Carol J. Howe is the Paula R. and Ronald C. Parker Endowed Professor in Nursing and an associate professor at the Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth. Tracine Adame is director of research and clinical innovation at Medical City Dallas/Medical City Children's Hospital, Dallas. Brennan Lewis is director of patient education and engagement at Children's Health, Children's Medical Centers in Dallas and Plano. Teresa Wagner is an assistant professor at the University of North Texas Health Science Center, Fort Worth. Contact author: Carol J. Howe,
Am J Nurs. 2020 Dec;120(12):24-33. doi: 10.1097/01.NAJ.0000723424.47838.4d.
In 2012, the Institute of Medicine Roundtable on Health Literacy established 10 attributes of a health literate health care organization that, if instated, would improve health information and empower patients to make more informed health decisions. Few studies have assessed how well organizations meet these attributes.
This study sought to describe the extent to which health care systems in North Texas were adopting policies and practices that address the 10 attributes of a health literate health care organization. More specifically, we sought to describe key organizational leaders' and clinicians' perceptions in this regard.
This was a mixed-methods study, conducted with a convenience sample of 74 key informants from 13 hospitals across five health care systems. Informants provided demographic data, and their perceptions of the extent to which their hospital met the 10 attributes were measured via the Health Literate Health Care Organization 10-item questionnaire (HLHO-10) and semistructured interviews.
Mean scores for HLHO-10 items ranged from 3.74 to 5.39, with 7 as a maximum score. Qualitative data provided richer content, elaborating on the survey results. Workforce training in health literacy, patient inclusion in health information development and evaluation, and communication about health care costs were rated the lowest and were described as issues of concern.
Study findings indicated limited leadership and little systemic promotion of efforts to ensure health literate health care organizations, although individual health literacy champions sometimes stepped up with creative initiatives.
2012 年,医学研究所健康素养圆桌会议确立了 10 项医疗卫生机构的健康素养属性,如果实施这些属性,将改善健康信息,并使患者能够做出更明智的健康决策。很少有研究评估组织在多大程度上符合这些属性。
本研究旨在描述北德克萨斯州的医疗系统在采用哪些政策和实践来解决医疗卫生机构的 10 项健康素养属性。更具体地说,我们试图描述主要组织领导人和临床医生在这方面的看法。
这是一项混合方法研究,对来自五个医疗系统的 13 家医院的 74 名关键信息提供者进行了便利抽样。信息提供者提供了人口统计学数据,并通过健康素养医疗卫生机构 10 项问卷(HLHO-10)和半结构化访谈来评估他们的医院在多大程度上符合 10 项属性的看法。
HLHO-10 项目的平均得分范围为 3.74 至 5.39,最高得分为 7。定性数据提供了更丰富的内容,详细阐述了调查结果。卫生素养方面的劳动力培训、患者参与卫生信息的制定和评估,以及医疗费用的沟通,这些都被评为得分最低,被认为是关注的问题。
研究结果表明,尽管有时个别卫生素养拥护者会提出有创意的倡议,但领导层在系统地推动确保卫生素养医疗卫生机构方面的领导作用有限。