Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2024 Jul;299:34-42. doi: 10.1016/j.jss.2024.03.003. Epub 2024 May 2.
As our growing population demonstrates a significant increase in the incidence of thyroid cancer, so does patient access to their medical records. Poor health literacy and understanding of disease severity, underscores the importance of effective and accessible patient-doctor communication. No previous studies on patient understanding of thyroid pathology reports exist; therefore, we sought to characterize health literacy in this population.
Using a modified Delphi technique, a 12-question multiple-choice survey regarding common pathology terms with possible definitions for each term was synthesized and administered to patients in a high-volume endocrine surgery clinic. Survey results, patient demographics, history of prior thyroid procedure (biopsy or surgery), and self-reported health literacy were collected. Data analysis included t tests, chi-squared, and multivariable linear regression using R.
The survey was completed by 54 patients (response rate: 69.8%). On univariate analysis, White race, previous thyroid procedure, and at least a high school level education were all more likely to score higher on the survey than their counterparts (P < 0.05). On multivariable logistic regression for predicting a higher survey score, only race (est: 2.48 [95% confidence interval: 1.01-3.96]) and higher educational attainment (est: 3.98 [95% confidence interval: 2.32-5.64]) remained predictive (P < 0.05). The remaining demographic groups (age, health literacy confidence, and previous thyroid procedure) did not show a statistically significant difference.
Overall, terms on a thyroid pathology report are poorly understood by patients. This is exacerbated by non-White race and low educational attainment. There is a need for patient-facing pathology education.
随着我们不断增长的人口中甲状腺癌发病率的显著增加，患者对其医疗记录的获取也在增加。健康素养差和对疾病严重程度的理解不足，凸显了医患有效沟通的重要性。目前尚无关于患者对甲状腺病理报告理解的研究，因此，我们试图描述这一人群的健康素养。
使用改良 Delphi 技术，综合了 12 个关于常见病理术语的多项选择题调查，以及每个术语的可能定义，并在一家高容量内分泌外科诊所的患者中进行了调查。收集了调查结果、患者人口统计学资料、既往甲状腺手术（活检或手术）史以及自我报告的健康素养。数据分析包括 t 检验、卡方检验和使用 R 进行的多变量线性回归。
共有 54 名患者（应答率：69.8%）完成了调查。在单变量分析中，白人种族、既往甲状腺手术史和至少高中教育程度的患者在调查中得分高于其对应者的可能性更大（P < 0.05）。在多变量逻辑回归预测更高的调查得分时，只有种族（估计值：2.48 [95%置信区间：1.01-3.96]）和更高的教育程度（估计值：3.98 [95%置信区间：2.32-5.64]）仍然具有预测性（P < 0.05）。其他人口统计学群体（年龄、健康素养信心和既往甲状腺手术史）没有表现出统计学上的显著差异。
总体而言，患者对甲状腺病理报告中的术语理解很差。这一问题因非白人和低教育程度而加剧。需要进行面向患者的病理教育。
