Department of Family Medicine, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences Turkey, Bursa, Turkey.
Department of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
Front Public Health. 2022 Mar 17;10:846768. doi: 10.3389/fpubh.2022.846768. eCollection 2022.
This study aimed to evaluate the relationship between health literacy (HL) and chronic obstructive pulmonary disease (COPD) severity.
Pulmonary function test, sociodemographic features, Modified Medical Research Council (mMRC) dyspnea scale, COPD assessment test (CAT), and the European Health Literacy Survey Questionnaire were used. The study examined 13,760 patients who underwent a pulmonary function test. Out of 13,760 patients, 673 patients had FEV1/FVC values less than 70%. Those with FEV1/FVC< 0.70 ( = 336) after the reversibility test were included in the study.
There was a significant decrease in HL and an increase in COPD severity ( < 0.001). In multivariate analysis, the risk of severe COPD was 2.74 times higher in patients in the poor income level than in patients in the good income level. In patients with inadequate HL, the risk of developing severe COPD was 1.80 times higher. A significant difference was found in HL index scores among the groups in terms of education level and income level ( < 0.001; < 0.001, respectively). The most difficult topics for patients with COPD were periodic health examinations, good practices in mental health, and adult vaccinations.
Patients with COPD were found to be at a HL level well below the expected level. The risk of severe COPD increased with poor income and inadequate HL. Healthcare providers should be careful in accessing, understanding, and interpreting the health information of patients with inadequate HL. Therefore, patient education should be prioritized in the follow-up and in the treatment of patients with COPD. Physicians should pay maximum attention to patients with COPD in the regular use of drugs, their proper use, in taking preventive measures, and in adult vaccination.
本研究旨在评估健康素养（HL）与慢性阻塞性肺疾病（COPD）严重程度之间的关系。
使用肺功能测试、社会人口统计学特征、改良医学研究委员会（mMRC）呼吸困难量表、COPD 评估测试（CAT）和欧洲健康素养调查问卷对 13760 名接受肺功能测试的患者进行研究。在 13760 名患者中，有 673 名患者的 FEV1/FVC 值小于 70%。对经过可逆性测试后 FEV1/FVC<0.70（=336）的患者进行了研究。
HL 显著下降，COPD 严重程度增加（<0.001）。在多变量分析中，收入水平较差的患者发生严重 COPD 的风险是收入水平较好的患者的 2.74 倍。在 HL 不足的患者中，发展为严重 COPD 的风险增加了 1.80 倍。在教育水平和收入水平方面，HL 指数得分在各组之间存在显著差异（<0.001；<0.001）。COPD 患者最困难的主题是定期健康检查、心理健康的良好实践和成人疫苗接种。
COPD 患者的 HL 水平明显低于预期水平。收入水平差和 HL 不足会增加严重 COPD 的风险。医疗保健提供者在获取、理解和解释 HL 不足的患者的健康信息时应格外小心。因此，在 COPD 患者的随访和治疗中应优先考虑患者教育。医生应在常规使用药物、正确使用、采取预防措施和成人疫苗接种方面对 COPD 患者给予最大关注。
