Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
Center for Integrated Science and Humanities, Fukushima Medical University, Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan.
Health Promot Int. 2023 Apr 1;38(2). doi: 10.1093/heapro/daac200.
We quantitatively analysed the relationship of health literacy with both anxiety about the COVID-19 outbreak and free-text qualitative data. A questionnaire was mailed to 5450 citizens aged 16-89 years in four prefectures between late April and May 2020. It gauged the level of anxiety about COVID-19, assessed health literacy (HL) on both critical and communicative HL subscales, and invited free-text responses. We compared anxiety levels in three groups of both HL subscales. Text-mining analyses were also conducted among the three HL groups. Two-thirds of respondents reported anxiety about COVID-19, and 42% of them also reported fear. The level of communicative HL was negatively associated with no or low anxiety (p < 0.01), and the same association was observed for critical HL (p < 0.01). Free-text analysis identified 11 categories related to concerns about COVID-19: response of the national government, appreciation of health care practitioners, early convergence, vaccine development, fear of infection, invisible, a school for children, everyday life, information-related issue, novel coronavirus and self-quarantine. Words that were characteristic of the high-HL group were 'information', 'going out', 'vaccines' and 'government'. This survey reveals high public anxiety under COVID-19, and while anxiety is associated with HL levels, people with higher HL may make more prudent and healthier decisions. In situations of uncertainty, different approaches to alleviate anxiety depending on HL are warranted, providing new insights and contributing to public health measures during the outbreaks.
我们定量分析了健康素养与 COVID-19 爆发焦虑以及自由文本定性数据之间的关系。2020 年 4 月底至 5 月期间，我们向四个县的 5450 名 16-89 岁的公民邮寄了一份问卷。该问卷衡量了对 COVID-19 的焦虑程度，评估了批判性和交际性健康素养（HL）两个子量表的水平，并邀请了自由文本回复。我们比较了两个 HL 子量表的三个组的焦虑水平。还在三个 HL 组之间进行了文本挖掘分析。三分之二的受访者报告对 COVID-19 感到焦虑，其中 42%的人也感到恐惧。交际性 HL 水平与无或低焦虑呈负相关（p < 0.01），批判性 HL 也存在同样的关联（p < 0.01）。自由文本分析确定了 11 个与 COVID-19 相关的担忧类别：国家政府的反应、对医疗保健从业者的赞赏、早期收敛、疫苗开发、对感染的恐惧、无形、儿童学校、日常生活、信息相关问题、新型冠状病毒和自我隔离。高 HL 组特有的词是“信息”、“外出”、“疫苗”和“政府”。这项调查揭示了 COVID-19 下公众的高度焦虑，而焦虑与 HL 水平相关，HL 水平较高的人可能会做出更谨慎和更健康的决策。在不确定的情况下，根据 HL 采取不同的缓解焦虑的方法是必要的，为公共卫生措施提供了新的见解，并为疫情期间的公共卫生措施做出了贡献。
