School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China.
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, China.
Patient Educ Couns. 2023 Sep;114:107829. doi: 10.1016/j.pec.2023.107829. Epub 2023 Jun 1.
This study was conducted to determine the effectiveness and impact of health literacy interventions for patients with chronic diseases.
We searched PubMed, Web of Science, Embase, Scopus, and EBSCO CINAHL from inception through March 2022. Eligible chronic diseases include diabetes, heart disease, cancer, and chronic obstructive pulmonary disease. RCTs were included in eligible studies to assess health literacy and other relevant health outcomes. Two investigators selected studies, extracted data, and assessed the methodological quality of included studies independently.
A total of 18 studies involving 5384 participants were included in the final analysis. The implementation of health literacy interventions exhibited a significant improvement in the health literacy level of individuals diagnosed with chronic diseases (SMD = 0.75, 95% CI = 0.40-1.10). Analysis of heterogeneity sources indicated statistically significant variations in the effects of interventions across different diseases and age groups (P < 0.05). However, no significant impact was observed on patients with chronic obstructive pulmonary disease (COPD), interventions with a follow-up duration exceeding three months, or application-based interventions on the health literacy level of individuals with chronic diseases. Remarkably, our findings revealed that health literacy interventions exerted a positive influence on health status (SMD = 0.74, 95% CI = 0.13-1.34), depression and anxiety (SMD = 0.90, 95% CI = 0.17-1.63), as well as self-efficacy (SMD = 0.28, 95% CI = 0.15-0.41) among patients diagnosed with chronic diseases. Furthermore, a specific analysis was conducted to evaluate the effects of these interventions on hypertension and diabetes control. The results demonstrated that health literacy interventions were more effective in enhancing hypertension control compared to diabetes control.
Health literacy interventions have demonstrated effectiveness in improving the health of patients with chronic diseases. The importance of emphasizing the quality of these interventions cannot be overstated, as factors such as appropriate intervention tools, extended intervention duration, and reliable primary care services play crucial roles in their efficacy.
本研究旨在确定针对慢性病患者的健康素养干预措施的效果和影响。
我们检索了 PubMed、Web of Science、Embase、Scopus 和 EBSCO CINAHL，检索时间截至 2022 年 3 月。纳入的慢性病包括糖尿病、心脏病、癌症和慢性阻塞性肺疾病。纳入的研究采用 RCT 来评估健康素养和其他相关健康结局。两名研究者独立选择研究、提取数据并评估纳入研究的方法学质量。
最终分析纳入了 18 项涉及 5384 名参与者的研究。健康素养干预措施的实施显著提高了慢性病患者的健康素养水平（SMD=0.75，95%CI=0.40-1.10）。异质性来源分析表明，干预措施在不同疾病和年龄组之间的效果存在统计学显著差异（P<0.05）。然而，对于慢性阻塞性肺疾病（COPD）患者、随访时间超过 3 个月的干预措施或基于应用的干预措施，并未观察到对慢性病患者健康素养水平的显著影响。值得注意的是，我们的研究结果表明，健康素养干预措施对健康状况（SMD=0.74，95%CI=0.13-1.34）、抑郁和焦虑（SMD=0.90，95%CI=0.17-1.63）以及自我效能感（SMD=0.28，95%CI=0.15-0.41）产生了积极影响。此外，我们还进行了一项特定分析，以评估这些干预措施对高血压和糖尿病控制的影响。结果表明，与糖尿病控制相比，健康素养干预措施在提高高血压控制方面更为有效。
健康素养干预措施在改善慢性病患者的健康方面具有有效性。强调这些干预措施质量的重要性怎么强调都不为过，因为适当的干预工具、延长的干预持续时间和可靠的初级保健服务等因素对其疗效至关重要。
