Gopinath Bamini, Jagnoor Jagnoor, Kifley Annette, Pozzato Ilaria, Craig Ashley, Cameron Ian D
John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.
Macquarie University Hearing, Department of Linguistics, Faculty of Medicine, Health and Human Sciences, The Australian Hearing Hub, 16 University Avenue, Macquarie University, Sydney, NSW, 2109, Australia.
BMC Public Health. 2022 Jul 19;22(1):1380. doi: 10.1186/s12889-022-13707-7.
Health literacy (HL) is rarely addressed in rehabilitation research and practice but can play a substantial role in the recovery process after an injury. We aimed to identify factors associated with low HL and its relationship with 6-month health outcomes in individuals recovering from a non-catastrophic road traffic injury.
Four hundred ninety-three participants aged ≥17 years who had sustained a non-catastrophic injury in a land-transport crash, underwent a telephone-administered questionnaire. Information was obtained on socio-economic, pre-injury health and crash-related characteristics, and health outcomes (quality of life, pain related measures and psychological indices). Low HL was defined as scoring < 4 on either of the two scales of the Health Literacy Questionnaire that covered: ability to actively engage with healthcare providers ('Engagement' scale); and/or understanding health information well enough to know what to do ('Understanding' scale).
Of the 493, 16.9 and 18.7% scored < 4 on the 'Understanding' and 'Engagement' scale (i.e. had low HL), respectively. Factors that were associated with low HL as assessed by both scales were: having pre-injury disability and psychological conditions; lodging a third-party insurance claim; experiencing overwhelming/great perceived sense of danger/death during the crash; type of road user; low levels of social satisfaction; higher pain severity; pain catastrophizing; and psychological- and trauma-related distress. Low HL (assessed by both scales) was associated with poorer recovery outcomes over 6 months. In these longitudinal analyses, the strongest association was with disability (p < 0.0001), and other significant associations were higher levels of catastrophizing (p = 0.01), pain severity (p = 0.04), psychological- (p ≤ 0.02) and trauma-related distress (p = 0.003), lower quality of life (p ≤ 0.03) and physical functioning (p ≤ 0.01).
A wide spectrum of factors including claim status, pre-injury and psychological measures were associated with low HL in injured individuals. Our findings suggest that targeting low HL could help improve recovery outcomes after non-catastrophic injury.
健康素养（HL）在康复研究和实践中很少被提及，但在受伤后的恢复过程中可能发挥重要作用。我们旨在确定与低健康素养相关的因素及其与非灾难性道路交通伤康复个体6个月健康结局的关系。
493名年龄≥17岁、在陆地交通碰撞中遭受非灾难性损伤的参与者接受了电话问卷调查。收集了社会经济、伤前健康和碰撞相关特征以及健康结局（生活质量、疼痛相关指标和心理指标）等信息。低健康素养被定义为在涵盖与医疗服务提供者积极互动能力（“参与”量表）和/或对健康信息理解程度足以知道如何行动（“理解”量表）的健康素养问卷的两个量表中任何一个得分<4分。
在493名参与者中，分别有16.9%和18.7%在“理解”量表和“参与”量表上得分<4分（即健康素养低）。两个量表评估的与低健康素养相关的因素包括：有伤前残疾和心理状况；提出第三方保险索赔；在碰撞过程中经历压倒性/强烈的危险/死亡感；道路使用者类型；社会满意度低；疼痛严重程度高；疼痛灾难化；以及心理和创伤相关困扰。低健康素养（通过两个量表评估）与6个月内较差的恢复结局相关。在这些纵向分析中，最强的关联是与残疾（p<0.0001），其他显著关联是更高水平的灾难化（p=0.01）、疼痛严重程度（p=0.04）、心理（p≤0.02）和创伤相关困扰（p=0.003）、较低的生活质量（p≤0.03）和身体功能（p≤0.01）。
包括索赔状态、伤前和心理指标在内的广泛因素与受伤个体的低健康素养相关。我们的研究结果表明，针对低健康素养可能有助于改善非灾难性损伤后的恢复结局。
