Bonaccorsi Guglielmo, Grazzini Maddalena, Pieri Luca, Santomauro Francesca, Ciancio Maria, Lorini Chiara
Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Florence, Italy.
Scuola di Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Firenze, Florence, Italy.
Ann Ist Super Sanita. 2017 Jul-Sep;53(3):205-212. doi: 10.4415/ANN_17_03_05.
Health literacy (HL) is a complex concept with multiple components; it involves the ability to effectively use and interpret texts, documents, and numbers.
to measure HL levels among a sample of adult Italian patients; to develop and validate the Italian version of the single-item literacy screener (SILS); to assess the diagnostic accuracy of the SILS as an indicator of limited reading ability regarding health documents, compared to the newest vital sign (NVS).
The subjects were enrolled in emergency departments, primary care settings, and specialist departments. The Italian versions of the NVS and of the SILS were administered to the patients, as well as a questionnaire aimed in collected socio-demographic information.
Overall, 174 patients completed the interview (compliance: 87%). Considering the NVS, 24.1% of the subjects presented high likelihood of limited HL, 13.2% a possibility of limited HL, and 62.6% adequate HL. SILS has shown a good concurrent validity compared to NVS (Spearman's rho r = -0.679; p < 0.001). The diagnostic accuracy of the SILS was high. The best performance parameters in assessing the diagnostic accuracy of SILS are found to be for threshold value of 2 in in identifying subjects with high likelihood of limited HL at the NVS (sensitivity: 83.3%; specificity: 82.6%; accuracy: 82.8%; positive predicted value: 60.3%; negative predicted value: 94%; Cohen's kappa: 0.6).
The Italian version of SILS - as an indicator of limited reading and understanding ability regarding health information - is a good tool to measure HL in comparison to more complex measurement instruments of functional HL, like NVS.
健康素养（HL）是一个包含多个组成部分的复杂概念；它涉及有效使用和解读文本、文件及数字的能力。
测量成年意大利患者样本中的健康素养水平；开发并验证单项素养筛查工具（SILS）的意大利语版本；与最新生命体征（NVS）相比，评估SILS作为健康文件阅读能力受限指标的诊断准确性。
研究对象来自急诊科、基层医疗单位和专科科室。向患者发放NVS和SILS的意大利语版本，以及一份旨在收集社会人口学信息的问卷。
总体而言，174名患者完成了访谈（依从率：87%）。考虑NVS，24.1%的受试者健康素养受限可能性高，13.2%的受试者有健康素养受限的可能性，62.6%的受试者健康素养足够。与NVS相比，SILS显示出良好的同时效度（Spearman等级相关系数r = -0.679；p < 0.001）。SILS的诊断准确性较高。在评估SILS的诊断准确性时，发现最佳性能参数是NVS中识别健康素养受限可能性高的受试者时阈值为2（敏感性：83.3%；特异性：82.6%；准确性：82.8%；阳性预测值：60.3%；阴性预测值：94%；Cohen's kappa系数：0.6）。
与更复杂的功能性健康素养测量工具（如NVS）相比，SILS的意大利语版本作为健康信息阅读和理解能力受限的指标，是测量健康素养的良好工具。
