Eneanya Nwamaka D, Olaniran Kabir, Xu Dihua, Waite Katherine, Crittenden Stanley, Hazar D Bora, Volandes Angelo E, Temel Jennifer S, Thadhani Ravi, Paasche-Orlow Michael K
J Health Care Poor Underserved. 2018;29(3):1069-1082. doi: 10.1353/hpu.2018.0080.
Black patients with chronic kidney disease (CKD) receive more cardiopulmonary resuscitation (CPR) than other racial groups, and knowledge of CPR influences preferences for care. As limited health literacy disproportionately affects Blacks and contributes to disparities in end-of-life (EOL) care, we investigated whether health literacy mediates racial disparities in CPR knowledge. Black and White adult patients with advanced CKD completed CPR knowledge surveys. Health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine. Among 149 patients, Black patients were more likely to have limited health literacy and lower mean CPR knowledge scores than White patients. In adjusted analyses, health literacy mediated racial differences in CPR knowledge. Knowledge of CPR is lower among Black compared with White CKD patients and health literacy is a mediator of this difference. Future CPR educational interventions should target health literacy barriers to improve informed decision-making and decrease racial disparities at the end of life.
患有慢性肾病（CKD）的黑人患者接受心肺复苏（CPR）的比例高于其他种族群体，而心肺复苏知识会影响对医疗护理的偏好。由于健康素养有限对黑人的影响尤为严重，并导致临终（EOL）护理方面的差异，我们调查了健康素养是否在心肺复苏知识的种族差异中起中介作用。患有晚期慢性肾病的黑人和白人成年患者完成了心肺复苏知识调查。使用《医学成人识字率快速评估》来评估健康素养。在149名患者中，黑人患者比白人患者更有可能健康素养有限，且平均心肺复苏知识得分更低。在调整分析中，健康素养在心肺复苏知识的种族差异中起中介作用。与白人慢性肾病患者相比，黑人患者的心肺复苏知识较低，而健康素养是造成这种差异的一个中介因素。未来的心肺复苏教育干预应针对健康素养障碍，以改善知情决策并减少临终时的种族差异。
