基于艺术的健康教育对尼泊尔西部孕妇贫血和健康素养的影响：一项随机对照试验。
Effectiveness of art-based health education on anemia and health literacy among pregnant women in Western Nepal: A randomized controlled trial.
机构信息
Faculty of Nursing, Graduate School of Nursing, Kansai Medical University, Hirakata, Japan.
Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
出版信息
PLoS One. 2024 Sep 30;19(9):e0281789. doi: 10.1371/journal.pone.0281789. eCollection 2024.
OBJECTIVE
As Nepalese pregnant women vary widely in literacy levels and cultural backgrounds and are reluctant to make decisions about their health, general interventions are insufficient to improve maternal anemia. This study aimed to assess the effectiveness of "face-to-face health education using educational material created using pictures, photos, and nomograms" in reducing anemia and improving health literacy.
METHODS
A total of 156 Nepalese pregnant women with hemoglobin (Hb) levels below 11.0 g/dl were divided into three groups: the education group received three sessions of face-to-face health education using art-based material unaffected by literacy skills; the distribution group received material used in the education group; and the control group underwent general perinatal checkups. Hb levels and health literacy scores were assessed at baseline early pregnancy (8-12 weeks) and late pregnancy (36-40 weeks). A Nepalese version of the 14-item Health Literacy Scale (HLS-14) was developed to assess health literacy.
RESULTS
The post-intervention three-group comparison showed a statistically significant difference (P < 0.042) in mean Hb levels after the intervention. Dunnett's test showed a statistically significant difference (P < 0.044) between the education and control groups but no significant difference between the distribution and control groups (P = 0.972). No significant differences in health literacy (total scores and subscales) were observed among the three groups before the intervention in the Kruskal-Wallis test and after the intervention (although there was a trend towards improvement). Total health literacy scores before and after the intervention were statistically significantly different for the total group and all three groups (P<0.001). Only the education group showed statistically significant differences in functional (P<0.012), communication (P<0.004), and critical (P<0.014) literacy subscale scores.
CONCLUSION
Continuous face-to-face health education using literacy material significantly reduced anemia and improved health literacy among Nepalese pregnant women.
TRIAL REGISTRATION
UMIN Clinical Trials Registry (UMIN-CTR), URL: https://www.umin.ac.jp/ctr/ (Registration number: UMIN000049603).
目的
尼泊尔孕妇的文化背景和受教育程度差异较大，且她们在健康决策方面较为保守，因此，一般性干预措施对于改善孕产妇贫血的效果有限。本研究旨在评估“使用图片、照片和图表制作的教育材料进行面对面健康教育”在降低贫血发生率和提高健康素养方面的效果。
方法
共纳入 156 名血红蛋白（Hb）水平低于 11.0 g/dl 的尼泊尔孕妇，将其分为三组：教育组接受三次基于艺术的面对面健康教育，所使用的材料不受读写能力的影响；发放材料组接受与教育组相同的材料；对照组接受常规围产期检查。在孕早期（8-12 周）和孕晚期（36-40 周）评估 Hb 水平和健康素养评分。开发了尼泊尔版 14 项健康素养量表（HLS-14）来评估健康素养。
结果
三组干预后的比较显示，干预后平均 Hb 水平存在统计学差异（P<0.042）。Dunnett 检验显示，教育组与对照组之间存在统计学差异（P<0.044），而发放材料组与对照组之间无显著差异（P=0.972）。在 Kruskal-Wallis 检验中，三组在干预前的健康素养（总分和各亚量表）均无显著差异，干预后也无显著差异（尽管存在改善趋势）。总健康素养评分在干预前后对于总组和所有三组均具有统计学意义（P<0.001）。仅教育组在功能（P<0.012）、沟通（P<0.004）和批判（P<0.014）三个亚量表评分上具有统计学意义。
结论
使用基于读写能力的材料进行持续的面对面健康教育可显著降低尼泊尔孕妇的贫血发生率并提高其健康素养。
试验注册
UMIN 临床研究注册（UMIN-CTR），网址：https://www.umin.ac.jp/ctr/（注册号：UMIN000049603）。
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