Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens
Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens
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DOI：
10.1136/bmjopen-2015-009627
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发表时间：
2016-01-01
期刊：
影响因子：
2.9
通讯作者：
Maindal, Helle T.
中科院分区：
文献类型：
--
作者：
Friis, Karina;Lasgaard, Mathias;Maindal, Helle T.
目的：（1）量化长期健康状况患者的主观健康素养水平（2）检查健康素养、社会经济特征和每个长期条件组中的合并症之间的关联。设计：丹麦中部地区基于人口的调查（n= 29473）.主要结果测量：健康素养使用健康素养问卷（HLQ）中的两个量表进行测量：（1）理解健康信息的能力和（2）积极与医疗服务提供者合作的能力。患有长期疾病的人报告说，在理解健康信息和积极与医疗保健提供者接触方面，比一般人群困难更多。在疾病组之间发现了很大的差异，癌症患者的困难较少，而精神健康障碍患者在积极与医疗服务提供者接触方面比其他长期疾病组更困难。患有一种以上的长期疾病与更难与医疗保健提供者接触和了解健康信息有关。受教育程度低的人有较低的健康素养比人高level.Conclusions：与一般人群相比，长期条件的人报告更多的困难，在了解健康信息，并与医疗服务提供者。这两个方面对于提供以患者为中心的医疗保健和优化健康结果至关重要。应做出更多努力，满足长期患病、多种合并症和教育水平低的个人的健康知识需求，以改善健康结果，减少健康方面的社会不平等。
Objectives: To (1) quantify levels of subjective health literacy in people with long-term health conditions (diabetes, cardiovascular disease, chronic obstructive pulmonary disease, musculoskeletal disorders, cancer and mental disorders) and compare these to levels in the general population and (2) examine the association between health literacy, socioeconomic characteristics and comorbidity in each long-term condition group.Design: Population-based survey in the Central Denmark Region (n=29 473).Main outcome measures: Health literacy was measured using two scales from the Health Literacy Questionnaire (HLQ): (1) Ability to understand health information and (2) Ability to actively engage with healthcare providers.Results: People with long-term conditions reported more difficulties than the general population in understanding health information and actively engaging with healthcare providers. Wide variation was found between disease groups, with people with cancer having fewer difficulties and people with mental health disorders having more difficulties in actively engaging with healthcare providers than other long-term condition groups. Having more than one long-term condition was associated with more difficulty in engaging with healthcare providers and understanding health information. People with low levels of education had lower health literacy than people with high levels of education.Conclusions: Compared with the general population, people with long-term conditions report more difficulties in understanding health information and engaging with healthcare providers. These two dimensions are critical to the provision of patient-centred healthcare and for optimising health outcomes. More effort should be made to respond to the health literacy needs among individuals with long-term conditions, multiple comorbidities and low education levels, to improve health outcomes and to reduce social inequality in health.