Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia.
J Public Health (Oxf). 2022 Aug 25;44(3):651-662. doi: 10.1093/pubmed/fdab133.
People with chronic conditions experience high psychological distress.
Using the National Health Survey in Australia during 2017-18, the study assessed whether and which health literacies moderated the relationship between chronic conditions and psychological distress for diabetes, chronic kidney disease (CKD), cardiovascular disease (CVD), arthritis, other musculoskeletal conditions, asthma, other chronic lower respiratory diseases and cancer. Psychological distress was regressed on chronic diseases, health literacy domains and their interactions, controlling for demographic, socioeconomic and health factors.
Of 5790 adults, 4212 (72.75%) aged 18-64; 846 (14.6%) had high or very high psychological distress, 1819 (31.4%) had diabetes, CKD or CVD, 2645 (45.7%) musculoskeletal conditions, and 910 (15.7%) lower respiratory conditions. Having sufficient information from healthcare providers was associated with the lowest level of psychological distress for CKD and cancer. Social support was associated with significantly lower levels of psychological distress for cardiovascular, musculoskeletal and lower respiratory conditions. Understanding health information was associated with the largest improvement in psychological distress for diabetes.
Higher health literacies were associated with reduced risks of psychological distress among individuals managing chronic conditions. Interventions for improving self-management and health inequalities should incorporate disease-specific health literacy enhancement strategies at individual and organizational levels.
患有慢性病的人会经历较高的心理困扰。
本研究使用了 2017-18 年澳大利亚国家健康调查的数据，评估了健康素养是否以及哪些方面调节了慢性病与糖尿病、慢性肾脏病（CKD）、心血管疾病（CVD）、关节炎、其他肌肉骨骼疾病、哮喘、其他慢性下呼吸道疾病和癌症患者心理困扰之间的关系。将心理困扰回归到慢性疾病、健康素养领域及其相互作用上，并控制了人口统计学、社会经济和健康因素。
在 5790 名成年人中，有 4212 名（72.75%）年龄在 18-64 岁之间；846 名（14.6%）有较高或极高的心理困扰，1819 名（31.4%）患有糖尿病、CKD 或 CVD，2645 名（45.7%）患有肌肉骨骼疾病，910 名（15.7%）患有下呼吸道疾病。从医疗保健提供者那里获得足够的信息与 CKD 和癌症患者的最低心理困扰水平相关。社会支持与心血管、肌肉骨骼和下呼吸道疾病患者的心理困扰显著降低相关。理解健康信息与糖尿病患者心理困扰的最大改善相关。
更高的健康素养与管理慢性病个体的心理困扰风险降低有关。改善自我管理和健康不平等的干预措施应在个人和组织层面纳入针对特定疾病的健康素养增强策略。
