Does numeracy correlate with measures of health literacy in the emergency department?
Does numeracy correlate with measures of health literacy in the emergency department?
复制标题
DOI：
10.1111/acem.12310
复制
发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Kaphingst KA
中科院分区：
文献类型：
--
作者：
Griffey RT;Melson AT;Lin MJ;Carpenter CR;Goodman MS;Kaphingst KA
量化急诊科（ED）设置中一般计算能力与健康素养之间的相关性。这是一项前瞻性横断面便捷样本研究，研究对象是每年就诊97,000次的城市学术急诊科成年患者。一般计算能力评估使用四个验证问题；使用三种常用的经过验证的筛查工具（成人功能健康素养短测试[S-TOFHLA]，成人医学素养快速评估[REALM-R]和最新生命体征[NVS]）。将健康素养测试的得分分为有限（低或边缘）和充分的健康素养，并计算正确回答所有算术问题的患者比例，并计算这些组中正确回答的平均比例。计算能力得分与健康素养筛查工具得分之间的相关性采用Spearman相关法进行评估。446名患者入组。在评估一般计算能力的问题上的表现普遍较差。只有18名患者（4%）正确回答了所有算术问题，88名患者（20%）回答了零题，总体正确答案的中位数为1 （IQR 1至2）。在使用的三种筛查工具中任何一种的健康素养有限的患者中，正确计算答案的平均数量约为具有充分健康素养的患者的一半。然而，即使在那些具有足够卫生知识的人中，根据所使用的筛选测试，计算问题的平均正确答案数在1.6到2.4之间。当被分为正确回答算术问题≤50%和正确回答算术问题的两组时，健康素养有限的人与算术得分≤50%的人之间存在显著差异。健康素养筛查结果与一般算术能力在中低范围内存在相关性：S-TOFHLA rs = 0.428 (p < 0.0001)；REALM, rs = 0.400 (p < 0.0001)；NVS, rs = 0.498 （p < 0.0001）。一般计算能力指标与卫生知识素养指标之间的相关性处于低至中等水平。在算术测试中的表现几乎普遍较差，即使在健康素养屏幕上表现良好的患者中，后者的患者中有相当大比例无法正确回答一半的算术项目。就计算能力被认为是健康素养的一个子集而言，这些结果表明，在基于教育的研究中，常用的健康素养筛查工具没有充分评估和高估计算能力。这表明，当这些技能对健康结果很重要时，可能需要单独的计算能力筛查。提供者应对那些本来可能具有正常卫生知识的人可能存在的计算缺陷保持敏感。
To quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. This was a prospective cross-sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numeracy was evaluated using four validated questions; and health literacy using three commonly used validated screening tools (Short Test of Functional Health Literacy in Adults [S-TOFHLA], Rapid Estimate of Adult Literacy in Medicine-Revised [REALM-R], and the Newest Vital Sign [NVS]). Scores were dichotomized for health literacy tests to limited (low or marginal) vs. adequate health literacy, and the proportion of patients answering all numeracy questions correctly were calculated with the mean proportion of correct responses in these groups. The correlation between numeracy scores and scores on the health literacy screening tools was evaluated using Spearman's correlation. Four hundred forty-six patients were enrolled. Performance on questions evaluating general numeracy was universally poor. Only 18 patients (4%) answered all numeracy questions correctly, 88 patients (20%) answered zero questions correctly, and overall the median number of correct answers was one (IQR 1 to 2). Among patients with limited health literacy by any of the three screening tools used, the mean number of correct numeracy answers was approximately half that of patients with adequate health literacy. However, even among those with adequate health literacy, the average number of correct answers to numeracy questions ranged from 1.6 to 2.4 depending on the screening test used. When dichotomized into those who answered ≤50% vs. >50% of numeracy questions correctly, there was a significant difference between those with limited health literacy and those who scored ≤50% on numeracy. Health literacy screening results were correlated with general numeracy in the low to moderate range: S-TOFHLA rs = 0.428 (p < 0.0001); REALM, rs = 0.400 (p < 0.0001); and NVS, rs = 0.498 (p < 0.0001). Correlations between measures of general numeracy and measures of health literacy are in the low to moderate range. Performance on numeracy testing was nearly universally poor, even among patients performing well on health literacy screens, with a substantial proportion of the latter patients unable to answer half of the numeracy items correctly. Insofar as numeracy is considered a subset of health literacy, these results suggest that commonly used health literacy screening tools in ED-based studies inadequately evaluate and overestimate numeracy. This suggests the potential need for separate numeracy screening when these skills are important for health outcomes of interest. Providers should be sensitive to potential numeracy deficits among those who may otherwise have normal health literacy.
登录
查看更多内容
影响因子：
7.4
作者：
Bass, PF;Wilson, JF;Barnett, DR
通讯作者：
Barnett, DR
影响因子：
4.4
作者：
Weiss, BD;Mays, MZ;Hale, FA
通讯作者：
Hale, FA
影响因子：
3.5
作者：
Kelly, P. Adam;Haidet, Paul
通讯作者：
Haidet, Paul
算术的临床意义：理论和实践。
影响因子：
3.8
作者：
Nelson, Wendy;Reyna, Valerie F.;Fagerlin, Angela;Lipkus, Isaac;Peters, Ellen
通讯作者：
Peters, Ellen
影响因子：
5.7
作者：
Bass, PF;Wilson, JF;Griffith, CH
通讯作者：
Griffith, CH