The association of health literacy with adherence and outcomes in moderate-severe asthma.
The association of health literacy with adherence and outcomes in moderate-severe asthma.
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DOI：
10.1016/j.jaci.2013.02.014
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发表时间：
2013-08
影响因子：
14.2
通讯作者：
Morales, Knashawn H.
中科院分区：
文献类型：
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作者：
Apter, Andrea J.;Wan, Fei;Reisine, Susan;Bender, Bruce;Rand, Cynthia;Bogen, Daniel K.;Bennett, Ian M.;Bryant-Stephens, Tyra;Roy, Jason;Gonzalez, Rodalyn;Priolo, Chantel;Ten Have, Thomas;Morales, Knashawn H.
关键词：
低健康素养与哮喘和其他疾病的不良预后有关，但控制这种关系的机制尚不明确。评估读写能力是否与随后的哮喘自我管理（以吸入类固醇的依从性衡量）和哮喘结局相关。在一项前瞻性纵向队列研究中，使用混合效应线性回归模型，在中度或重度哮喘患者的基线上评估数字（哮喘算术问卷（ANQ））和印刷识字（成人功能健康素养短测试（S-TOFHLA））对随后26周电子监测依从性和哮喘结局（哮喘控制、哮喘相关生活质量和FEV1）的影响。284名成人参与：48±14岁，71%女性，70%非洲裔美国人，6%拉丁裔，平均FEV1 66%±19%，86名（30%）住院，148名（52%）前一年因哮喘就诊。平均ANQ评分（范围0-4）为2.3±1.2；S-TOFHLA平均评分31±8分（范围0 ~ 36）。在未经调整的分析中，识字和识字与更好的依从性（p=0.01, p=0.08）、哮喘控制（p=0.005, p<0.001）和生活质量（p<0.001, p<0.001）相关。在控制了年龄、性别和种族/民族后，这种关联减弱，只有生活质量（数字：p=0.03，印刷体p=0.006）和哮喘控制（印刷体p=0.005）仍然与识字显著相关。种族/民族、收入和受教育程度相关（p<0.001）。虽然识字与健康之间的关系很复杂，但考虑到并解决患者识字需求的干预措施可能会改善哮喘结果。在患有中度或重度哮喘的成年人中，较高的健康素养得分与随后更好的生活质量和哮喘控制相关。
Low health literacy is associated with poor outcomes in asthma and other diseases but the mechanisms governing this relationship are not well-defined. To assess whether literacy is related to subsequent asthma self-management, measured as adherence to inhaled steroids, and asthma outcomes. In a prospective longitudinal cohort study, numeric (Asthma Numeracy Questionnaire (ANQ)) and print literacy (Short Test of Functional Health Literacy in Adults (S-TOFHLA)) were assessed at baseline in adults with moderate or severe asthma for their impact on subsequent electronically monitored adherence and asthma outcomes (asthma control, asthma-related quality of life, and FEV1) over 26 weeks, using mixed-effects linear regression models. 284 adults participated: 48±14 years, 71% female, 70% African American, 6% Latino, mean FEV1 66% ± 19%, 86 (30%) with hospitalizations and 148 (52%) with ED visits for asthma in the prior year. Mean ANQ score (range 0–4) was 2.3 ± 1.2; mean S-TOFHLA score 31 ± 8 (range 0–36). In unadjusted analyses numeric and print literacy were associated with better adherence (p=0.01, p=0.08), asthma control (p=0.005, p <0.001), and quality of life (p<0.001, p<0.001). After controlling for age, sex, and race/ethnicity, the associations diminished and only quality of life (numeric: p=0.03, print p=0.006) and asthma control (print p=0.005) remained significantly associated with literacy. Race/ethnicity, income, and educational attainment were correlated (p<0.001). While the relationship between literacy and health is complex, interventions which account for and address the literacy needs of patients may improve asthma outcomes. In adults with moderate or severe asthma, higher health literacy scores were associated with better subsequent quality of life and asthma control.
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影响因子：
14.2
作者：
Apter, AJ;Boston, RC;Feldman, HI
通讯作者：
Feldman, HI
影响因子：
5.9
作者：
Bender, B;Wamboldt, FS;Wamboldt, MZ
通讯作者：
Wamboldt, MZ
影响因子：
14.2
作者：
Bogen, D;Apter, AJ
通讯作者：
Apter, AJ
DOI：
10.1164/rccm.200902-0166oc
发表时间：
2009-11-01
影响因子：
24.7
作者：
Gamble, Jacqueline;Stevenson, Michael;Heaney, Liam G.
通讯作者：
Heaney, Liam G.
DOI：
10.1164/ajrccm.152.3.7663792
发表时间：
1995-09-01
影响因子：
24.7
作者：
通讯作者：
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