School of Health and Welfare, Halmstad University, Halmstad, SE-30118, Sweden.
Spenshult Research and Development Centre, Halmstad, Sweden.
BMC Public Health. 2023 Aug 29;23(1):1656. doi: 10.1186/s12889-023-16585-9.
Low health literacy is associated with worse pain and poorer self-management. This study (1) examined the level of health literacy and associations with lifestyle habits, health status, chronic pain, and radiographic knee osteoarthritis; and (2) explored experiences illuminating health literacy among individuals with knee pain.
A convergent parallel mixed-methods design was used, including 221 individuals. Health literacy was assessed by HLS-EU-Q16 and eHEALS. The questionnaire included questions on lifestyle habits, health status, and pain distribution. Radiographic knee osteoarthritis was assessed with x-rays. Associations were analysed using logistic regression analyses. Individual semi-structured interviews were conducted (n = 19) and analysed with qualitative content analysis.
The result showed that 71% reported sufficient health literacy. Higher education, healthy lifestyle habits, better general health, and absence of widespread pain were associated with sufficient health literacy. Experiences regarding health literacy influencing the decision-making process toward a decision on action comprised: (1) searching for information actively or passively; (2) processing of the information included being informed, critical, and interpretive; and (3) taking a stand on the information based on trustfulness and motivation.
Seven out of 10 reported sufficient health literacy. Despite this, unhealthy lifestyles were common, suggesting that having sufficient HL is not enough for a behavioural change and the decision-making process, including different phases such as searching, processing, and taking a stand on health information is important to consider. More research on health literacy is needed to gain knowledge of how best to develop health promotion in individuals with knee pain.
健康素养低与更严重的疼痛和较差的自我管理有关。本研究（1）调查了健康素养水平，并探讨了其与生活方式习惯、健康状况、慢性疼痛和放射学膝关节骨关节炎的关系；（2）探讨了膝关节疼痛患者的健康素养体验。
采用汇聚平行混合方法设计，纳入 221 名参与者。采用 HLS-EU-Q16 和 eHEALS 评估健康素养。问卷包括生活方式习惯、健康状况和疼痛分布的问题。采用 X 射线评估放射学膝关节骨关节炎。采用逻辑回归分析评估相关性。对 19 名参与者进行了个体半结构式访谈，并进行了定性内容分析。
结果显示，71%的参与者报告有足够的健康素养。受教育程度较高、健康的生活方式习惯、更好的总体健康状况以及没有广泛疼痛与足够的健康素养相关。影响决策过程以做出行动决策的健康素养体验包括：（1）主动或被动搜索信息；（2）信息处理包括被告知、批判性和解释性；（3）基于信任和动机对信息采取立场。
7 成参与者报告有足够的健康素养。尽管如此，不健康的生活方式仍然很常见，这表明有足够的 HL 并不足以促成行为改变，决策过程包括搜索、处理和对健康信息采取立场等不同阶段都需要考虑。需要进一步研究健康素养，以了解如何最好地在膝关节疼痛患者中开展健康促进。
