澳大利亚社区精神健康诊所就诊的精神分裂症患者的健康素养、认知功能与一般文化程度之间的关系。
Associations between health literacy, cognitive function and general literacy in people with schizophrenia attending community mental health clinics in Australia.
机构信息
Northern Adelaide Local Health Network, Adelaide, South, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, South, Australia.
出版信息
BMC Psychiatry. 2022 Apr 7;22(1):245. doi: 10.1186/s12888-022-03901-7.
BACKGROUND
Health literacy (HL) has been defined as the ability of individuals to access, understand, and utilise basic health information. HL is crucial to patient engagement in treatment through supporting patient autonomy, informed consent and collaborative care. In people with physical disorders, poor HL is associated with poor health outcomes, but less is known about HL in people with severe mental illness. This study aimed to assess HL and investigate the associations between education, cognitive function, general literacy, and HL in participants with schizophrenia attending community mental health clinics.
METHOD
Fifty-two outpatients with schizophrenia attending a public community mental health clinic in Adelaide, Australia completed the Test of Functional Health Literacy in Adults-Short Form (S-TOFHLA) along with tests of cognition, aural and reading literacy and numeracy including Digit Symbol Coding (DSC), verbal fluency, the Wechsler Adult Intelligence Scale (WAIS-IV), Woodcock-Johnson III (Part 4 and 9) and the Lipkus numeracy scale. Sixty-one percent of participants were male. Participants had a mean age of 41.2 (SD 9.9) years and a mean of 11.02 (SD 1.5) years of education.
RESULTS
The majority of participants had very poor aural and verbal literacy and poorer literacy correlated with fewer years of education. On the S-TOFHLA, 81% of participants had adequate HL; 6% were marginal and 13% were inadequate. There was a positive correlation between education and HL, with those with more years of education scoring higher for HL. There was also a significant association between better HL and better working memory and attention.
CONCLUSIONS
Consistent with previous research in schizophrenia, our participants had reduced educational attainment, aural and reading literacy and cognitive function compared to population norms. However, HL was better than expected given that previous research has found that people with psychiatric disorders tend to have lower HL, compared to the general population. This may reflect effective case management of our participants whilst attending the community clinics and supports ongoing research and intervention regarding HL in people living with mental illness.
背景
健康素养（HL）已被定义为个体获取、理解和利用基本健康信息的能力。HL 对患者参与治疗至关重要，可通过支持患者自主性、知情同意和协作护理来实现。在患有身体障碍的人群中，HL 较差与较差的健康结果相关，但在患有严重精神疾病的人群中，HL 知之甚少。本研究旨在评估 HL，并调查在参加社区心理健康诊所的精神分裂症患者中，教育、认知功能、一般文化程度与 HL 之间的关联。
方法
52 名在澳大利亚阿德莱德一家公共社区心理健康诊所就诊的精神分裂症门诊患者完成了成人功能性健康素养测试简短版（S-TOFHLA），以及认知测试、听说读写和算术测试，包括数字符号编码（DSC）、言语流畅性、韦氏成人智力量表（WAIS-IV）、伍兹科克-约翰逊三世（第 4 部分和第 9 部分）和利普库斯算术量表。61%的参与者为男性。参与者的平均年龄为 41.2（SD 9.9）岁，平均受教育年限为 11.02（SD 1.5）年。
结果
大多数参与者听说读写能力较差，受教育程度较低的参与者的读写能力较差。在 S-TOFHLA 上，81%的参与者具有足够的 HL；6%为边缘状态，13%为不足。教育程度与 HL 呈正相关，受教育程度越高的人 HL 得分越高。HL 较好与更好的工作记忆和注意力也存在显著关联。
结论
与精神分裂症的先前研究一致，与人群正常值相比，我们的参与者受教育程度、听说读写能力和认知功能均有所下降。然而，HL 比预期的要好，因为先前的研究发现，与一般人群相比，患有精神障碍的人 HL 往往较低。这可能反映了我们的参与者在参加社区诊所时得到了有效的病例管理，并支持了针对精神疾病患者 HL 的持续研究和干预。
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