Center for Health Services Research, University of Kentucky, 740 South Limestone, Lexington, KY 40536, USA.
Department of Surgery, Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA.
Spine J. 2018 Feb;18(2):370-376. doi: 10.1016/j.spinee.2017.09.005. Epub 2017 Sep 19.
Health literacy (HL) and the overall ability of patients to seek, understand, and apply health information play an important role in the management of chronic pain conditions. Awareness of how patients' HL skills influence their pain experience and how their ability to understand the treatment regimen and to manage chronic pain may allow physicians to adjust clinical treatment accordingly. Despite the prevalence and the substantial economic impact of chronic low back pain (LBP), little is known about the relationship between HL and the treatment and management of this common disease entity.
The purpose of this systematic review of published research was to examine the importance and the implications of HL in the treatment and management of LBP.
A literature search was performed in Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsychInfo using medical subject heading (MeSH) terms related to LBP, HL, and patient education, which yielded only three studies that directly addressed HL among patients suffering from LBP.
We identified only a limited number of studies that focused specifically on HL in the LBP population that were included in this review. The majority of studies excluded from this review focused on patient levels of educational attainment and patient education programs without addressing patients' HL levels and their impact on adherence to educational programs, self-care management, and rehabilitation, among other factors. The three studies that are critically reviewed in this review either use a direct measure of HL or make an effort to address HL in their programs. All three studies emphasize the importance of considering the HL of patients in the treatment and management of LBP.
Building on these studies and the narrative review of other relevant literature, we identified significant gaps in current research addressing HL in the treatment and management of LBP. We developed recommendations for future research based on an assessment of strengths and limitations of available evidence-based studies.
健康素养（HL）和患者寻求、理解和应用健康信息的整体能力在慢性疼痛管理中起着重要作用。了解患者的 HL 技能如何影响他们的疼痛体验，以及他们理解治疗方案和管理慢性疼痛的能力如何，可以让医生相应地调整临床治疗。尽管慢性下腰痛（LBP）的普遍性和巨大的经济影响，但是人们对 HL 与这种常见疾病实体的治疗和管理之间的关系知之甚少。
本系统评价发表研究的目的是研究 HL 在 LBP 治疗和管理中的重要性和意义。
通过 Web of Science、PubMed、 Cumulative Index to Nursing and Allied Health Literature 和 PsychInfo 进行文献检索，使用与 LBP、HL 和患者教育相关的医学主题词（MeSH）术语，仅检索到三项直接针对 LBP 患者 HL 的研究。
我们只确定了少数专门针对 LBP 人群 HL 的研究，这些研究被纳入本综述。从本综述中排除的大多数研究都侧重于患者的教育程度和患者教育计划，而没有解决患者的 HL 水平及其对教育计划的依从性、自我护理管理、康复等因素的影响。这三项研究都批判性地回顾了，或者使用直接衡量 HL 的方法，或者努力在他们的方案中解决 HL。所有三项研究都强调了在 LBP 的治疗和管理中考虑患者 HL 的重要性。
基于这些研究和对其他相关文献的叙述性回顾，我们确定了当前研究在治疗和管理 LBP 中的 HL 方面存在重大差距。我们根据对现有基于证据的研究的优势和局限性的评估，提出了未来研究的建议。
