考察健康素养和数算能力与前列腺相关知识和前列腺癌治疗后悔的关联。
Examining the association of health literacy and numeracy with prostate-related knowledge and prostate cancer treatment regret.
机构信息
Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Department of Urology, Mayo Clinic, Rochester, MN.
出版信息
Urol Oncol. 2020 Aug;38(8):682.e11-682.e19. doi: 10.1016/j.urolonc.2020.04.007. Epub 2020 May 21.
INTRODUCTION
Educational materials used in prostate cancer shared decision-making are often written above the health literacy levels of the patients that may benefit the most from such tools. Poor understanding the oncologic and functional outcomes of prostate cancer treatment may influence patient regret during this process. In this study, we assess the association between health literacy, numeracy, prostate-related knowledge and treatment regret in a diverse population.
MATERIALS AND METHODS
Patients obtaining care between June and August of 2016 at both community-based and academic tertiary care facilities were assessed for health literacy and numeracy using validated instruments. Prostate knowledge was tested in those patients without a history of prostate cancer using a 29-item questionnaire and patient-level predictors of knowledge were assessed. Prostate cancer treatment regret was assessed in those patients who had a history of prostate cancer.
RESULTS
A total of 90 patients were enrolled, 38 (42%) of whom had a history of prostate cancer. African American race (I = 0.039), financial strain (P < 0.001), and educational attainment (P < 0.001) were all associated with lower health literacy on multivariable analysis. Possessing a professional degree (P = 0.021) and higher health literacy (P = 0.001) were associated with greater prostate-related knowledge. Of those with a history of prostate cancer, 9 (24%) expressed treatment regret. Patients with regret were more likely to be African American (n = 6, 66.7% vs. 5, 17.2%, P = 0.004), not married (P = 0.016), and score lower on the literacy (1.0 vs. 8.0, P = 0.009) and numeracy (10.0 vs. 16.0, P = 0.016) scales.
CONCLUSIONS
We identified lower health literacy among African American men, and lower prostate-related knowledge in those with poor health literacy. To our knowledge, this is the first study to show an association between health literacy and prostate cancer treatment regret.
简介
在前列腺癌的共同决策中使用的教育材料通常高于最能从这些工具中受益的患者的健康素养水平。对前列腺癌治疗的肿瘤学和功能结果理解不佳可能会影响患者在这一过程中的遗憾。在这项研究中，我们评估了在不同人群中健康素养、计算能力、前列腺相关知识和治疗遗憾之间的关系。
材料和方法
2016 年 6 月至 8 月期间，在社区和学术三级保健机构接受治疗的患者使用经过验证的工具评估健康素养和计算能力。在没有前列腺癌病史的患者中，使用 29 项问卷测试前列腺知识，并评估患者水平的知识预测因素。对有前列腺癌病史的患者评估前列腺癌治疗遗憾。
结果
共纳入 90 例患者，其中 38 例（42%）有前列腺癌病史。非洲裔美国人（I = 0.039）、经济紧张（P < 0.001）和教育程度（P < 0.001）在多变量分析中均与较低的健康素养相关。拥有专业学位（P = 0.021）和较高的健康素养（P = 0.001）与更大的前列腺相关知识相关。在有前列腺癌病史的患者中，有 9 例（24%）表示治疗遗憾。有遗憾的患者更可能是非洲裔美国人（n = 6，66.7%比 5，17.2%，P = 0.004）、未婚（P = 0.016），并且在文化程度（1.0 比 8.0，P = 0.009）和计算能力（10.0 比 16.0，P = 0.016）评分上得分较低。
结论
我们发现非洲裔美国男性的健康素养较低，而健康素养较低的患者的前列腺相关知识较低。据我们所知，这是第一项表明健康素养与前列腺癌治疗遗憾之间存在关联的研究。
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