Health literacy and health outcomes in chronic obstructive pulmonary disease
Health literacy and health outcomes in chronic obstructive pulmonary disease
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DOI：
10.1016/j.rmed.2016.04.016
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发表时间：
2016-06-01
影响因子：
4.3
通讯作者：
Lee, Shoou-Yih D.
中科院分区：
文献类型：
--
作者：
Puente-Maestu, Luis;Calle, Myriam;Lee, Shoou-Yih D.
背景：关于健康素养（HL）对COPD临床结局的影响，全球范围内的信息很少。我们的目的是量化不充分的HL在西班牙，西班牙成人健康素养问卷的短期评估，并检查HL和COPD的结果和健康状况之间的关联。方法：296 COPD患者68（SD = 9）年和FEV1%预测为53%（SD = 18%），并随访一年。结果：HL不足的个体年龄较大（70[SD = 9] vs 65[SD = 8]岁; p < 0.001），并且通过低HL-COPD问卷测量，对其疾病的了解较少（6.9[SD = 2.3] vs 7.5 [SD = 1.9]; p < 0.001）。虽然他们的肺功能没有差异，但他们报告了mMRC（1.6[SD = 1] vs 1.4[SD = 1]; p < 0.001）、CAT（19.2[SD = 8.1] vs 18.3[SD = 7.5]; p = 0.049）和EQ-5（3.1[SD = 2.2] vs 2.3[SD = 1.9]; p < 0.00）的显著差异。HL不足的患者有≥ 2种合并症的风险也较高（OR = 1.87; 95%CI = 1.14-3.08），需要帮助（OR = 2.5; 95%CI = 1.5-4.2），焦虑/抑郁（OR = 1.9; 95% CI = 1.2-3.0），入院或急诊就诊（OR = 1.70; 95% CI = 1.1-2.7），以及次年的全因死亡（3.8%（SE = 1.1%）vs 0%; p = 0.051）。HL不足在COPD患者中普遍存在，与健康状况和疾病的相关临床结局相关。在规划COPD患者的护理时，需要考虑HL。(C)2016爱思唯尔有限公司版权所有。
Background: There is little information worldwide about the impact of health literacy (HL) on clinical outcomes of COPD. Our aim was to quantify inadequate HL in Spain, as measured by the Short Assessment of Health Literacy for Spanish Adults questionnaire, and to examine the associations between HL and both COPD outcomes and health status.Methods: 296 COPD patients of 68(SD = 9) years and a FEV1% predicted of 53%(SD = 18%) were enrolled and followed-up for one year. 59% showed "inadequate" HL.Results: Individuals with inadequate HL were older (70[SD = 9] vs 65[SD = 8] years; p < 0.001) and had less knowledge of their disease, as measured by the low HL-COPD questionnaire, (6.9[SD = 2.3] vs 7.5 [SD = 1.9]; p < 0.001). While their lung function was no different, they reported significant differences in mMRC (1.6[SD = 1] vs 1.4[SD = 1]; p < 0.001), CAT (19.2[SD = 8.1] vs 18.3[SD = 7.5]; p = 0.049), and EQ-5 (3.1[SD = 2.2] vs 2.3[SD = 1.9]; p < 0.00). Those with inadequate HL had also higher risk of having >= 2 comorbidities (OR = 1.87; 95% CI = 1.14-3.08), need of assistance (OR = 2.5; 95% CI = 1.5-4.2), anxiety/depression (OR = 1.9; 95% CI = 1.2-3.0), admissions or visits to the emergency department (OR = 1.70; 95% CI = 1.1-2.7), and all-cause deaths in the following year (3.8% (SE = 1.1%) vs 0%; p = 0.051).Conclusions: Inadequate HL is prevalent among COPD patients and it is related to health status and relevant clinical outcomes of the disease. HL needs to be considered when planning the care for COPD patients. (C) 2016 Elsevier Ltd. All rights reserved.