TDM influences HL.
The importance of HL to the three stages of TDM is unclear because of the knowledge gaps and measurement-related problems that exist.
There are many uncertainties about how TDM, or the design and use of patient decision aids, should respond to patients with different levels of HL.
本研究提出以下问题：现有文献中关于健康素养（HL）与治疗决策（TDM）过程的三个阶段——信息交流、审议以及决定实施何种治疗——之间的实证关系有哪些了解？
对文献进行了范围综述。检索了四个数据库，共返回2772条记录。经过去重和三个层次的相关性筛选，纳入了41项主要研究。
与HL和审议以及决定实施何种治疗之间的关系相比，HL与信息交流之间的关系受到的研究更多。在这41项研究中，所采用的HL测量方法、所考虑的TDM方面以及研究人群的特征几乎没有重叠，这使得研究结果难以比较。发现了多个知识空白和与测量相关的问题，包括TDM过程可能影响HL的可能性。
由于存在知识空白和与测量相关的问题，HL对TDM三个阶段的重要性尚不清楚。
关于TDM或患者决策辅助工具的设计和使用应如何应对不同HL水平的患者，存在许多不确定性。
