EngageMinds Hub - Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, L.go Agostino Gemelli 1, 20143 Milano, Italy.
Int J Environ Res Public Health. 2020 Mar 7;17(5):1741. doi: 10.3390/ijerph17051741.
Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL; hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients in becoming more and more engaged in their healthcare, thus augmenting their literacy skills. Our main hypothesis is that the well-known relationship between patients' perceived autonomy supportive healthcare climate and HL skills is mediated by the Patient Health Engagement Model (PHE-model) which describes the patients' progressive maturation of a psychological readiness to become active players in their healthcare. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking an autonomy-supportive healthcare climate to PHE-model and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of the PHE-model between autonomy-supportive healthcare climate and HL. Results show that the theoretical model has a good fit indexes and that PHE-model fully mediates the relationship between autonomy-supportive healthcare climate and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.
个体健康素养水平较低（HL）与健康素养水平较高的个体相比，其健康结果更差，死亡率更高；因此，提高 HL 是现代医疗保健系统的关键结果。因此，医疗保健提供者被要求支持患者更多地参与他们的医疗保健，从而提高他们的读写能力。我们的主要假设是，患者感知到的自主支持医疗保健环境与 HL 技能之间的众所周知的关系是由描述患者在心理上逐渐准备好成为其医疗保健积极参与者的患者健康参与模型（PHE 模型）介导的。本研究的目的是制定一个假设的结构方程模型（SEM），将自主支持的医疗保健环境与 PHE 模型和 HL 联系起来。采用横断面调查设计，涉及 1007 名意大利慢性患者。使用 SEM 测试假设模型，以验证 PHE 模型在自主支持的医疗保健环境与 HL 之间的中介作用。结果表明，理论模型具有良好的拟合指标，并且 PHE 模型完全介导了自主支持的医疗保健环境与 HL 之间的关系。这一发现表明医疗保健系统需要实施一种新的模式，即支持患者在自己的医疗保健中发挥自主作用。
