Performance of a brief survey to assess health literacy in patients receiving hemodialysis
Performance of a brief survey to assess health literacy in patients receiving hemodialysis
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DOI：
10.1093/ckj/sfv037
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发表时间：
2015-08-01
影响因子：
4.6
通讯作者：
Wallston, Kenneth A.
中科院分区：
文献类型：
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作者：
Cavanaugh, Kerri L.;Osborn, Chandra Y.;Wallston, Kenneth A.
背景：健康素养与肾脏疾病患者的重要结局相关，但广泛使用的健康素养衡量标准可能是繁重的。为了提供一个实用的评估，我们比较了三个项目的简明健康素养筛查(BHLS)和其他广泛使用的终末期肾病(ESRD)患者健康素养的测量。方法：从2009年到2012年，来自4个城市透析机构的150名成年血液透析患者参加了一项横断面研究。实施了三项健康素养措施，包括(I)成人医学素养的快速评估(领域)，(Ii)成人功能健康素养的短期测试(S-TOFHL)和(Iii)BHLS的三个项目。简易精神状态检查评估认知状况，慢性血液透析知识调查(CHEKS)和感知肾脏疾病知识调查(PIKS)评估肾脏知识。斯皮尔曼、S和受试者工作曲线下面积检验了上述变量之间的关系。结果：参与者接受透析的平均时间为4.6年。她们49%是女性，73%是非裔美国人，平均年龄为52岁。在所有三项健康素养指标中，教育程度较低和认知能力较弱均与健康素养较低有关(P<；0.05)。在BHLS上的表现与领域[0.35(95%可信区间(95%CI)：0.20-0.49)；P<；0.001]和S-TOFHLA[0.49(95%CI：0.35-0.69)；P<；0.001]、CHACK[0.43(95%CI：0.28-0.55)；P<；0.001]和PIK[0.41(95%CI：0.27-0.54)；P<；0.001]和PIK[0.41(95%CI：0.27-0.54)；P<；0.001]、CHACK[0.43(95%CI：0.28-0.55)；P<；0.001]和PIK[0.41(95%CI：0.27-0.54)；P<；0.001]、CHACK[0.43(95%CI：0.28-0.55)；P<；0.001]和PIK[0.41(95%CI：0.27-0.54)；P0.001]结论：BHLS在终末期肾病患者中显示出结构效度的证据。此外，健康素养与肾脏知识相关，支持将其作为一个潜在的干预目标，以改善健康素养较低患者的预后。
Background: Health literacy is associated with important outcomes among patients with kidney disease, but widely used measures of health literacy can be burdensome. In an effort to make a practical assessment available, we compared the performance of the three-item brief health literacy screen (BHLS) to other widely used measures of health literacy among patients with end-stage renal disease (ESRD).Methods: Adult hemodialysis patients (n = 150) from four urban dialysis facilities participated in a cross-sectional study from 2009 to 2012. Three health literacy measures were administered including (i) the rapid estimate of adult literacy in medicine (REALM), (ii) the short test of functional health literacy in adults (S-TOFHLA) and (iii) the three-item BHLS. The mini-mental state exam assessed cognitive status, and the chronic hemodialysis knowledge survey (CHeKS) and perceived kidney disease knowledge survey (PiKS) assessed kidney knowledge. Spearman'rho s and area under the receiver-operating curves examined relationships between the aforementioned variables.Results: Participants had received dialysis for a mean of 4.6 years. They were 49% female, 73% African American and averaged 52 years of age. Less education and less cognitive capacity were each associated (P < 0.05) with lower health literacy for all three health literacy measures. Performance on the BHLS was significantly associated with the REALM [0.35 (95% confidence interval (95% CI): 0.20-0.49); P < 0.001] and S-TOFHLA [0.49 (95% CI: 0.35-0.69); P < 0.001], the CHeKS [0.43 (95% CI: 0.28-0.55); P < 0.001] and PiKS [0.41 (95% CI: 0.27-0.54); P < 0.001].Conclusions: The BHLS demonstrates evidence of construct validity among ESRD patients. Furthermore, health literacy was associated with kidney knowledge, supporting it as a potential intervention target to improve outcomes among patients with lower health literacy.