Vo Anh Thu, Fang Lisa, Yang Lixia, Urquhart Robin, Yi Yanqing, Wang Peizhong Peter
Memorial University of Newfoundland Faculty of Medicine, St. John's, Newfoundland, Canada.
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
BMJ Open. 2025 Sep 14;15(9):e102788. doi: 10.1136/bmjopen-2025-102788.
The healthcare system is complex, involving multiple interactions among individuals, organisations and systems. Many patients, particularly those with limited health system literacy, struggle to navigate it. A reliable instrument is crucial for accurately measuring individuals' navigational abilities. However, a systematic review of psychometric properties of existing instruments for measuring health system literacy has not been conducted. This review aims to provide a comprehensive assessment of methodological quality and measurement properties of these instruments.
A search was conducted in MEDLINE, EMBASE, CINAHL, APA Psyfor, SCOPUS, Web of Science and Google Scholar from the date the database was created to 14 December 2024. Eligible studies include those published in English and focusing on developing and validating an instrument for measuring the construct of health system literacy in adults aged 18 or older. Two researchers will independently review, select and extract eligible studies, while all members of the research team will be involved in assessing methodological quality and the quality of measurement properties. This systematic review will adhere to the Consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines for conducting systematic reviews of psychometric properties. We will provide summary tables of study characteristics and instrument characteristics used to measure health system literacy. Measurement properties and their quality will be assessed using the COSMIN standard criteria and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We will also evaluate methodological quality of measurement properties using the COSMIN Risk of Bias checklist.
This review does not collect original data, so obtaining ethical approval is not applicable. The findings will be disseminated through peer-reviewed journals, which can assist researchers and providers in choosing the appropriate instrument measuring health system literacy.
CRD420251004362.
医疗保健系统十分复杂，涉及个人、组织和系统之间的多重互动。许多患者，尤其是那些健康系统素养有限的患者，在应对该系统时面临困难。一种可靠的工具对于准确测量个人的应对能力至关重要。然而，尚未对现有的用于测量健康系统素养的工具的心理测量特性进行系统综述。本综述旨在对这些工具的方法学质量和测量特性进行全面评估。
在MEDLINE、EMBASE、CINAHL、APA Psyfor、SCOPUS、Web of Science和谷歌学术上进行检索，检索时间范围从数据库创建之日至2024年12月14日。符合条件的研究包括以英文发表且专注于开发和验证用于测量18岁及以上成年人健康系统素养结构的工具的研究。两名研究人员将独立审查、选择和提取符合条件的研究，而研究团队的所有成员将参与评估方法学质量和测量特性的质量。本系统综述将遵循基于共识的健康测量工具选择标准（COSMIN）指南，以对心理测量特性进行系统综述。我们将提供用于测量健康系统素养的研究特征和工具特征的汇总表。测量特性及其质量将使用COSMIN标准标准和推荐分级、评估、制定与评价（GRADE）进行评估。我们还将使用COSMIN偏倚风险清单评估测量特性的方法学质量。
本综述不收集原始数据，因此无需获得伦理批准。研究结果将通过同行评审期刊进行传播，这有助于研究人员和提供者选择合适的测量健康系统素养的工具。
PROSPERO注册号：CRD420251004362。
