School of Nursing, Queensland University of Technology, Brisbane, Australia.
Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia.
BMC Health Serv Res. 2019 Jul 26;19(1):523. doi: 10.1186/s12913-019-4335-3.
Health literacy is strongly associated with health outcomes and is important for health policy and service delivery. Low health literacy was reported in 59% of Australian adults, however, there is no national data on the health literacy of Aboriginal and Torres Strait Islander (ATSI) peoples. The ATSI population in Australia experience a notable gap in health outcomes compared with non-Indigenous Australians which is due, in part to a higher prevalence of chronic diseases. The health outcome gap is more pronounced in rural and remote locations. This study aims to establish the health literacy profile of ATSI adults with chronic disease living in remote North-West Queensland Australia, and to investigate associations between the Health Literacy Questionnaire (HLQ) domains and self-reported chronic disease and demographic characteristics.
Using a cross-sectional design, 200 ATSI adults with a diagnosis of chronic disease/s (cardiovascular disease, diabetes, respiratory disease and/or chronic kidney disease) were recruited from two sites with the assistance of Aboriginal Health Workers. Data were collected using the HLQ, a multidimensional 44 item instrument to assess nine domains of health literacy. Demographic and health data were also collected. Analysis of variance using backwards modelling was used to determine predictors of health literacy.
Participants were mostly male (53.5%) and aged between 19 and 89 years. The most prevalent chronic disease was cardiovascular disease (74%) followed by diabetes (67.5%). More than half (62%) had two or more chronic diseases. There was at least one independent predicator for each of the nine health literacy domains. Age, number of chronic diseases, gender, and level of education were all highly significant predictors of health literacy.
Improved health literacy will enable individuals to take an active role in their health. Understanding the health literacy of ATSI adults is a crucial first step. Our findings can assist Australian healthcare organisations to review their health literacy responsiveness and examine ways to improve patients' needs and health capabilities to better support people to engage in effective self-management for chronic diseases.
健康素养与健康结果密切相关，对卫生政策和服务提供具有重要意义。报告称，澳大利亚 59%的成年人健康素养水平较低，但是，目前尚无关于澳大利亚原住民和托雷斯海峡岛民（ATSI）人群健康素养的全国数据。与非原住民澳大利亚人相比，澳大利亚的 ATSI 人群在健康结果方面存在明显差距，部分原因是慢性病的患病率较高。在农村和偏远地区，健康结果差距更为明显。本研究旨在确定居住在澳大利亚西北部偏远地区的患有慢性病的 ATSI 成年人的健康素养状况，并调查健康素养问卷（HLQ）各领域与自我报告的慢性病和人口统计学特征之间的关联。
本研究采用横断面设计，在两名土著卫生工作者的协助下，从两个地点招募了 200 名患有慢性疾病（心血管疾病、糖尿病、呼吸疾病和/或慢性肾病）的 ATSI 成年人。使用 HLQ 收集数据，HLQ 是一种多维的 44 项工具，用于评估健康素养的九个领域。还收集了人口统计学和健康数据。采用向后建模的方差分析来确定健康素养的预测因素。
参与者主要为男性（53.5%），年龄在 19 至 89 岁之间。最常见的慢性病是心血管疾病（74%），其次是糖尿病（67.5%）。超过一半（62%）的人患有两种或更多种慢性病。九个健康素养领域中的每一个都至少有一个独立的预测因素。年龄、慢性病数量、性别和教育水平都是健康素养的高度显著预测因素。
提高健康素养将使个人能够积极参与自身健康。了解 ATSI 成年人的健康素养是至关重要的第一步。我们的研究结果可以帮助澳大利亚医疗机构审查其健康素养响应能力，并研究改善患者需求和健康能力的方法，以更好地支持人们有效地管理慢性病。
