Gundling Felix, Parasiris Paris, Bunz Anna-Lena, Sohn Maximilian, Haller Bernhard, Schepp Wolfgang, Mühling Tobias
Klinik für Gastroenterologie, Hepatologie, Gastroenterologische Onkologie, Klinikum Bogenhausen, Städtisches Klinikum München GmbH.
Klinik für Herzchirurgie, Klinikum Bogenhausen, Städtisches Klinikum München GmbH.
Dtsch Med Wochenschr. 2019 Feb;144(4):e21-e29. doi: 10.1055/a-0758-0647. Epub 2019 Feb 13.
Systematic investigations of health literacy in German patients are rare and mostly based on subjective self-assessment.
In a cross-sectional survey, 196 patients (female 38 %, male 62 %) in medical and surgical units were asked to complete a questionnaire that we had developed for this purpose. This questionnaire contained 43 questions about common medical terms. We investigated whether patients were familiar with these terms and could name the meaning according to correct definition. Furthermore, the association with the patients' socio-economic and demographic parameters (e. g. education, insurance status, utilization of media) was analyzed.
Among all questions of the questionnaire, more patients claimed to know their meaning than this was the case by objective testing. Association of medical knowledge with demographic and socio-economic data revealed that correct answers were more frequent among women compared to men (51.1 % vs. 47.2 %; p = 0.12). Patients' age was negatively correlated with medical knowledge (p < 0.001). Higher educational level was associated with a higher percentage of correct answers (p < 0.001). Private insurance status had significant influence on medical knowledge (p = 0.002). Male patients working intellectually (compared to working physically) had a higher percentage of correct answers (p = 0.001). Other factors like reading newspapers, watching TV and number of consultations per year did not influence the percentage of correct answers.
Physicians should make sure by active inquiries whether the patient understands them correctly. Furthermore, there is a considerable gap between subjective and objective medical knowledge that future evaluations of health literacy should be aware of.
对德国患者健康素养的系统调查很少见，且大多基于主观自我评估。
在一项横断面调查中，我们要求医疗和外科科室的196名患者（女性占38%，男性占62%）填写为此目的而编制的问卷。该问卷包含43个关于常见医学术语的问题。我们调查了患者是否熟悉这些术语，并能否根据正确定义说出其含义。此外，还分析了与患者社会经济和人口统计学参数（如教育程度、保险状况、媒体使用情况）之间的关联。
在问卷的所有问题中，声称知道其含义的患者比客观测试的情况更多。医学知识与人口统计学和社会经济数据的关联显示，女性的正确答案比男性更频繁（51.1%对47.2%；p = 0.12）。患者年龄与医学知识呈负相关（p < 0.001）。较高的教育水平与较高的正确答案百分比相关（p < 0.001）。私人保险状况对医学知识有显著影响（p = 0.002）。从事脑力工作的男性患者（与从事体力工作相比）正确答案的百分比更高（p = 0.001）。其他因素，如阅读报纸、看电视和每年的就诊次数，对正确答案的百分比没有影响。
医生应通过积极询问确保患者正确理解他们。此外，主观和客观医学知识之间存在相当大的差距，未来健康素养评估应予以关注。
