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与健康素养低的患者沟通中的挑战与解决方案:医疗服务提供者的观点

Challenges and solutions in communication with patients with low health literacy: Perspectives of healthcare providers.

作者信息

Murugesu Laxsini, Heijmans Monique, Rademakers Jany, Fransen Mirjam P

机构信息

Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands.

Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.

出版信息

PLoS One. 2022 May 4;17(5):e0267782. doi: 10.1371/journal.pone.0267782. eCollection 2022.

Abstract

Insights in the challenges that healthcare providers encounter in serving low health literate patients is lagging behind. This study explored challenges perceived by healthcare providers and provides strategies in communication with low health literate patients. Primary and secondary healthcare providers (N = 396) filled in an online survey. We assessed the frequency of challenges prior to, during and following a consultation, and which strategies were used and recommended. Survey outcomes were validated in in-depth interviews with healthcare providers (N = 7). Providers (76%) reported one or more challenges that were subscribed to patients' difficulties in comprehending or applying health-related information, in communicating with professionals, or in taking responsibility for their health. Providers (31%) perceived difficulties in recognizing low health literate patients, and 50% rarely used health literacy specific materials. Providers expressed needs for support to recognize and discuss low health literacy, to adapt communication and to assess patient's comprehension. Future research should focus on developing strategies for providers to ensure patients' understanding (e.g. applying teach-back method), to recognize low health literate patients, and to support patients' in taking responsibility for their health (e.g. motivational interviewing).

摘要

医疗服务提供者在为健康素养低的患者提供服务时所面临挑战的相关见解仍较为滞后。本研究探讨了医疗服务提供者所察觉到的挑战,并提供了与健康素养低的患者进行沟通的策略。初级和二级医疗服务提供者(N = 396)填写了一份在线调查问卷。我们评估了会诊前、会诊期间和会诊后各种挑战出现的频率,以及所使用和推荐的策略。通过对医疗服务提供者(N = 7)进行深入访谈,对调查结果进行了验证。76%的提供者报告了一项或多项挑战,这些挑战与患者在理解或应用健康相关信息、与专业人员沟通或对自身健康负责方面的困难有关。31%的提供者认为识别健康素养低的患者存在困难,50%的提供者很少使用针对健康素养的特定材料。提供者表示需要获得支持,以识别和讨论低健康素养问题、调整沟通方式并评估患者的理解情况。未来的研究应侧重于为提供者制定策略,以确保患者理解(例如应用反馈教学法)、识别健康素养低的患者,并支持患者对自身健康负责(例如动机性访谈)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/9067671/3938fa7cd076/pone.0267782.g001.jpg

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