Tailored education may reduce health literacy disparities in asthma self-management
Tailored education may reduce health literacy disparities in asthma self-management
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DOI：
10.1164/rccm.200409-1291oc
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发表时间：
2005-10-15
影响因子：
24.7
通讯作者：
Krishnan, JA
中科院分区：
文献类型：
--
作者：
Paasche-Orlow, MK;Riekert, KA;Krishnan, JA
基本原理：虽然健康素养不足与哮喘药物知识较低和计量吸入器（MDI）技术较差有关，但健康素养与学习哮喘自我管理技能的能力之间的关系尚不清楚。目的：这项前瞻性队列研究的对象是在市中心两家医院因严重哮喘急性发作住院的成年人，我们研究了健康素养不足与学习困难之间的关系，并保留了出院药物和适当MDI技术的说明。在出院时，参与者接受一对一，30分钟，指南为基础的，书面和口头的指示，他们的哮喘出院方案以及适当的MDI technology.Measurements和主要结果：73例患者参加。在16名（22%）参与者中发现了健康素养不足。在指导之前，健康素养不足与哮喘药物知识较低（5.2/10 vs. 7.2/10，p < 0.001）和MDI技术较差（3.2/6 vs. 3.9/6，p = 0.03）相关。然而，健康素养不足与学习困难（p = 0.33）或保留（p = 0.35）有关出院方案的指示无关。同样，健康知识普及不足与难以学习（p = 0.26）或保留（p = 0.97）适当的MDI技术无关。结果是相似的多变量模型调整人口特征和哮喘严重程度indicators.Conclusions：这些研究结果表明，健康素养不足是一个可以克服的障碍，学习和记住关键的哮喘自我管理技能。
Rationale: Although inadequate health literacy has been associated with lower asthma medication knowledge and worse metered-dose inhaler (MDI) technique, the relationship between health literacy and the capacity to learn asthma self-management skills is unknown.Objectives: In this prospective cohort study of adults hospitalized for severe asthma exacerbations at two inner-city hospitals, we examined the relationship between inadequate health literacy and difficulties learning and retaining instructions about discharge medications and appropriate MDI technique.Methods: At hospital discharge, participants received one-on-one, 30-min, guideline-based, written and oral instruction about their asthma discharge regimen as well as appropriate MDI technique.Measurements and Main Results: Seventy-three patients were enrolled. Inadequate health literacy was identified in 16 (22%) participants. Before instruction, inadequate health literacy was associated with lower asthma medication knowledge (5.2/10 vs. 7.2/10, p < 0.001) and worse MDI technique (3.2/6 vs. 3.9/6, p = 0.03). However, inadequate health literacy was not associated with difficulty learning (p = 0.33) or retaining (p = 0.35) instructions about the discharge regimen. Similarly, inadequate health literacy was not associated with difficulty learning (p = 0.26) or retaining (p = 0.97) appropriate MDI technique. Results were similar in multivariable models adjusted for demographic characteristics and asthma severity indicators.Conclusions: These findings suggest that inadequate health literacy is a surmountable barrier to learning and remembering key asthma self-management skills.