Israel Frederico Epalanga Albano, Vincze Ferenc, Ádány Róza, Bíró Éva
Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.
Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
BMC Public Health. 2025 Jan 30;25(1):390. doi: 10.1186/s12889-025-21590-1.
In an efficient and effective healthcare delivery, good communication plays an essential role. The communicative health literacy (COMM-HL) of the patients is an important attribute, but the number of validated COMM-HL assessment tools is low, and they do not cover all aspects of COMM-HL. That's why a new scale has been developed within an international collaboration. Our aims are to check the measurement properties of the Hungarian version of this COMM-HL questionnaire, to describe the COMM-HL of the Hungarian adult population and to investigate its determinants.
A total of 1205 adults completed the telephone interview in 2020 as part of the European Health Literacy Population Survey 2019-2021. The questionnaire included items on sociodemographic data, self-perceived health, social support and COMM-HL. The questionnaire's measurement properties were assessed using Cronbach's alpha, Spearman-Brown, and item-total correlation coefficients, while the construct validity was investigated with principal component (PCA) and confirmatory factor analysis. The determinants of the COMM-HL were investigated by linear regression.
Both the value of Cronbach's alpha and the Spearman-Brown correlation were 0.87. The items belonged to one factor and 62.2% of the total variation was explained by this factor based on the PCA. The fit indices indicated that the one-factor structure of the six-item questionnaire exhibited a good fit for the data. The mean score on the COMM-HL scale was 86.8. The easiest task was explaining health concerns while getting enough time in the consultation was rated as the most difficult one. COMM-HL was lower among females, while it was higher among people aged 66-75 years (compared with 18-25 years), those with greater social support and those without financial deprivation.
The questionnaire can be characterized with good internal consistency and the structure of the COMM-HL questionnaire was best explained as a one factor model. In consultations with patients, the effectiveness of communication should be improved, so that patients do not feel that there is not enough time for consultation. At-risk groups with low COMM-HL need special attention during the interactions and the role of social support has to be clarified, too.
在高效的医疗服务中，良好的沟通起着至关重要的作用。患者的沟通健康素养（COMM-HL）是一个重要属性，但经过验证的COMM-HL评估工具数量较少，且未涵盖COMM-HL的所有方面。因此，在一项国际合作中开发了一种新的量表。我们的目的是检验该COMM-HL问卷匈牙利语版本的测量属性，描述匈牙利成年人群的COMM-HL，并调查其决定因素。
作为2019 - 2021年欧洲健康素养人口调查的一部分，2020年共有1205名成年人完成了电话访谈。问卷包括社会人口学数据、自我感知健康、社会支持和COMM-HL等项目。使用克朗巴哈系数、斯皮尔曼 - 布朗系数和项目 - 总分相关系数评估问卷的测量属性，同时用主成分分析（PCA）和验证性因素分析研究结构效度。通过线性回归研究COMM-HL的决定因素。
克朗巴哈系数值和斯皮尔曼 - 布朗相关系数均为0.87。基于主成分分析，这些项目属于一个因素，该因素解释了总变异的62.2%。拟合指数表明，六项问卷的单因素结构与数据拟合良好。COMM-HL量表的平均得分为86.8。最容易的任务是解释健康问题，而在咨询中获得足够时间被评为最困难的任务。女性的COMM-HL较低，而66 - 75岁的人群（与18 - 25岁相比）、社会支持较强的人群以及没有经济贫困的人群的COMM-HL较高。
该问卷具有良好的内部一致性，COMM-HL问卷的结构最好解释为单因素模型。在与患者的咨询中，应提高沟通的有效性，使患者不会觉得咨询时间不足。在互动过程中，COMM-HL较低的高危人群需要特别关注，同时也必须明确社会支持的作用。
