Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C.
Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan, R.O.C.
Health Soc Care Community. 2019 Sep;27(5):e724-e733. doi: 10.1111/hsc.12791. Epub 2019 Jun 18.
The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community-dwelling elderly participants. This cross-sectional study enrolled 990 community-dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer-administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.
本研究旨在探讨健康素养与社区居住老年人临终关怀知识、态度和决策之间的关系。本横断面研究纳入了三个住宅区的 990 名社区居住老年人，平均年龄为 71.53±7.22 岁。健康素养使用简体中文版欧洲健康素养调查问卷进行评估。采用访谈者管理的问卷评估对临终关怀的知识、态度和决策。使用偏最小二乘法进行数据分析。超过一半的受访者对临终关怀有足够的了解（60.7%），对临终关怀持积极的态度（77.3%）和积极的决策（85%）。在结构方程模型中，一般健康素养正向预测临终关怀知识（β=0.73，p<0.001）、态度（β=0.06，p=0.038）和决策（β=0.14，p<0.001）。一般健康素养对临终关怀决策的总体影响（β=0.57）大于对临终关怀知识的影响（β=0.54）。此外，疾病预防健康素养对临终关怀决策的影响（β=0.59）也高于对临终关怀知识的影响（β=0.53）。健康素养与临终关怀知识、态度和决策有关。建议将健康素养干预措施纳入临终关怀推广策略中。
