Seo Yon Hee, Osborne Richard H, Kwak Yeunhee, Ahn Jung-Won
Department of Nursing Science, Andong National University, Andong-si, Gyeongsangbuk-do, Korea.
Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.
PLoS One. 2024 Aug 1;19(8):e0308086. doi: 10.1371/journal.pone.0308086. eCollection 2024.
Health literacy plays a crucial role in promoting and maintaining the health of patients with chronic illnesses. Therefore, adequate assessments and the application of interventions based on people's health literacy strengths, needs, and preferences are required to improve health outcomes. This study aimed to evaluate the psychometrical properties of the Health Literacy Questionnaire (HLQ) in Koreans with chronic diseases. Data were collected from 278 patients (57.04±15.22 years) diagnosed with chronic disease, including kidney disease, hypertension, and diabetes, who visited the outpatient clinic of a university hospital from June to December 2020. For validity assessment, construct, convergent, and discriminant validities were evaluated, along with the HLQ reliability using Cronbach's α. One-way analysis of variance was used to evaluate mean differences in the HLQ scale scores based on patients' characteristics. The confirmatory factor analysis (CFA) indicated that all items were loaded on their respective factors. The model fit of a full nine-factor CFA model showed satisfactory or better fit compared with nine one-factor CFA model; χ2WLSMV (866) = 576.596 (p < .001), comparative normed fit index of 1.000 (reference: >0.950), Tucker-Lewis index of 0.981 (reference: >0.950), root mean square error of approximation of 0.066 (reference: <0.080), and standardized root mean square residual of 0.055 (reference: <0.080). All scales demonstrated good to excellent internal consistency (Cronbach's α ≥.757). Sociodemographic characteristic variables with significant score differences in HLQ scores were reported across nine scales, with the level of education and income showing significant score differences in 8 and 6 scales, respectively. This study revealed that the Korean version of the HLQ has many strong measurement properties among patients with chronic diseases. The validation indicated the HLQ as a robust tool that is used cross-culturally and is recommended for use in the Korean population.
健康素养在促进和维持慢性病患者的健康方面起着至关重要的作用。因此，需要基于人们的健康素养优势、需求和偏好进行充分的评估并应用干预措施，以改善健康状况。本研究旨在评估韩国慢性病患者健康素养问卷（HLQ）的心理测量特性。数据收集自2020年6月至12月在某大学医院门诊就诊的278例慢性病患者（年龄57.04±15.22岁），这些慢性病包括肾病、高血压和糖尿病。为了进行效度评估，对结构效度、聚合效度和区分效度进行了评估，并使用Cronbach's α评估HLQ的信度。采用单因素方差分析来评估基于患者特征的HLQ量表得分的均值差异。验证性因素分析（CFA）表明所有项目都加载在各自的因素上。与九个单因素CFA模型相比，完整的九因素CFA模型的模型拟合显示出令人满意或更好的拟合；χ2WLSMV（866）= 576.596（p <.001），比较规范拟合指数为1.000（参考值：>0.950），塔克-刘易斯指数为0.981（参考值：>0.950），近似均方根误差为0.066（参考值：<0.080），标准化均方根残差为0.055（参考值：<0.080）。所有量表均显示出良好到优秀的内部一致性（Cronbach's α≥.757）。九个量表中均报告了在HLQ得分上存在显著差异的社会人口学特征变量，教育水平和收入分别在8个和6个量表中显示出显著的得分差异。本研究表明，韩语版HLQ在慢性病患者中具有许多强大的测量特性。验证表明HLQ是一种稳健的工具，可跨文化使用，建议在韩国人群中使用。
