Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
J Neurooncol. 2018 Jan;136(2):335-342. doi: 10.1007/s11060-017-2657-8. Epub 2017 Nov 8.
Determining health literacy level is an important prerequisite for effective patient education. We assessed multiple dimensions of health literacy and sociodemographic predictors of health literacy in patients with neurofibromatosis. In 86 individuals with a confirmed diagnosis of neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), or schwannomatosis, we assessed health literacy status using two HL tools-the adapted functional, communicative, and critical health literacy scale (adapted FCCHL) and health literacy assessment using talking touchscreen technology (Health LiTT). Factor analyses of the adapted FCCHL in NF patients showed factor structure and psychometric properties similar to pilot work in other patient populations. As a group, patients with NF had moderate scores on the Health LiTT and moderate to high scores on the adapted FCCHL, with the highest score on the functional health literacy subscale. Patients with NF1, those with lower education and those with learning disabilities had lower scores on Health LiTT; in multivariate analysis, learning disability and education remained significant predictors of HealthLiTT scores. Only lower education was associated with lower adapted FCCHL scores. Results suggest utilizing health literacy tools in NF patients is feasible and could provide physicians with valuable information to tailor health communication to subpopulations with lower health literacy levels.
确定健康素养水平是有效进行患者教育的重要前提。我们评估了神经纤维瘤病患者的健康素养的多个维度和社会人口统计学预测因素。在 86 名确诊为神经纤维瘤病 1 型(NF1)、神经纤维瘤病 2 型(NF2)或雪旺细胞瘤病的患者中,我们使用两种 HL 工具评估健康素养状况:改良功能、交流和批判性健康素养量表(改良 FCCHL)和使用触摸屏技术的健康素养评估(Health LiTT)。NF 患者改良 FCCHL 的因子分析显示,其因子结构和心理测量特性与其他患者群体的初步研究相似。作为一个整体,NF 患者在 Health LiTT 上的得分中等,在改良 FCCHL 上的得分中等偏上,其中功能健康素养分量表得分最高。NF1 患者、受教育程度较低和有学习障碍的患者在 Health LiTT 上的得分较低;在多变量分析中,学习障碍和教育仍然是 HealthLiTT 评分的显著预测因素。只有较低的教育程度与改良 FCCHL 评分较低有关。研究结果表明,在 NF 患者中使用健康素养工具是可行的,并且可以为医生提供有价值的信息,以便根据健康素养水平较低的亚人群调整健康沟通。