健康素养与乳腺钼靶筛查指南依从性的关联。
Association of health literacy with adherence to screening mammography guidelines.
作者信息
Komenaka Ian K, Nodora Jesse N, Hsu Chiu-Hsieh, Martinez Maria Elena, Gandhi Sonal G, Bouton Marcia E, Klemens Anne E, Wikholm Lauren I, Weiss Barry D
机构信息
Maricopa Medical Center, Phoenix, the Arizona Cancer Center, the Mel and Enid Zuckerman Arizona College of Public Health, and the Department of Family and Community Medicine, University of Arizona, Tucson, and New Horizon Women's Care, Chandler, Arizona; and Moores University of California-San Diego Cancer Center, San Diego, California.
出版信息
Obstet Gynecol. 2015 Apr;125(4):852-859. doi: 10.1097/AOG.0000000000000708.
OBJECTIVE
To investigate the relationship of health literacy and screening mammography.
METHODS
All patients seen at a breast clinic underwent prospective assessment of health literacy from January 2010 to April 2013. All women at least 40 years of age were included. Men and women diagnosed with breast cancer before age 40 years were excluded. Routine health literacy assessment was performed using the Newest Vital Sign. Demographic data were also collected. Medical records were reviewed to determine if patients had undergone screening mammography: women aged 40-49 years were considered to have undergone screening if they had another mammogram within 2 years. Women 50 years or older were considered to have undergone screening mammography if they had another mammogram within 1 year.
RESULTS
A total of 1,664 consecutive patients aged 40 years or older were seen. No patient declined the health literacy assessment. Only 516 (31%) patients had undergone screening mammography. Logistic regression analysis that included ethnicity, language, education, smoking status, insurance status, employment, income, and family history found that only three factors were associated with not obtaining a mammogram: low health literacy (odds ratio [OR] 0.27, 95% confidence interval [CI] 0.19-0.37; P<.001), smoking (OR 0.64, 95% CI 0.47-0.85; P=.002), and being uninsured (OR 0.66, 95% CI 0.51-0.85; P=.001).
CONCLUSION
Of all the sociodemographic variables examined, health literacy had the strongest relationship with use of screening mammography.
目的
探讨健康素养与乳腺钼靶筛查之间的关系。
方法
2010年1月至2013年4月期间，在一家乳腺诊所就诊的所有患者均接受了健康素养的前瞻性评估。纳入所有年龄至少40岁的女性。排除40岁之前被诊断为乳腺癌的男性和女性。使用最新生命体征进行常规健康素养评估。还收集了人口统计学数据。查阅病历以确定患者是否接受过乳腺钼靶筛查：40 - 49岁的女性如果在2年内进行过另一次乳房X光检查，则被视为接受过筛查。50岁及以上的女性如果在1年内进行过另一次乳房X光检查，则被视为接受过乳腺钼靶筛查。
结果
共诊治了1664例年龄40岁及以上的连续患者。没有患者拒绝健康素养评估。只有516例（31%）患者接受过乳腺钼靶筛查。逻辑回归分析纳入了种族、语言、教育程度、吸烟状况、保险状况、就业情况、收入和家族史，结果发现只有三个因素与未进行乳房X光检查有关：健康素养低（比值比[OR] 0.27，95%置信区间[CI] 0.19 - 0.37；P <.001）、吸烟（OR 0.64，95% CI 0.47 - 0.85；P =.002）和未参保（OR 0.66，95% CI 0.51 - 0.85；P =.001）。
结论
在所有检查的社会人口统计学变量中，健康素养与乳腺钼靶筛查的使用之间的关系最为密切。
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