健康素养与脊柱裂青少年和青年健康相关生活质量的关系：一项横断面研究。
The Association of Health Literacy with Health-Related Quality of Life in Youth and Young Adults with Spina Bifida: A Cross-Sectional Study.
机构信息
Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC.
出版信息
J Pediatr. 2022 Dec;251:156-163.e2. doi: 10.1016/j.jpeds.2022.08.005. Epub 2022 Aug 12.
OBJECTIVE
The objective of the study was to determine if health literacy is associated with health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with spina bifida.
STUDY DESIGN
Between June 2019 and March 2020, the Patient-Reported Outcome Measurement Information System Pediatric Global Health-7 (PGH-7), a measure of HRQOL, and the Brief Health Literacy Screening Tool (BRIEF) were administered to patients ≥12 years old with a diagnosis of spina bifida seen in our multidisciplinary spina bifida center. Questionnaires were completed at scheduled clinic visits. The primary outcome was the PGH-7 normalized T-score. The primary exposure was the BRIEF score. Demographic and clinical characteristics were obtained from the medical record. Nested, multivariable linear regression models assessed the association between health literacy and the PGH-7 score.
RESULTS
Of 232 eligible patients who presented to clinic, 226 (97.4%) met inclusion criteria for this study. The median age was 17.0 years (range: 12-31). Most individuals were female (54.0%) and had myelomeningocele (61.5%). Inadequate, marginal, and adequate health literacy levels were reported by 35.0%, 28.3%, and 36.7% of individuals. In univariable analysis, higher health literacy levels were associated with higher PGH-7 scores. In nested, sequentially adjusted multivariable linear regression models, a higher health literacy level was associated with a stepwise increase in the PGH-7 score. In the fully adjusted model, adequate health literacy and marginal health literacy, compared with inadequate health literacy, were associated with increases in a PGH-7 score of 3.3 (95% CI: 0.2-6.3) and 1.1 (95% CI: -2.0 to 4.2), respectively.
CONCLUSIONS
Health literacy was associated with HRQOL after adjusting for demographic and clinical factors. Strategies incorporating health literacy are needed to improve HRQOL in AYAs with spina bifida.
目的
本研究旨在探讨健康素养是否与脊柱裂青少年和年轻人（AYA）的健康相关生活质量（HRQOL）相关。
研究设计
2019 年 6 月至 2020 年 3 月，对在我们多学科脊柱裂中心就诊、诊断为脊柱裂且年龄≥12 岁的患者，使用患者报告的结局测量信息系统儿科全球健康-7（PGH-7）和简要健康素养筛查工具（BRIEF）进行调查，这是一种 HRQOL 衡量工具。调查问卷在预约的门诊就诊时完成。主要结局是 PGH-7 标准化 T 评分。主要暴露因素是 BRIEF 评分。从病历中获取人口统计学和临床特征。嵌套多变量线性回归模型评估了健康素养与 PGH-7 评分之间的关联。
结果
在 232 名符合条件的就诊患者中，226 名（97.4%）符合本研究的纳入标准。中位年龄为 17.0 岁（范围：12-31）。大多数患者为女性（54.0%），患有脊髓脊膜膨出（61.5%）。35.0%、28.3%和 36.7%的患者报告存在健康素养不足、边缘和充足水平。在单变量分析中，较高的健康素养水平与较高的 PGH-7 评分相关。在嵌套的逐步调整多变量线性回归模型中，较高的健康素养水平与 PGH-7 评分的逐步增加相关。在完全调整的模型中，与健康素养不足相比，健康素养充足和边缘健康素养与 PGH-7 评分分别增加 3.3（95%CI：0.2-6.3）和 1.1（95%CI：-2.0-4.2）。
结论
在调整人口统计学和临床因素后，健康素养与 HRQOL 相关。需要采取策略来提高脊柱裂 AYA 的 HRQOL。
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