Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany.
Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne, Cologne, Germany.
Int J Soc Psychiatry. 2020 Feb;66(1):10-22. doi: 10.1177/0020764019873683. Epub 2019 Sep 14.
Health literacy (HL) is considered a key concept to positively address relevant decisions concerning physical and mental health. According to an integrated model of a European Consortium, the process to access, understand, appraise and apply health information is at the centre of practising HL.
In this study, we examine HL in a population with an early onset of a mental disorder (MD).
Results are based on a cross-sectional survey among people with MD ( = 310) who sought help at an early detection centre for MD in Cologne, Dresden or Munich. Help-seekers filled out the European Health Literacy Survey questionnaire (HLS-EU-Q) on perception-based HL, socio-demographic data and general health status. Psychopathology was assessed separately by trained specialists. Data are compared with a representative sample of the German population.
Overall, HL was lower in a sample with MD compared with the general population. Disease-specific limitations were present in accessing, appraising and applying health information, whereas understanding was perceived fairly easy. Statistical analysis of limited HL revealed correlations with the diagnosis of affective disorders and anxiety disorders, an increase of depressive symptoms as well as the presence of more than one MD. In line with these findings, low levels of HL were associated with a worse general health status.
In a population with MD, accessing, appraising and applying health information seemed to be particularly challenging. Therefore, educational programmes that mainly focus on increasing knowledge might not be sufficient for improving the HL in people with MD. Further research should concentrate on context-specific HL to foster behavioural change and improve overall health.
健康素养（HL）被认为是积极解决与身心健康相关决策的关键概念。根据一个欧洲联盟的综合模型，获取、理解、评估和应用健康信息的过程是实践 HL 的核心。
本研究旨在考察早期发病的精神障碍（MD）人群的 HL。
结果基于在科隆、德累斯顿或慕尼黑的 MD 早期发现中心寻求帮助的 MD 患者（ = 310）的横断面调查。求助者填写了基于感知的 HL、社会人口统计学数据和一般健康状况的欧洲健康素养调查问卷（HLS-EU-Q）。精神病理学由经过培训的专家单独评估。数据与德国人口的代表性样本进行比较。
总体而言，与一般人群相比，MD 患者的 HL 较低。在获取、评估和应用健康信息方面存在特定于疾病的限制，而理解则被认为相对容易。对有限 HL 的统计分析显示，与情感障碍和焦虑障碍的诊断、抑郁症状的增加以及存在多种 MD 相关。与这些发现一致，HL 水平较低与一般健康状况较差相关。
在 MD 患者人群中，获取、评估和应用健康信息似乎特别具有挑战性。因此，主要侧重于增加知识的教育计划可能不足以提高 MD 患者的 HL。进一步的研究应集中在特定于情境的 HL 上，以促进行为改变和改善整体健康。
