Functional health literacy and the quality of physician-patient communication among diabetes patients
Functional health literacy and the quality of physician-patient communication among diabetes patients
复制标题
DOI：
10.1016/s0738-3991(03)00107-1
复制
发表时间：
2004-03-01
影响因子：
3.5
通讯作者：
Piette, J
中科院分区：
文献类型：
--
作者：
Schillinger, D;Bindman, A;Piette, J
虽然功能性健康素养（FHL）较差的患者在阅读和理解书面医疗说明方面存在困难，但尚不清楚这些患者是否也会遇到其他沟通方式的问题，例如与初级保健医生的面对面接触。我们招募了408名讲英语和西班牙语的糖尿病患者，以检查FHL不足的患者是否比FHL充足的患者报告更差的沟通。我们使用不同人群中人际护理过程工具中的子量表评估患者的沟通体验。在多变量模型中，与FHL充足的患者相比，FHL不足的患者更有可能在总体清晰度（调整后的比值比[AOR] 6.29，P < 0.01）、病情解释（AOR 4.85，P = 0.03）和护理过程解释（AOR 2.70，P = 0.03）方面报告较差的沟通。不良的FHL似乎是口腔沟通问题的一个标志，特别是在临床医生与患者对话的技术，解释领域。需要进行研究，以确定改善这组患者沟通的策略。(C)2003爱思唯尔科学爱尔兰有限公司保留所有权利。
While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English-and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with adequate FHL. We assessed patients' experiences of communication using sub-scales from the Interpersonal Processes of Care in Diverse Populations instrument. In multivariate models, patients with inadequate FHL, compared to patients with adequate FHL, were more likely to report worse communication in the domains of general clarity (adjusted odds ratio [AOR] 6.29, P < 0.01), explanation of condition (AOR 4.85, P = 0.03), and explanation of processes of care (AOR 2.70, P = 0.03). Poor FHL appears to be a marker for oral communication problems, particularly in the technical, explanatory domains of clinician-patient dialogue. Research is needed to identify strategies to improve communication for this group of patients.(C) 2003 Elsevier Science Ireland Ltd. All rights reserved.