Fernández-González Loreto, Bravo-Valenzuela Paulina
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
Nursing School, Pontificia Universidad Catolica de Chile, Santiago 7820436, Chile.
Ecancermedicalscience. 2019 Oct 10;13:966. doi: 10.3332/ecancer.2019.966. eCollection 2019.
Health literacy (HL) refers to the cognitive and social abilities that are determinants in the motivation and capacity of the individual to access, understand and use information for the care of one's own health. In oncology, increased survival, navigation of the healthcare system, the many different forms of treatment and the management of adverse effects/outcomes make HL a critical factor in patient care. The objective of this study is to identify the structure, content and effectiveness of interventions to improve HL in cancer patients.
A literature review was performed using the '(health literacy OR Cancer Literacy) AND Cancer AND Intervention' strategy on seven multidisciplinary databases. Studies that intervened in subjects diagnosed with cancer and treating HL explicitly as a variable to be measured were included.
One thousand two hundred and thirty-six abstracts were retrieved. Eight studies met the inclusion criteria. Research focused on patients diagnosed with breast cancer or prostate cancer. Interventions used multimedia resources and face-to-face interactions. No study defined HL. HL was usually a secondary outcome. There is high variability in the design of studies and interventions and in the instruments used to measure HL. The effectiveness of the interventions varied between studies, with improvements that were diminished over time or insufficient in participants with initial low literacy.
The evidence to date in interventions oriented to study HL in patients with cancer is focused on other constructs, leaving HL as a phenomenon difficult to define both conceptually and clinically. Variability in designs and measurements makes comparison between interventions difficult. Defining and operationalizing HL is critical to design and measure effective interventions, which must be adapted to patients' needs.
健康素养（HL）是指个人获取、理解和使用信息以维护自身健康的动机和能力的认知及社会能力的决定因素。在肿瘤学领域，提高生存率、在医疗体系中顺利就医、应对多种不同治疗方式以及管理不良反应/结果使得健康素养成为患者护理中的关键因素。本研究的目的是确定改善癌症患者健康素养的干预措施的结构、内容和效果。
采用“（健康素养或癌症素养）与癌症与干预”策略在七个多学科数据库中进行文献综述。纳入对被诊断患有癌症的受试者进行干预并将健康素养明确作为一个待测量变量的研究。
检索到1236篇摘要。八项研究符合纳入标准。研究主要聚焦于被诊断患有乳腺癌或前列腺癌的患者。干预措施使用了多媒体资源和面对面互动。没有研究对健康素养进行定义。健康素养通常是次要结果。研究和干预措施的设计以及用于测量健康素养的工具存在很大差异。不同研究中干预措施的效果各不相同，随着时间推移改善效果减弱，或者初始健康素养较低的参与者改善不足。
迄今为止，针对癌症患者健康素养研究的干预措施的证据主要集中在其他结构方面，使得健康素养在概念和临床层面都难以定义。设计和测量方面的差异使得不同干预措施之间难以比较。定义和实施健康素养对于设计和测量有效的干预措施至关重要，这些干预措施必须适应患者的需求。
