The development of health literacy in patients with a long-term health condition: the health literacy pathway model
The development of health literacy in patients with a long-term health condition: the health literacy pathway model
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DOI：
10.1186/1471-2458-12-130
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发表时间：
2012-02-14
影响因子：
4.5
通讯作者：
Edwards, Adrian
中科院分区：
文献类型：
--
作者：
Edwards, Michelle;Wood, Fiona;Edwards, Adrian
背景资料：健康知识普及不足与长期健康状况管理不善有关，已被确定为健康成果的一个关键社会决定因素。然而，很少有人了解健康素养如何随着时间的推移而发展，或者人们可能变得更加健康的过程。我们的目标是描述长期疾病患者如何在健康管理和与卫生专业人员沟通中实践健康素养，他们如何随着时间的推移变得更加健康，以及他们使用卫生服务的经验。我们还试图确定和描述的动机，促进者和障碍，在实践中的健康素养在healthcare consultations.Methods：我们设计了一个纵向定性研究，采用系列访谈与18名参与者，探讨他们的经验，学习管理自己的条件和他们的经验，健康素养时，参与医疗过程。参与者从患者教育计划中招募，并在9个月内接受了三次采访。一个框架的方法被用来分析data.Results：一个模型，说明健康素养的发展沿着一个轨迹，其中包括知识的发展，健康素养的技能和做法，健康素养的行动，在寻求选择和知情和共享的决策机会的能力。发展和实践健康素养技能的动机和障碍部分反映了参与者的特点，但也受到卫生专业人员的影响。一些参与者发展他们的健康素养的一个点，他们成为更多地参与医疗保健过程（包括知情和共享的决策）。结论：长期条件的患者可以发展健康素养的技能，随着时间的推移，并把他们的技能付诸实践，变得更加积极的医疗咨询。我们的研究结果对制定健康素养干预措施具有重要意义，这些干预措施旨在使患者参与医疗保健过程，并改善长期状况的自我管理。
Background: Inadequate health literacy has been associated with poor management of long-term health conditions and has been identified as a key social determinant of health outcomes. However, little is understood about how health literacy might develop over time or the processes by which people may become more health literate. Our objectives were to describe how patients with a long-term condition practice health literacy in the management of their health and communication with health professionals, how they become more health literate over time and their experience of using health services. We also sought to identify and describe the motivations, facilitators and barriers in the practice of health literacy in healthcare consultations.Methods: We designed a longitudinal qualitative study using serial interviews with 18 participants to explore their experiences of learning to manage their condition and their experiences of health literacy when participating in healthcare processes. Participants were recruited from patient education programmes and were interviewed three times over a period of 9 months. A framework approach was used to analyse data.Results: A model is presented that illustrates the development of health literacy along a trajectory that includes the development of knowledge, health literacy skills and practices, health literacy actions, abilities in seeking options and informed and shared decision making opportunities. Motivations and barriers to developing and practising health literacy skills partly reflected participants' characteristics but were also influenced by health professionals. Some participants developed their health literacy to a point where they became more involved in healthcare processes (including informed and shared decision-making).Conclusions: Patients with a long-term condition can develop health literacy skills over time and put their skills into practice in becoming more active in healthcare consultations. Our findings have implications for developing health literacy interventions aimed at patient involvement in healthcare processes and improved self-management of long-term conditions.