From the University of Utah School of Medicine.
Division of Pediatric Critical Care, Department of Pediatrics.
Pediatr Emerg Care. 2023 Dec 1;39(12):e80-e85. doi: 10.1097/PEC.0000000000003076.
Health literacy is a growing concern because of its effects on communication and health outcomes. One aspect of this communication is the ability of the health care provider to estimate the health literacy of a patient or their caregiver. The objectives of this study are to quantify misestimation of caregiver health literacy by providers and identify potential descriptive or demographic factors that might be related to those misestimations.
Providers were asked to perceive descriptive factors and estimate the health literacy of caregivers in a pediatric Emergency Department. Then, the health literacy of the caregiver was tested using the Short Assessment of Health Literacy, and cross-tabulated with provider estimates.
Providers correctly estimated the health literacy of the caregivers 60% of the time, and misestimates were often underestimates (27.7%) rather than overestimates (12.3%). Providers overestimated the health literacy of 24.1% of fathers and only 9.8% of mothers (P = 0.012). They correctly estimated the health literacy of 63.9% of English-speaking caregivers compared with 30.6% of Spanish-speaking caregivers, and underestimated the health literacy of 50% of Spanish-speaking caregivers and 24.8% of English-speaking caregivers (P < 0.001). Providers correctly estimated the health literacy of 34.4% of racially and ethnically diverse caregivers compared with 71.5% of White/non-Hispanic caregivers. They underestimated the health literacy of 52.1% of these racially and ethnically diverse caregivers and 16.8% of White/non-Hispanic caregivers (P < 0.001).
Providers often overestimate and underestimate the health literacy of parents in the pediatric emergency department. Misestimates are related to race, caregiver role, and language spoken by the caregiver. When providers misestimate health literacy, they may use words or phrases that are above or below the health literacy level of the caregiver. These results suggest a need for further health literacy research and interventions in provider education and clinical practice.
由于健康素养对沟通和健康结果的影响，健康素养日益受到关注。沟通的一个方面是医疗保健提供者估计患者或其照顾者健康素养的能力。本研究的目的是量化提供者对照顾者健康素养的错误估计，并确定可能与这些错误估计相关的潜在描述性或人口统计学因素。
要求提供者感知描述性因素并估计儿科急诊室中照顾者的健康素养。然后，使用简短的健康素养评估来测试照顾者的健康素养，并与提供者的估计进行交叉制表。
提供者正确估计照顾者健康素养的比例为 60%，错误估计往往是低估（27.7%）而不是高估（12.3%）。提供者高估父亲健康素养的比例为 24.1%，而母亲则为 9.8%（P = 0.012）。他们正确估计了 63.9%的讲英语的照顾者的健康素养，而只正确估计了 30.6%的讲西班牙语的照顾者的健康素养，并且低估了 50%的讲西班牙语的照顾者和 24.8%的讲英语的照顾者的健康素养（P < 0.001）。提供者正确估计了 34.4%的种族和民族多样化的照顾者的健康素养，而正确估计了 71.5%的白人/非西班牙裔照顾者的健康素养。他们低估了 52.1%的这些种族和民族多样化的照顾者和 16.8%的白人/非西班牙裔照顾者的健康素养（P < 0.001）。
提供者在儿科急诊室中经常高估和低估父母的健康素养。错误估计与种族、照顾者角色以及照顾者所说的语言有关。当提供者错误估计健康素养时，他们可能会使用高于或低于照顾者健康素养水平的词语或短语。这些结果表明需要进一步研究提供者教育和临床实践中的健康素养，并进行干预。
