Institute of Communication & Health, University of Lugano, Via Giuseppe Buffi 13, 6904 Lugano, Switzerland.
Patient Educ Couns. 2017 Nov;100(11):2020-2027. doi: 10.1016/j.pec.2017.05.023. Epub 2017 May 13.
This study aimed at investigating the association between functional health literacy and knowledge on when to seek medical help for potentially harmless (overutilization) or serious (underutilization) situations among immigrants and non-immigrants in Switzerland.
Data was collected among three immigrant groups and the native population (N=1146) in the German- and Italian-speaking part of Switzerland. Health literacy was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) and three Brief Health Literacy Screeners. Over- and underutilization of healthcare services was assessed with items asking participants about when to seek medical help for minor, respectively major, physical symptoms.
Immigrants were more likely to seek medical help when unwarranted (overutilization). Health literacy, when assessed with the S-TOFHLA, was significantly associated with over- and underutilization. Yet, once controlled for covariates, the association between health literacy and overutilization was negative. Immigration background and micro-cultural differences emerged as important predictors of utilization.
Results suggest that functional health literacy is directly related to healthcare utilization. The effects might be amplified by (micro-)cultural differences.
Healthcare providers should be aware of differences in health literacy and utilization patterns among different population groups. Communication between patients and providers should be literacy and culturally sensitive.
本研究旨在调查瑞士移民和非移民人群在功能性健康素养与何时因潜在无害（过度利用）或严重（利用不足）情况寻求医疗帮助的知识之间的关联。
在瑞士德语区和意大利语区，对三个移民群体和本族群（N=1146）进行了数据收集。采用简短功能性健康素养测试（S-TOFHLA）和三个简短健康素养筛查器来评估健康素养。通过询问参与者在出现轻微和严重身体症状时何时寻求医疗帮助的项目来评估过度和利用不足的医疗服务情况。
与本族群相比，移民更有可能在不必要的情况下（过度利用）寻求医疗帮助。当使用 S-TOFHLA 评估健康素养时，健康素养与过度和利用不足均显著相关。然而，在控制了协变量后，健康素养与过度利用之间的关联呈负相关。移民背景和微观文化差异成为利用的重要预测因素。
结果表明，功能性健康素养与医疗保健利用直接相关。（微观）文化差异可能会放大这些影响。
医疗保健提供者应该意识到不同人群群体之间在健康素养和利用模式方面的差异。患者与提供者之间的沟通应具备文化敏感性。
