Should Health Numeracy Be Assessed Objectively or Subjectively?
Should Health Numeracy Be Assessed Objectively or Subjectively?
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DOI：
10.1177/0272989x15584332
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发表时间：
2016-10-01
影响因子：
3.6
通讯作者：
Veazie, Peter J.
中科院分区：
文献类型：
--
作者：
Dolan, James G.;Cherkasky, Olena A.;Veazie, Peter J.
导言。由于目前的证据表明，算术能力会影响人们做出决定的方式，因此在评估医疗决策支持干预措施的有效性的研究中，这是一个重要的因素。主观和客观的计算能力评估方法在理论背景、评估的技能、与决策技能的已知关系以及实施容易程度等方面各有不同。在进行医学决策研究时，使用这些工具评估计算能力的最佳方式目前尚不清楚。方法：研究方法。我们进行了互联网调查，比较了使用主观算术能力量表(SNS)和5个客观算术能力量表获得的算术能力评估。每个研究参与者都完成了SNS和1个客观算术测量。在每次评估之后，参与者表示愿意重复评估，并对其用户可接受性进行评级。结果。总体回复率为78%，总样本量为673个。SNS和客观计算标准之间的Spearman相关系数在0.19到0.44之间。简式医学数字理解量表与SNS的可接受性评估无显著差异。其他客观量表的可接受性评分均低于社交网络。结论。这些发现与之前的研究一致，这些研究表明，客观和主观计算标准衡量的是相关但不同的结构。由于目前不确定哪个结构更有可能影响决策支持干预的有效性，这些发现值得进一步研究，以确定在医疗决策研究中正确使用客观和主观计算评估。在获得更多信息之前，一种合理的方法是同时测量客观和主观计算能力，以便全面考虑实际和感知的计算技能。
Introduction. Because current evidence suggests that numeracy affects how people make decisions, it is an important factor to account for in studies assessing the effectiveness of medical decision support interventions. Subjective and objective numeracy assessment methods are available that vary in theoretical background, skills assessed, known relationship with decision making skills, and ease of implementation. The best way to use these tools to assess numeracy when conducting medical decision-making research is currently unknown. Methods. We conducted Internet surveys comparing numeracy assessments obtained using the subjective numeracy scale (SNS) and 5 objective numeracy scales. Each study participant completed the SNS and 1 objective numeracy measure. Following each assessment, participants indicated willingness to repeat the assessment and rated its user acceptability. Results. The overall response rate was 78%, resulting in a total sample size of 673. Spearman correlations between the SNS and the objective numeracy measures ranged from 0.19 to 0.44. Acceptability assessments for the short form of the Numeracy Understanding in Medicine Instrument and the SNS did not differ significantly. The other objective scales all had lower acceptability ratings than the SNS. Conclusions. These findings are consistent with prior research suggesting that objective and subjective numeracy scales measure related but distinct constructs. Due to current uncertainty regarding which construct is more likely to influence the effectiveness of decision support interventions, these findings warrant further investigation to determine the proper use of objective versus subjective numeracy assessments in medical decision-making research. Pending additional information, a reasonable approach is to measure both objective and subjective numeracy so that the full range of actual and perceived numeracy skills can be taken into account.