Koch Peter, Schillmöller Zita, Nienhaus Albert
Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany.
Faculty of Life Sciences, Hamburg University of Applied Sciences (HAW), 21033 Hamburg, Germany.
Healthcare (Basel). 2021 Dec 21;10(1):2. doi: 10.3390/healthcare10010002.
Health literacy (HL) is a resource that can help individuals to achieve more control over their health and over factors that influence health. In the present follow-up study, we have investigated the extent to which HL in trainees changes over time and whether or to what extent HL influences health behaviour and health.
In 2017, we performed a baseline survey (T0) of trainees from six different branches, who were contacted through vocational colleges in four northern federal states in Germany. The survey was repeated at the midpoint of their training in 2019 (T1). Demographic data were surveyed, together with information on HL (HLS-EU-Q16), health behaviour and on health status (psychological well-being, subjective health status). Multivariate regression analyses were performed in SPSS 26.
Three hundred and ninety-one (391) data sets were evaluated, with a follow-up rate of 27%; 79% of the trainees were female. The mean age was 21.2 years. Over all subjects, the mean HL increased over time (x¯ (SD): 11.9 (2.9) to 12.2 (2.9), = 0.070). This increase was only statistically significant for the health service trainees (x¯ (SD): 12.1 (2.8) to 12.5 (2.9), = 0.019). Relative to persons with adequate HL, the odds ratio over time for impaired psychological well-being was increased by 230% in persons with inadequate HL (OR: 3.3, 95% CI: 1.70-6.32, < 0.001). For persons with problematical HL, the corresponding increase in odds ratio was 110% (OR: 2.1, 95% CI: 1.30-3.38, = 0.002). Relative to persons with adequate HL, trainees with inadequate HL exhibited a significant increase in odds ratio of 2.8 over time for poor or less good subjective health status (OR: 2.8, 95% CI: 1.23-6.33, = 0.014).
We observed a positive longitudinal association between HL and health. A significant increase in HL was observed in trainees in the health service. Thus the study shows that the concept of HL may provide a potential preventive approach for trainees.
健康素养（HL）是一种资源，可帮助个人更好地掌控自身健康以及影响健康的因素。在本随访研究中，我们调查了学员的健康素养随时间的变化程度，以及健康素养是否以及在多大程度上影响健康行为和健康状况。
2017年，我们对来自六个不同行业的学员进行了基线调查（T0），通过德国北部四个联邦州的职业学院联系到这些学员。在2019年培训中期（T1）重复进行了该调查。收集了人口统计学数据，以及有关健康素养（HLS-EU-Q16）、健康行为和健康状况（心理健康、主观健康状况）的信息。在SPSS 26中进行了多变量回归分析。
共评估了391个数据集，随访率为27%；79%的学员为女性。平均年龄为21.2岁。在所有受试者中，健康素养的平均值随时间增加（x¯（标准差）：11.9（2.9）至12.2（2.9），P = 0.070）。这种增加仅在卫生服务专业学员中具有统计学意义（x¯（标准差）：12.1（2.8）至12.5（2.9），P = 0.019）。与健康素养充足的人相比，健康素养不足的人心理健康受损的时间比值比增加了230%（比值比：3.3，95%置信区间：1.70 - 6.32，P < 0.001）。对于健康素养有问题的人，相应的比值比增加为110%（比值比：2.1，95%置信区间：1.30 - 3.38，P = 0.002）。与健康素养充足的人相比，健康素养不足的学员主观健康状况较差或不太好的时间比值比显著增加2.8（比值比：2.8，95%置信区间：1.23 - 6.33，P = 0.014）。
我们观察到健康素养与健康之间存在积极的纵向关联。在卫生服务专业学员中观察到健康素养有显著提高。因此，该研究表明健康素养概念可能为学员提供一种潜在预防方法。
