Williams M V, Baker D W, Parker R M, Nurss J R
Division of General Medicine, Emory University School of Medicine, Atlanta, Ga, USA.
Arch Intern Med. 1998 Jan 26;158(2):166-72. doi: 10.1001/archinte.158.2.166.
Inadequate functional health literacy is common, but its impact on patients with chronic diseases is not well described.
To examine among patients with hypertension or diabetes the relationship between their functional health literacy level and their knowledge of their chronic disease and treatment.
We conducted a cross-sectional survey of patients with hypertension and diabetes presenting to the general medicine clinics at 2 urban public hospitals. Literacy was measured by the Test of Functional Health Literacy in Adults. Knowledge of their illness was assessed in patients with diabetes or hypertension using 21 hypertension and 10 diabetes questions based on key elements in educational materials used in our clinics.
A total of 402 patients with hypertension and 114 patients with diabetes were enrolled. Mean (+/- SD) knowledge scores for patients with hypertension with inadequate (n = 189), marginal (n = 49), or adequate (n = 155) literacy were 13.2 +/- 3.1, 15.3 +/- 2.2, and 16.5 +/- 2.3, respectively (range, 4-20; P < .001). A total of 92% of patients with hypertension and adequate literacy levels knew that a blood pressure reading of 160/100 mm Hg was high compared with 55% of those in the lowest reading level (P < .001). Mean (+/- SD) knowledge scores for patients with diabetes with inadequate (n = 50), marginal (n = 13), or adequate (n = 51) literacy were 5.8 +/- 2.1, 6.8 +/- 1.9, and 8.1 +/- 1.6, respectively (range, 1-10; P < .001). A total of 94% of patients with diabetes and adequate functional health literacy knew the symptoms of hypoglycemia compared with 50% of those with inadequate literacy (P < .001).
Inadequate functional health literacy poses a major barrier to educating patients with chronic diseases, and current efforts to overcome this appear unsuccessful.
功能性健康素养不足的情况很常见，但它对慢性病患者的影响尚未得到充分描述。
研究高血压或糖尿病患者的功能性健康素养水平与其对慢性病及治疗的认知之间的关系。
我们对两家城市公立医院普通内科门诊的高血压和糖尿病患者进行了横断面调查。通过成人功能性健康素养测试来衡量素养水平。根据我们诊所使用的教育材料中的关键要素，使用21个高血压问题和10个糖尿病问题对糖尿病或高血压患者的疾病认知情况进行评估。
共纳入402例高血压患者和114例糖尿病患者。高血压患者中，素养不足（n = 189）、边缘水平（n = 49）或充足（n = 155）的患者的平均（±标准差）知识得分分别为13.2 ± 3.1、15.3 ± 2.2和16.5 ± 2.3（范围4 - 20；P <.001）。素养水平充足的高血压患者中，共有92%知道血压读数为160/100 mmHg属于高血压，而素养水平最低的患者中这一比例为55%（P <.001）。糖尿病患者中，素养不足（n = 50）、边缘水平（n = 13）或充足（n = 51）的患者的平均（±标准差）知识得分分别为5.8 ± 2.1、6.8 ± 1.9和8.1 ± 1.6（范围1 - 10；P <.001）。功能性健康素养充足的糖尿病患者中，共有94%知道低血糖症状，而素养不足的患者中这一比例为50%（P <.001）。
功能性健康素养不足对慢性病患者的教育构成了重大障碍，目前克服这一障碍的努力似乎并不成功。
