Nielsen Maja Hykkelbjerg, Seibæk Lene, Pedersen Michael Lynge, Jensen Annesofie Lunde
Steno Diabetes Center Greenland, Queen Ingrid's Hospital, Jens Kreutzmannip aqq. 11, Nuuk, 3900, Greenland.
Department of Health and Nature, Greenlandic Center for Health Research, Ilisimatusarfik/University of Greenland, Manutooq 1, Nuussuaq, Nuuk, 3905, Greenland.
BMC Public Health. 2025 Sep 24;25(1):3106. doi: 10.1186/s12889-025-24431-3.
Health literacy plays an important role in self-management of non-communicable diseases. To lay the groundwork for development of a patient education intervention for people with chronic obstructive pulmonary disease (COPD) or type 2 diabetes (T2D), this study investigates health literacy and self-management of people with COPD or T2D in Greenland.
Individual, semi-structured interviews about the experiences of living with COPD or T2D in Greenland were conducted at the National Hospital in Nuuk and at the four regional hospitals. Informants (n = 24) were selected by purposeful sampling. Interviews were audio-recorded. During the analyses, we applied the results using the qualitative methodology Interpretive Description, alongside Osborne's Health Literacy Questionnaire (HLQ) and the Precaution Adoption Process Model (PAPM) as theoretical frameworks.
Three themes emerged: Gaining knowledge of one's disease; Understanding how to apply knowledge in everyday life, and Integrating knowledge to perform self-management. We created a model to illustrate how the three themes could be related to the seven stages in PAPM and with the nine health literacy domains in the HLQ. We found varying levels of knowledge about disease and health literacy among the informants. Furthermore, the informants' experiences were situated at different places in our model. Depending on their position in the model, they needed certain kinds of knowledge related to their disease, such as bio-medical knowledge or experience-based knowledge. Social support from society, peers, and health care professionals was essential at all places in the model. The ability to perform self-management required several skills and competences, which had to be supported to some extent to be able to change lifestyle behaviours and perform self-management.
There was a great desire for more knowledge about COPD and T2D and for information in Greenlandic. The study showed considerable individual variation in knowledge about disease and health literacy, and involving the informants' network in management of the disease was found essential. The study's results can support the development of a culturally adapted patient education intervention. The intervention must be multifaceted, accessible to all citizens in Greenland, targeted to the individuals' situations, prioritised, and quality assured as an integrated part of overall care.
健康素养在非传染性疾病的自我管理中发挥着重要作用。为了为针对慢性阻塞性肺疾病（COPD）或2型糖尿病（T2D）患者的患者教育干预措施的制定奠定基础，本研究调查了格陵兰岛COPD或T2D患者的健康素养和自我管理情况。
在努克的国家医院和四家地区医院，对格陵兰岛COPD或T2D患者的生活经历进行了个人半结构化访谈。通过目的抽样选择了24名受访者。访谈进行了录音。在分析过程中，我们运用定性方法“解释性描述”的结果，并将奥斯本的健康素养问卷（HLQ）和预防采用过程模型（PAPM）作为理论框架。
出现了三个主题：了解自己的疾病；理解如何在日常生活中应用知识；整合知识以进行自我管理。我们创建了一个模型来说明这三个主题如何与PAPM中的七个阶段以及HLQ中的九个健康素养领域相关联。我们发现受访者对疾病和健康素养的了解程度各不相同。此外，受访者的经历在我们的模型中处于不同位置。根据他们在模型中的位置，他们需要与疾病相关的某些类型的知识，例如生物医学知识或基于经验的知识。社会、同龄人以及医疗保健专业人员的社会支持在模型的各个位置都至关重要。进行自我管理的能力需要多种技能和能力，这些技能和能力必须在一定程度上得到支持，以便能够改变生活方式行为并进行自我管理。
人们非常渴望获得更多关于COPD和T2D的知识以及格陵兰语的信息。研究表明，在疾病知识和健康素养方面存在相当大的个体差异，并且发现让受访者的社交网络参与疾病管理至关重要。该研究结果可为制定文化适应性患者教育干预措施提供支持。该干预措施必须是多方面的，格陵兰岛所有公民都可获得，针对个人情况，具有优先性，并作为整体护理的一个组成部分确保质量。
