Salim H, Shariff Ghazali S, Lee P Y, Cheong A T, Harrun N H, Mohamed Isa S, Pinnock H
Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, EH89AG, United Kingdom.
BMC Public Health. 2021 Jun 22;21(1):1186. doi: 10.1186/s12889-021-11194-w.
Limited health literacy among people with asthma is associated with poor adherence to self-management activities, thus poor clinical outcomes. This study aimed to determine the prevalence of health literacy level and its determinants among people with asthma in the Malaysian primary healthcare settings.
A cross-sectional study was conducted among participants aged > 18 years with asthma who attended five primary health clinics in Malaysia. Systematic random sampling was employed with a final sample of 550 participants. The questionnaires included the validated Malay version of Health Literacy Scale (HLS) and asthma control questionnaire (ACQ). Statistical analysis was done using SPSS version 25. Multiple logistic regression was performed to determine the determinants for limited health literacy.
The participants mean age of the participants was 48 (SD15.4) years. Most of the participants were women (64%) and of Malay ethnicity (51.1%). Nearly half had a secondary level of education, n = 112, (45.8%). Mean duration of asthma diagnosis is 20.6 (SD 15.9) years. More than half (62.5%) had a family history of asthma. About half (50.9%) had uncontrolled asthma, with 87.3% self-rated themselves as having controlled asthma. About a third (29.1%) received education on of asthma action plan, but only 7.1% of these owned a written version an asthma action plan. Limited health literacy accounts for 60.5% of the participants. The significant determinants for limited health literacy included lower educational attainment (p < 0.001), family history of asthma (p = 0.034), < 20 years duration of asthma diagnosis (p = 0.031) and not receiving asthma action plan education (p < 0.001).
In this study population, more than half of the people living with asthma were found to have limited health literacy, which was associated with not having received self-management education supported by an asthma action plan. Future interventions should include strategies that ensure they meet the needs of people with limited health literacy.
哮喘患者健康素养有限与自我管理活动依从性差相关，进而导致临床结局不佳。本研究旨在确定马来西亚初级卫生保健机构中哮喘患者的健康素养水平及其决定因素。
对马来西亚五家初级卫生诊所中年龄大于18岁的哮喘患者进行横断面研究。采用系统随机抽样，最终样本为550名参与者。问卷包括经过验证的马来语版健康素养量表（HLS）和哮喘控制问卷（ACQ）。使用SPSS 25版进行统计分析。进行多因素逻辑回归以确定健康素养有限的决定因素。
参与者的平均年龄为48岁（标准差15.4）。大多数参与者为女性（64%），马来族裔（51.1%）。近一半人接受过中等教育，n = 112人（45.8%）。哮喘诊断的平均时长为20.6年（标准差15.9）。超过一半（62.5%）的人有哮喘家族史。约一半（50.9%）的人哮喘未得到控制，87.3%的人自我评估认为哮喘得到了控制。约三分之一（29.1%）的人接受过哮喘行动计划教育，但其中只有7.1%的人拥有书面的哮喘行动计划。60.5%的参与者健康素养有限。健康素养有限的显著决定因素包括较低的教育程度（p < 0.001）、哮喘家族史（p = 0.034）、哮喘诊断时长<20年（p = 0.031）以及未接受哮喘行动计划教育（p < 0.001）。
在本研究人群中，发现超过一半的哮喘患者健康素养有限，这与未接受哮喘行动计划支持的自我管理教育有关。未来的干预措施应包括确保满足健康素养有限人群需求的策略。
