Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden.
Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden.
Drug Alcohol Depend. 2020 Sep 1;214:108186. doi: 10.1016/j.drugalcdep.2020.108186. Epub 2020 Jul 22.
Poor health and unmet healthcare needs is common among people with substance use disorder (SUD) including patients in opioid substitution treatment (OST). Low health literacy (HL) is associated with poverty, low education and physical limitations, but is unexplored in an OST context.
Mixed-methods were used. Participants were consecutively recruited by clinic staff or researcher, from five OST clinics in Malmö, Sweden, during September - November 2019. HL level was measured through HLS-EU-Q16 (n?=?286). Self-reported socioeconomic correlates of HL were analyzed through logistic regression. Patients' experiences of HL-related problems were assessed through six focus group interviews (n?=?23) moderated by an OST employee.
While 46% had sufficient HL (13-16 points of maximum 16), 32% did not receive a HL score due to too many missing answers. No correlates of sufficient HL level were found. Missing HL level was associated with low educational attainment (Ajusted odds ratio [AOR] 1.94; 95% Confidence interval [CI] 1.13-3.32) and negatively associated with employment (AOR 0.28; 95% CI 0.11-0.71). Qualitative data revealed a diversity in participants' self-assessed capabilities, and problems associated with access, comprehension, trust and dependency on addiction-specific services.
This study highlights that HL level is low, and identifies a number of concrete problems related to HL in the studied population. The results implicate a need for tailored interventions regarding health information among OST patients.
患有物质使用障碍（SUD）的人，包括接受阿片类药物替代治疗（OST）的患者，普遍健康状况不佳且无法满足医疗需求。健康素养（HL）较低与贫困、低教育水平和身体限制有关，但在 OST 环境中尚未得到探索。
采用混合方法。2019 年 9 月至 11 月，研究人员在瑞典马尔默的五家 OST 诊所通过诊所工作人员或研究人员连续招募参与者。使用 HLS-EU-Q16 （n？=？286）来测量 HL 水平。通过逻辑回归分析 HL 与自我报告的社会经济相关性。通过由 OST 员工主持的六次焦点小组访谈（n？=？23）评估患者与 HL 相关问题的体验。
虽然 46%的人具有足够的 HL（13-16 分中的 16 分），但由于太多答案缺失，32%的人未获得 HL 评分。没有发现与足够 HL 水平相关的因素。缺失 HL 评分与教育程度较低相关（调整后的优势比 [AOR] 1.94；95%置信区间 [CI] 1.13-3.32），与就业呈负相关（AOR 0.28；95% CI 0.11-0.71）。定性数据显示，参与者对自身能力的自我评估存在差异，并且与获取、理解、信任和依赖成瘾特定服务相关的问题。
本研究表明 HL 水平较低，并确定了在研究人群中与 HL 相关的一些具体问题。结果表明，OST 患者需要针对健康信息进行有针对性的干预。
