Margat Aurore, Gagnayre Rémi, Lombrail Pierre, de Andrade Vincent, Azogui-Levy Sylvie
Sante Publique. 2017 Nov-Dec;29(6):811-820. doi: 10.3917/spub.176.0811.
Low health literacy (HL) is an obstacle to therapeutic patient education (TPE), especially for people in a vulnerable situation, who are also at greater risk of chronic illnesses and their complications. It therefore seems essential to rethink TPE programmes in order to ensure greater equity based on analysis of the characteristics of HL interventions and their possible relationships with TPE.
A scoping review of the literature was performed from November 2014 to January 2016 using the following search engines: MEDLINE/PubMed, EMBASE, PsycINFO, ERIC, OpenGrey, SUDOC, thèses.fr and BDSP and the following search terms: ?health literacy?, ?Littératie en santé?, ?literacy?, ?Littératie?, ?numeracy?, ?numératie?, ?compétence en santé? combined with the keywords: ?programme?, ?program?, ?intervention?, ?méthode?, ?method?, ?technique?, ?outil?, ?tool?.
After selecting forty out of 206 studies, interventions were classified into two main types of specific interventions to promote comprehension of resources intended for patients and generally complex interventions designed to support and improve HL skills.
While the level of health literacy has an impact on TPE programme accessibility, TPE programmes need to be made more accessible and TPE must constitute an opportunity to address health literacy needs via its own specific modalities. Creating partnerships between social/educational and health settings might be an effective strategy to strengthen the interrelationships between HL and TPE, as might training that prepares caregivers-educators to improve patient HL.
Interrelationships between HL and TPE are possible. Research should question the pedagogical modalities to be used to adapt TPE programs to the HL.
低健康素养是治疗性患者教育（TPE）的障碍，尤其对于处于弱势状况的人群而言，他们患慢性病及其并发症的风险也更高。因此，基于对健康素养干预措施的特征及其与TPE可能关系的分析，重新思考TPE计划似乎至关重要，以确保更大的公平性。
2014年11月至2016年1月，使用以下搜索引擎对文献进行了范围综述：MEDLINE/PubMed、EMBASE、PsycINFO、ERIC、OpenGrey、SUDOC、thèses.fr和BDSP，并使用以下检索词：“健康素养”、“Littératie en santé”、“读写能力”、“Littératie”、“算术能力”、“numératie”、“健康能力”，并结合关键词：“计划”、“项目”、“干预”、“方法”、“technique”、“工具”、“outil”。
在从206项研究中筛选出40项后，干预措施被分为两类主要的特定干预措施，以促进患者对资源的理解，以及一般复杂的干预措施，旨在支持和提高健康素养技能。
虽然健康素养水平会影响TPE计划的可及性，但TPE计划需要更易于获取，并且TPE必须通过其自身的特定方式成为解决健康素养需求的契机。在社会/教育和健康环境之间建立伙伴关系可能是加强健康素养与TPE之间相互关系的有效策略，培训护理教育工作者以提高患者的健康素养也可能如此。
健康素养与TPE之间的相互关系是可能的。研究应探讨用于使TPE计划适应健康素养的教学方式。
