一项关于健康素养的交流——在丹麦市立医疗中心使用对话式健康素养评估工具（CHAT）的定性可行性研究。
A CHAT about health literacy - a qualitative feasibility study of the Conversational Health Literacy Assessment Tool (CHAT) in a Danish municipal healthcare centre.
机构信息
Department of Public Health, Aarhus University, Aarhus, Denmark.
Health Promotion, Steno Diabetes Centre Copenhagen, Gentofte, Denmark.
出版信息
Scand J Caring Sci. 2021 Dec;35(4):1250-1258. doi: 10.1111/scs.12943. Epub 2020 Dec 13.
BACKGROUND
Understanding individual health literacy needs is crucial when designing supportive and effective health care. However, tools assessing health literacy in practice are lacking. The Conversational Health Literacy Assessment Tool (CHAT) was recently developed, but its ability to assess health literacy remains unexplored. We aimed to investigate the implementation and adoption of CHAT, its ability to increase awareness of health literacy among healthcare providers, and if CHAT could assess health literacy needs in patients.
METHODS
We performed a qualitative feasibility study of CHAT among healthcare providers (nurses, physiotherapists and occupational therapists) who provide rehabilitation services for patients with noncommunicable diseases in a municipal healthcare centre in Denmark. The study used the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to structure interview guide and analysis. We collected qualitative data from four small focus groups with healthcare providers (n = 11). The data were analysed using a deductive thematic three-step method for organising and interpreting data. All informants provided written informed consent prior to data collection.
RESULTS
CHAT seems to be a feasible and efficient tool for assessing health literacy needs among individuals with different socio-demographic characteristics and with different diagnoses. CHAT was easiest implemented and adopted by healthcare providers, who were already familiarly with the concept of health literacy. The informants emphasised that an introduction to CHAT and health literacy as concept was valuable for the adoption. Some of them felt frustrated that they did not have opportunity and options to meet the health literacy needs identified by CHAT.
CONCLUSIONS
CHAT is a promising tool for assessing individual health literacy needs and increasing awareness of health literacy among healthcare providers. For successfully implementation of CHAT, we recommend developing a structured implementation programme, including an introduction to health literacy and an outline of the options for acting upon CHAT results.
背景
在设计支持性和有效的医疗保健时，了解个人健康素养需求至关重要。然而，目前缺乏评估健康素养的工具。最近开发了会话健康素养评估工具（CHAT），但其评估健康素养的能力尚未得到探索。我们旨在调查 CHAT 的实施和采用情况、其提高医疗保健提供者对健康素养的认识的能力，以及 CHAT 是否能够评估患者的健康素养需求。
方法
我们在丹麦一家市立医疗中心为非传染性疾病患者提供康复服务的医护人员（护士、物理治疗师和职业治疗师）中进行了 CHAT 的定性可行性研究。该研究使用了 RE-AIM 框架（覆盖范围、效果、采用、实施和维持）来构建访谈指南和分析。我们从四个小焦点小组（n=11）中收集了定性数据。使用演绎主题三步法对数据进行了分析，以组织和解释数据。所有参与者在数据收集前均提供了书面知情同意书。
结果
CHAT 似乎是一种可行且高效的工具，可用于评估具有不同社会人口特征和不同诊断的个体的健康素养需求。CHAT 最容易被已经熟悉健康素养概念的医护人员实施和采用。受访者强调，介绍 CHAT 和健康素养作为概念对采用很有价值。他们中的一些人感到沮丧，因为他们没有机会和选择来满足 CHAT 确定的健康素养需求。
结论
CHAT 是评估个体健康素养需求和提高医疗保健提供者健康素养意识的有前途的工具。为了成功实施 CHAT，我们建议制定一个结构化的实施计划，包括健康素养介绍和针对 CHAT 结果的行动选项概述。
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