Inadequate literacy is a barrier to asthma knowledge and self-care
Inadequate literacy is a barrier to asthma knowledge and self-care
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DOI：
10.1378/chest.114.4.1008
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发表时间：
1998-10-01
期刊：
影响因子：
9.6
通讯作者：
Nowlan, A
中科院分区：
文献类型：
--
作者：
Williams, MV;Baker, DW;Nowlan, A
研究目的：确定哮喘患者的识字能力与哮喘知识和使用计量吸入器(MDI)能力的关系。设计：横断面调查，地点：一家城市公立医院的急诊科和哮喘诊所，患者：方便抽样的273名哮喘急性发作期患者和210名来专科哮喘诊所接受常规护理的患者。干预：用成人医学素养快速评估来衡量识字能力，哮喘知识(20个问题口试)，MDI技术示范(6个项目评估)。测量和结果：只有27%的患者在高中水平阅读，尽管有三分之二的人声称自己是高中毕业生；阅读水平与哮喘知识得分(+/-SD)呈正相关，分别为15.1+/-2.5、13.9+/-2.5、13.4+/-2.8、11.9+/-2.5(p<；0.01)，患者阅读水平是哮喘知识得分的最强预测因子。89%的患者在三年级以下的阅读水平上发现MDI技术不佳(少于或等于3个正确步骤)，相比之下，48%的患者在高中水平上阅读。在多元回归分析中，阅读水平是MDI技术的最强预测因素。结论：识字不足普遍存在，且与哮喘知识较差和MDI使用不当密切相关。
Study objectives: To determine the relationship of literacy to asthma knowledge and ability to use a metered-dose inhaler (MDI) among patients with asthma.Design: Cross-sectional survey,Setting: Emergency department and asthma clinic at an urban public hospital,Patients: Convenience sample of 273 patients presenting to the emergency department for an asthma exacerbation and 210 patients presenting to a specialized asthma clinic for routine care.Interventions: Measurement of literacy with the Rapid Estimate of Adult Literacy in Medicine, asthma knowledge (20 question oral test), and demonstration of MDI technique (six-item assessment).Measurements and results: Only 27% of patients read at the high-school level, although two thirds reported being high-school graduates; 33% read at the seventh- to eighth-grade level, 27% at the fourth- to sixth-grade level, and 13% at or below the third-grade level, Mean asthma knowledge scores (+/-SD) were directly related to reading levels: 15.1 +/- 2.5, 13.9 +/- 2.5, 13.4 +/- 2.8, 11.9 +/- 2.5, respectively (p < 0.01), Patient reading level was the strongest predictor of asthma knowledge score in multivariate analysis. Poor MDI technique (less than or equal to 3 correct steps) was found in 89% of patients reading at less than the third-grade level compared with 48% of patients reading at the high-school level. In multivariate regression analyses, reading level was the strongest predictor of MDI technique.Conclusions: Inadequate literacy was common and strongly correlated with poorer knowledge of asthma and improper MDI use.