Hopp Morgan J, Soe-Lin Hahn, Lowe Trevor M, Chapple Kristina M, Bogert James N, Weinberg Jordan A
Department of Surgery, Creighton University School of Medicine Phoenix Regional Campus, Phoenix, Arizona, USA.
Department of Surgery, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Trauma Surg Acute Care Open. 2023 Jan 31;8(1):e001029. doi: 10.1136/tsaco-2022-001029. eCollection 2023.
Patients with health literacy (HL) disparities are less likely to comprehend hospital discharge instructions and less satisfied with physician communication. In this prospective cohort study, we sought to examine the interaction of HL, physician communication, and quality of life after hospital discharge among postoperative emergency surgery and trauma patients.
Emergency surgery and trauma surgery patients were prospectively enrolled between December 2020 and December 2021 at an urban level 1 trauma center. Newest Vital Sign (NVS) instrument was used to measure HL during hospitalization. After discharge, patients were administered Revised Trauma Quality of Life (RT-QOL) and Interpersonal Processes of Care (IPC) instruments. An adjusted regression model was used to determine associations among NVS the emotional well-being subscale on the RT-QOL, and patient perception of physician compassion and respect on the IPC.
94 patients completed all instruments. HL was proficient (high HL) in 59.6% and less than proficient (low HL) in 40.4%. HL was positively associated with RT-QOL emotional well-being, (94)=0.212, p=0.040. However, higher rating of surgeon compassion and respect on IPC moderated the relationship between HL and emotional well-being such that patients with low HL and high perception of physician compassion and respect had similar emotional well-being as the high HL group (p=0.042).
Favorable patient perception of surgeon compassion and respect was correlated with higher emotional well-being, independent of HL proficiency. Although the allocation of resources toward improving HL disparities remains warranted, improving patient perception of caregiver compassion during hospitalization may be a target of opportunity with respect to improving quality of life after hospital discharge.
Level III.
健康素养（HL）存在差异的患者理解医院出院指导的可能性较小，对医生沟通的满意度也较低。在这项前瞻性队列研究中，我们试图研究术后急诊手术和创伤患者出院后HL、医生沟通与生活质量之间的相互作用。
2020年12月至2021年12月期间，前瞻性纳入了一家城市一级创伤中心的急诊手术和创伤手术患者。住院期间使用最新生命体征（NVS）工具测量HL。出院后，对患者进行修订的创伤生活质量（RT-QOL）和人际关怀过程（IPC）工具评估。采用调整后的回归模型来确定NVS、RT-QOL上的情感幸福感子量表以及患者对IPC上医生同情心和尊重的感知之间的关联。
94名患者完成了所有工具评估。HL熟练（高HL）的患者占59.6%，不熟练（低HL）的患者占40.4%。HL与RT-QOL情感幸福感呈正相关，（94）=0.212，p=0.040。然而，在IPC上对外科医生同情心和尊重的评分较高，调节了HL与情感幸福感之间的关系，使得低HL但对医生同情心和尊重感知较高的患者与高HL组的情感幸福感相似（p=0.042）。
患者对外科医生同情心和尊重的良好感知与较高的情感幸福感相关，与HL熟练程度无关。尽管仍有必要分配资源来改善HL差异，但在住院期间提高患者对医护人员同情心的感知可能是改善出院后生活质量的一个机会靶点。
三级。
