Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY 40202, USA.
Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY 40202, USA.
Spine J. 2019 Apr;19(4):711-716. doi: 10.1016/j.spinee.2018.10.012. Epub 2018 Nov 3.
Health literacy, defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," has been demonstrated to affect access to care and appropriate healthcare utilization.
To determine the impact of health literacy in the evaluation and management of patients with chronic low back pain.
Cross sectional.
Patients seen at a multisurgeon spine specialty clinic.
Oswestry Disability Index, EQ-5D, and Numeric Rating Scales (0-10) for back and leg pain.
The Newest Vital Sign (NVS) and Health Literacy Survey, Oswestry Disability Index, EQ-5D and pain scales were administered to patients undergoing evaluation and treatment for lumbar degenerative disease in the outpatient setting. Patients were surveyed regarding their use of medication, therapy, and pain management modalities.
Of 201 patients approached for participation, 186 completed the health literacy surveys. Thirty (17%) were assessed as having limited literacy, 52 (28%) as possibly having limited literacy and 104 (56%) having adequate literacy based on their NVS scores. The cohort with low NVS scores also had low Health Literacy Survey Scores. Patients with limited literacy had worse back and leg pain scores compared with patients with possibly limited literacy and adequate literacy. Patients with adequate health literacy were more likely to use medications (80% vs. 53%, p = .017) and were more likely to see a specialist (34% vs. 17%) compared with those with limited literacy. Patients with limited health literacy were not more likely to see a chiropractor (7% vs. 7%), but reported more visits (19 vs. 8).
Patients with lower health literacy reported worse back and leg pain scores, indicating either more severe disease or a fundamental difference in their responses to standard health-related quality of life measures. This study also suggests that patients with limited health literacy may underutilize some resources and overutilize other resources. Further study is needed to clarify these patterns, and to examine their impact on health status and clinical outcomes.
健康素养是指“个体获取、处理和理解基本健康信息和服务以做出适当健康决策的能力”，已被证明会影响获得医疗保健的机会和适当的医疗保健利用。
确定健康素养在评估和管理慢性下背痛患者中的影响。
横断面研究。
在多外科医生脊柱专科诊所就诊的患者。
Oswestry 残疾指数、EQ-5D 和背部和腿部疼痛的数字评分量表（0-10）。
在门诊环境下，对接受腰椎退行性疾病评估和治疗的患者进行了最新生命体征（NVS）和健康素养调查、Oswestry 残疾指数、EQ-5D 和疼痛量表的评估。调查了患者对药物、治疗和疼痛管理方式的使用情况。
在 201 名接受参与评估的患者中，有 186 名完成了健康素养调查。根据 NVS 评分，30 名（17%）患者被评估为具有有限的读写能力，52 名（28%）患者可能具有有限的读写能力，104 名（56%）患者具有足够的读写能力。NVS 评分较低的患者的腰背疼痛评分也较差。与可能具有有限读写能力和足够读写能力的患者相比，读写能力有限的患者腰背疼痛评分更差。具有足够健康素养的患者更有可能使用药物（80%对 53%，p=0.017），并且更有可能看专科医生（34%对 17%），而读写能力有限的患者则不然。具有有限健康素养的患者看脊医的可能性没有更高（7%对 7%），但就诊次数更多（19 次对 8 次）。
健康素养较低的患者报告的腰背疼痛评分更差，这表明他们的疾病更严重，或者对标准健康相关生活质量测量的反应存在根本差异。本研究还表明，读写能力有限的患者可能没有充分利用一些资源，而过度利用其他资源。需要进一步研究来阐明这些模式，并检查它们对健康状况和临床结果的影响。
