Huntsman Cancer Institute and Department of Communication, University of Utah, Salt Lake City, UT, USA.
Memorial Sloan Kettering Cancer Center, New York, USA.
Patient Educ Couns. 2021 Jan;104(1):12-19. doi: 10.1016/j.pec.2020.07.019. Epub 2020 Aug 1.
Few studies have examined how health literacy impacts responses to genetic information.
We examined this issue among 145 English or Spanish-speaking adult primary care patients enrolled in a trial that offered testing for MC1R gene variants that confer moderately increased melanoma risk. We investigated whether health literacy skills, educational attainment, or melanoma risk were related to short-term cognitive and affective responses to genetic test results.
On average, participants found the test results to be highly believable and clear, with low levels of negative emotional responses and moderate levels of positive responses. In adjusted models, health literacy skills were significantly inversely associated with confusion (OR = 0.75, 95 % CI = 0.58, 0.96); those with higher education thought significantly less about their test results (β = -0.66), were less hopeful (β = -0.89), and had lower distress (β = -1.15). We also observed a significant interaction (p < .001) between health literacy and melanoma risk in affecting the frequency of thoughts about test results.
The findings indicate that health literacy skills may affect to what extent individuals elaborate cognitively on genetic information.
Patients with lower health literacy skills or education may need support in understanding genetic test results.
很少有研究探讨健康素养如何影响对遗传信息的反应。
我们在一项试验中调查了这个问题，该试验为 MC1R 基因变体检测提供了服务，这些变体增加了中度增加的黑色素瘤风险。我们调查了健康素养技能、教育程度或黑色素瘤风险是否与对遗传测试结果的短期认知和情感反应有关。
平均而言，参与者发现测试结果高度可信且清晰，负面情绪反应水平较低，正面反应水平中等。在调整后的模型中，健康素养技能与困惑呈显著负相关（OR=0.75，95%CI=0.58，0.96）；受教育程度较高的人认为他们的测试结果显著减少（β=-0.66），希望减少（β=-0.89），焦虑减少（β=-1.15）。我们还观察到健康素养和黑色素瘤风险之间存在显著的交互作用（p<.001），影响对测试结果的思考频率。
这些发现表明，健康素养技能可能会影响个体对遗传信息进行认知加工的程度。
健康素养技能或教育程度较低的患者可能需要支持，以帮助他们理解遗传测试结果。
