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健康素养与乳腺癌患者感知的共同决策之间的关系。

The relationship between health literacy and perceived shared decision making in patients with breast cancer.

机构信息

Department of Intensive Care Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan.

Department of Physical Medicine and Rehabilitation, E-Da Hospital and I-Shou University, No. 1, Yida Rd., Yanchao District, Kaohsiung City, 82445, Taiwan.

出版信息

Patient Educ Couns. 2019 Feb;102(2):360-366. doi: 10.1016/j.pec.2018.09.017. Epub 2018 Sep 18.

Abstract

OBJECTIVES

We explored the relationship between patient-perceived shared decision making (SDM) and three domains of health literacy (HL) in patients with breast cancer.

METHODS

In this cross-sectional study, we prospectively recruited a convenience sample of 511 breast cancer patients from 3 hospitals in Taiwan. Patients completed questionnaires about HL and perceived SDM in a recent consultation. Sequential regressions, controlling for International Classification of Functioning, Disability and Health (ICF)-related factors) were conducted. Interactions of each HL domain with age or education were also assessed for the relationship with perceived SDM.

RESULTS

Higher scores in the HL domains of healthcare and disease prevention, but lower scores in the health promotion domain, were significantly associated with a higher perceived level of SDM after controlling for ICF-related factors (R = 33.44%). The association of SDM with two domains of HL varied with age, while the relationship between the 3 HL domains and SDM differed across education levels.

CONCLUSION

Each HL domain was significantly associated with perceived SDM after controlling for the ICF-related factors and across different age- and education-stratifications.

PRACTICE IMPLICATIONS

Clinicians should be cognizant of patients' HL levels and incorporate HL best practices into consultations and interactions with patients with breast cancer to facilitate SDM.

摘要

目的

我们探讨了乳腺癌患者中患者感知的共同决策(SDM)与三个健康素养(HL)领域之间的关系。

方法

在这项横断面研究中,我们前瞻性地从台湾的 3 家医院招募了 511 名乳腺癌患者作为便利样本。患者在最近的咨询中完成了关于 HL 和感知 SDM 的问卷。在控制国际功能、残疾和健康分类(ICF)相关因素的情况下,进行了顺序回归。还评估了每个 HL 领域与年龄或教育的交互作用与感知 SDM 的关系。

结果

在控制 ICF 相关因素后,HL 领域的医疗保健和疾病预防得分较高,而健康促进领域的得分较低,与感知 SDM 水平较高显著相关(R=33.44%)。SDM 与 HL 的两个领域的关联随年龄而变化,而 3 个 HL 领域与 SDM 的关系在不同的教育水平上有所不同。

结论

在控制 ICF 相关因素和不同年龄和教育层次的情况下,每个 HL 领域都与感知 SDM 显著相关。

实践意义

临床医生应该意识到患者的 HL 水平,并将 HL 最佳实践纳入与乳腺癌患者的咨询和互动中,以促进 SDM。

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