健康素养在糖尿病知识、自我护理和血糖控制中的作用：一项荟萃分析。
The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis.
机构信息
Faculty of Communication Sciences, Institute of Communication and Health, Università della Svizzera italiana, Via Giuseppe Buffi 13, 6904, Lugano, Switzerland.
出版信息
J Gen Intern Med. 2019 Jun;34(6):1007-1017. doi: 10.1007/s11606-019-04832-y. Epub 2019 Mar 15.
BACKGROUND
Empirical evidence on how health literacy affects diabetes outcomes is inconsistent. The purpose of this meta-analysis was to quantitatively summarize the findings on the associations between health literacy and diabetes knowledge, self-care activities, and glycemic control as disease-related outcomes, with specific focus on the type of health literacy assessment.
DATA SOURCES
Nine databases (MEDLINE, CINAHL, Communication and Mass Media Complete, PsychInfo, PsychArticles, Psychology and Behavioral Sciences Collection, ERIC, Sociology, Embase) were searched for peer-reviewed original research articles published until 31 March 2018.
METHODS
Studies with type 1 and/or type 2 diabetes patients aged 18 or older, providing a calculable baseline effect size for functional health literacy and diabetes knowledge, self-care activities, or HbA1C were included.
RESULTS
The meta-analysis includes 61 studies with a total of 18,905 patients. The majority were conducted in the USA, on type 2 diabetes patients, and used the S-TOFHLA as a performance-based or the BHLS as a perception-based measure of functional health literacy. Meta-analytic results show that all three outcomes are related to health literacy. Diabetes knowledge was best predicted by performance-based health literacy measures, self-care by self-report measures, and glycemic control equally by both types of health literacy assessment.
DISCUSSION
Health literacy plays a substantial role in diabetes knowledge. Findings for the role of health literacy in self-care and glycemic control remain heterogeneous, partly due to the type of health literacy assessment (performance- vs. perception-based). This has implications for the use of health literacy measures in clinical settings and original research. This meta-analysis was limited to functional health literacy and, due to the paucity of studies, did not investigate the role of other dimensions including communicative and critical health literacy.
背景
健康素养如何影响糖尿病结局的实证证据并不一致。本荟萃分析的目的是定量总结健康素养与糖尿病知识、自我护理活动和血糖控制（作为与疾病相关的结局）之间关联的研究结果，并特别关注健康素养评估的类型。
资料来源
检索了 9 个数据库（MEDLINE、CINAHL、Communication and Mass Media Complete、PsychInfo、PsychArticles、Psychology and Behavioral Sciences Collection、ERIC、Sociology、Embase），以获取截至 2018 年 3 月 31 日发表的同行评议原始研究文章。
方法
纳入了年龄在 18 岁及以上的 1 型和/或 2 型糖尿病患者的研究，这些研究提供了可计算的功能健康素养与糖尿病知识、自我护理活动或 HbA1C 的基线效应量。
结果
荟萃分析包括 61 项研究，共纳入 18905 例患者。这些研究大多在美国进行，针对 2 型糖尿病患者，且使用 S-TOFHLA 作为基于表现的或 BHLS 作为基于感知的功能健康素养测量。荟萃分析结果表明，所有三种结局都与健康素养相关。糖尿病知识最好由基于表现的健康素养测量来预测，自我护理由自我报告的测量来预测，而血糖控制则由两种类型的健康素养评估同样预测。
讨论
健康素养在糖尿病知识中起着重要作用。健康素养在自我护理和血糖控制中的作用的研究结果仍然存在异质性，部分原因是健康素养评估的类型（基于表现的与基于感知的）。这对临床环境中健康素养测量的使用和原始研究有影响。本荟萃分析仅限于功能健康素养，由于研究数量较少，因此没有调查包括沟通和批判健康素养在内的其他维度的作用。
Zotero 插件