The meaning and the measure of health literacy
The meaning and the measure of health literacy
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DOI：
10.1111/j.1525-1497.2006.00540.x
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发表时间：
2006-08-01
影响因子：
5.7
通讯作者：
Baker, David W.
中科院分区：
文献类型：
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作者：
Baker, David W.
结论健康素养是一个复杂的结构，取决于个人的沟通能力和社会和卫生保健系统的需求。需要进行更全面的测试，以了解能力与当前需求之间的差距，帮助指导对儿童和成人进行健康问题教育的工作，并编制更多公众能够理解的健康相关信息。对于研究来说，需要新的工具来更精确地测量个人阅读流畅度，而不会造成不适当的反应负担。计算机辅助测试根据基线预测的阅读能力和对先前问题的回答，从可能的项目库中选择项目，应该允许更准确地测量个人能力，而不增加完成测试所需的时间。目前尚不清楚是否有可能开发一种准确、实用的“筛查”测试，以识别健康素养有限的个人。即使这一目标得以实现，目前仍不清楚是对患者进行筛查更好，还是采取“普遍预防措施”，通过在所有口头和书面交流中使用简单的语言，并通过让所有患者重复他们对诊断和治疗计划的理解来确认与所有患者的理解，以避免误解。乔治萧伯纳说：“沟通的主要问题是假设它已经发生了。”这是一个超越阅读能力的普遍真理。
ConclusionsHealth literacy is a complicated construct that depends on individual capacity to communicate and the demands posed by society and the health care system. More comprehensive tests are needed to understand the gap between capacities and current demands to help guide efforts to educate children and adults about health issues and to develop health-related information that more of the general public can understand. For research, new instruments are needed that will measure individuals reading fluency more precisely without posing an undue response burden. Computer-assisted testing, which selects items from a bank of possible items according to a baseline-predicted reading ability and responses to previous questions, should allow more accurate measurement of indiidual capacity without increasing the time required to complete testing. It remains unclear whether it is possible to develop an accurate, practical “screening” test to identify individuals with limited health literacy. Even if this goal is achieved, it remains unclear whether it is better to screen patients or to adopt “universal precautions” to avoid miscommunication by using plain language in all oral and written communication and confirming understanding with all patients by having them repeat back their understanding of their diagnosis and treatment plan. George Bernard Shaw said, “The main problem with communication is the assumption that it has occurred.” This is a universal truth that transcends reading ability.