Chang Michelle E, Baker Samantha J, Dos Santos Marques Isabel C, Liwo Amandiy N, Chung Sebastian K, Richman Joshua S, Knight Sara J, Fouad Mona N, Gakumo C Ann, Davis Terry C, Chu Daniel I
Health Lit Res Pract. 2020 Feb 11;4(1):e46-e65. doi: 10.3928/24748307-20191121-01.
Low health literacy is associated with poor health outcomes in many chronic diseases and may have an important role in determining surgical outcomes. This study aims to comprehensively review the current state of science on adult health literacy in surgery and to identify knowledge gaps for future research.
Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search was conducted to identify all studies from January 2002 through May 2018 that used validated instruments to assess health literacy among adult patients undergoing surgery. Studies were assessed for quality using the Newcastle-Ottawa scale and evaluated on findings by their focus on identifying health literacy levels, understanding associations with surgical outcomes, and/or developing interventions to address low health literacy.
There were 51 studies on health literacy with data from 22,139 patients included in this review. Low health literacy was present in more than one-third of surgical patients (34%, interquartile range 16%-50%). The most commonly used validated instrument for assessment of health literacy in the surgical population was the Newest Vital Sign. Most studies were focused on identifying the prevalence of low health literacy within a surgery population (84%, n = 43). Few studies focused on understanding the association of health literacy to surgical outcomes (12%, n = 6) and even fewer studies developed interventions to address health literacy (4%, n = 2).
Low health literacy is common among surgical patients. Important opportunities exist to better understand the role of health literacy in determining surgical outcomes and to develop more health literacy-sensitive models of surgical care. [HLRP: Health Literacy Research and Practice. 2020;4(1):e45-e65.] PLAIN LANGUAGE SUMMARY: Health literacy has not been well-studied in surgery but likely plays an important role. In this article, we reviewed all current research on health literacy in surgery to help us understand where we are at and where we need to go. We found that low health literacy is common and we need more ways to address it in surgery.
健康素养低下与许多慢性病的不良健康结局相关，并且在决定手术结局方面可能起重要作用。本研究旨在全面综述目前关于手术中成人健康素养的科学现状，并确定未来研究的知识空白。
采用PRISMA（系统评价和Meta分析的首选报告项目）指南，进行系统检索，以识别2002年1月至2018年5月期间所有使用经过验证的工具评估接受手术的成年患者健康素养的研究。使用纽卡斯尔-渥太华量表评估研究质量，并根据其对确定健康素养水平、理解与手术结局的关联和/或制定解决低健康素养问题的干预措施的关注程度对研究结果进行评估。
本综述纳入了51项关于健康素养的研究，数据来自22139名患者。超过三分之一的手术患者存在健康素养低下的情况（34%，四分位间距16%-50%）。手术人群中评估健康素养最常用的经过验证的工具是《最新生命体征》。大多数研究集中于确定手术人群中健康素养低下的患病率（84%，n = 43）。很少有研究关注理解健康素养与手术结局的关联（12%，n = 6），更少的研究制定了解决健康素养问题的干预措施（4%，n = 2）。
健康素养低下在手术患者中很常见。存在重要机遇来更好地理解健康素养在决定手术结局中的作用，并开发对健康素养更敏感的手术护理模式。[《健康素养研究与实践》。2020；4(1):e45-e65。]
健康素养在手术领域尚未得到充分研究，但可能发挥重要作用。在本文中，我们综述了目前所有关于手术中健康素养的研究，以帮助我们了解现状和未来方向。我们发现健康素养低下很常见，并需要更多方法来在手术中解决这一问题。
