Lawrence Emma R, Irani Sanaya, Nartey Betty, Collins Brittney, Segbedzi-Rich Elorm, Pangori Andrea, Beyuo Titus K, Moyer Cheryl A, Lori Jody R, Oppong Samuel A
University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI, USA (Lawrence, Pangori, and Moyer).
University of Michigan Medical School, Ann Arbor, MI, USA (Irani and Collins).
AJOG Glob Rep. 2025 Feb 22;5(2):100468. doi: 10.1016/j.xagr.2025.100468. eCollection 2025 May.
Hypertensive disorders of pregnancy are associated with poor maternal and neonatal outcomes. Since elevated blood pressure is often a first presenting sign, a major function of antenatal care is frequent blood pressure monitoring. A newer approach to this-patient-performed home monitoring-has not been widely implemented in low- and middle-income countries, including Ghana. Patient numeracy levels that are sufficient to understand and interpret home blood pressure values are a critical component of a successful home monitoring intervention.
To evaluate perceived, objective, and applied numeracy to identify elevated blood pressure values among pregnant women engaged in home blood pressure monitoring in Ghana.
Participants were 80 pregnant women at a tertiary hospital in Accra, Ghana. After training, participants engaged in home blood pressure monitoring for 2 to 4 weeks. A post-monitoring survey evaluated confidence and experience interpreting blood pressure values, a validated numeracy scale, and interpretation of blood pressure monitor outputs-half with numbers only and half with both numbers and colors. Mean correct responses on numbers only and numbers and colors outputs were compared. Linear regression evaluated predictors of correct interpretation of blood pressures.
On a validated numeracy scale, mean score was 16.73 (SD: 6.01) out of 25, with 73.8% (n=59) having numeracy. Perceived ability was high, with 70.9% (n=56) definitely believing they could interpret blood pressures values. However, on objective evaluation, only 36.3% (n=29) correctly identified the cutoff for elevated systolic and 26.3% (n=21) for elevated diastolic blood pressure values. Out of eight displayed blood pressure monitor outputs, correct identification was significantly higher on outputs with both numbers and colors (μ=7.19, σ=0.81) compared to numbers only (μ=6.54, σ=1.35). On an adjusted linear regression, only scores on the numeracy scale had a significant yet small association with correctly identifying blood pressure monitor outputs (β 0.07, =.025).
Home blood pressure monitoring would benefit from monitors with both numerical and color-coded output. Focused training, rather than education level or general numeracy, may best predict blood pressure interpretation.
妊娠高血压疾病与孕产妇和新生儿不良结局相关。由于血压升高往往是首要表现症状，产前护理的一项主要功能就是频繁监测血压。包括加纳在内的低收入和中等收入国家尚未广泛采用一种新的方法——患者自行在家监测。足以理解和解读家庭血压值的患者计算能力水平是成功的家庭监测干预的关键组成部分。
评估认知、客观和应用计算能力，以确定加纳参与家庭血压监测的孕妇中血压升高值。
参与者为加纳阿克拉一家三级医院的80名孕妇。经过培训后，参与者进行2至4周的家庭血压监测。监测后调查评估了对解读血压值的信心和经验、经过验证的计算能力量表以及对血压监测仪输出结果的解读——一半仅显示数字，一半同时显示数字和颜色。比较了仅数字输出和数字与颜色输出的平均正确回答情况。线性回归评估了正确解读血压的预测因素。
在经过验证的计算能力量表上，25分中平均得分为16.73分（标准差：6.01），73.8%（n = 59）具备计算能力。认知能力较高，70.9%（n = 56）的人坚信自己能够解读血压值。然而，在客观评估中，只有36.3%（n = 29）的人正确识别出收缩压升高的临界值，26.3%（n = 21）的人正确识别出舒张压升高的临界值。在显示的八个血压监测仪输出结果中，与仅显示数字的输出结果（μ = 6.54，σ = 1.35）相比，同时显示数字和颜色的输出结果的正确识别率显著更高（μ = 7.19，σ = 0.81）。在调整后的线性回归中，只有计算能力量表得分与正确识别血压监测仪输出结果存在显著但较小的关联（β = 0.07，P = 0.025）。
家庭血压监测采用同时具有数字和颜色编码输出的监测仪会更有益。针对性培训而非教育水平或一般计算能力可能是预测血压解读能力的最佳指标。
