Health literacy and kidney transplant outcomes
Health literacy and kidney transplant outcomes
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DOI：
10.7182/pit2015463
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发表时间：
2015-03-01
影响因子：
0.8
通讯作者：
Baliga, Prabhakar
中科院分区：
文献类型：
--
作者：
Kazley, Abby S.;Hund, Jessica Jordan;Baliga, Prabhakar
肾脏疾病是一种常见病，最好通过肾移植来治疗。肾脏移植过程很复杂，很难操作，很可能需要足够的健康知识。目的：评估健康素养与移植结果之间的关系，包括患者是否被列入移植名单或接受移植。设计-测量患者健康素养和移植结果的横断面研究。环境和参与者-来自单一移植中心的参与者，如果他们被转介到移植中心并且会说英语，则被邀请参加。92例患者中，30例（33%）在血管通路诊所，31例（34%）在移植后，31例（34%）在移植前。干预健康素养采用成人医学移植素养快速评估（real - t）、最新生命体征（NVS）和决策能力评估工具（DMCAT） 3种工具进行测量。主要结局指标：两个二分类变量：患者是否被列入移植名单和/或接受了移植。计算描述性和单变量统计量。使用六个逻辑回归模型来检验每种工具与患者被列入和/或接受移植的可能性之间的相关性。结果：53例（58%）患者被正式列入移植名单，36例（39%）患者接受了移植。REALM-T、NVS和DMCAT均能显著预测患者是否被列入移植名单（优势比分别为1.044、1.672和1.408）。NVS和DMCAT显著预测患者是否接受移植（优势比分别为1.667和1.256）。健康素养是移植结果的一个积极和显著的预测因子。临床医生在与患者谈论肾脏移植时应考虑健康素养评估。(C) 2015 NATCO，器官移植专业人员组织
Context-Kidney disease is a common disease that is best treated through' kidney transplant. The kidney transplant process is complex and can be difficult to navigate and most likely requires an adequate amount of health literacy.Objective-To assess the relationship between health literacy and transplant outcomes, including whether a patient was listed for or received a transplant.Design-A crciss-sectional study measuring patients' health literacy and transplant outcomes.Setting and Participants-Participants from a single transplant center were invited to participate if they were referred to the center for transplant and spoke English. Of the 92 patients, 30 (33%) were in the vascular access clinic, 31(34%) were posttransplant, and 31(34%) were pretransplant.Intervention-Health literacy was measured by using 3 tools: Rapid Estimate of Adult Literacy of Medicine-Transplant (REALM-T), Newest Vital Sign (NVS), and Decision-Making Capacity Assessment Tool (DMCAT).Main Outcome Measure-Two dichotomous variables: whether the patient was listed for transplant and/or received a transplant. Descriptive and univariate statistics were calculated. Six logistic regression models were used to test for a correlation between each of the tools and patients' likelihood to be listed for and/or receive a transplant.Results-Fifty-three patients (58%) were formally listed for a transplant, and 36 (39%) received a transplant. The REALM-T, NVS, and DMCAT each significantly predicted whether or not a patient was listed for transplant (odds ratios, 1.044, 1.672, and 1.408). The NVS and DMCAT significantly predicted whether a patient received a transplant (odds ratios, 1.667 and 1.256). Health literacy is a positive and significant predictor of transplant outcomes. Clinicians should take assessments of health literacy into account when speaking to patients about kidney transplant. (C) 2015 NATCO, The Organization for Transplant Professionals