THE TEST OF FUNCTIONAL HEALTH LITERACY IN ADULTS - A NEW INSTRUMENT FOR MEASURING PATIENTS LITERACY SKILLS
THE TEST OF FUNCTIONAL HEALTH LITERACY IN ADULTS - A NEW INSTRUMENT FOR MEASURING PATIENTS LITERACY SKILLS
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DOI：
10.1007/bf02640361
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发表时间：
1995-10-01
影响因子：
5.7
通讯作者：
NURSS, JR
中科院分区：
文献类型：
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作者：
PARKER, RM;BAKER, DW;NURSS, JR
目的：开发一种有效、可靠的工具来测量患者的功能健康素养。设计：成人功能健康素养测试（TOFHLA）是使用实际医院材料开发的。 TOFHLA 包括 50 项阅读理解和 17 项数字能力测试，最多需要 22 分钟进行。 TOFHLA、大范围成绩测试修订版 (WRAT-R) 和成人医学素养快速评估 (REALM) 进行比较，还开发了西班牙语版本 (TOFHLA-S)。设置：两家公立教学医院的门诊环境。患者：接触了 256 名英语和 249 名西班牙语患者，其中 78% 的英语患者和 82% 的西班牙语患者患者给予 知情同意，完成人口调查，并进行 TOFHLA 或 TOFHLA-S。结果：TOFHLA 显示与 WRAT-R 和 REALM 具有良好的相关性（相关系数分别为 0.74 和 0.84）。只有 52% 的英语使用者正确完成了 80% 以上的问题。 15% 的患者无法阅读和解释处方瓶上的说明，其中说明每天四次口服一粒药，37% 的患者不理解空腹服药的说明，48% 的患者无法确定自己是否有资格获得免费护理。 结论：TOFHLA 是衡量患者阅读健康相关材料能力的有效、可靠的指标。数据表明，很大一部分患者无法执行基本的阅读任务，需要开展额外的工作来确定功能性健康文盲的患病率及其对医疗保健体验的影响。
OBJECTTVE: To develop a valid, reliable instrument to measure the functional health literacy of patients.DESIGN: The Test of Functional Health Literacy in Adults (TOFHLA) was developed using actual hospital materials. The TOFHLA consists of a 50-item reading comprehension and 17-item numerical ability test, taking up to 22 minutes to administer. The TOFHLA, the Wide Range Achievement Test-Revised (WRAT-R), and the Rapid Estimate of Adult Literacy in Medicine (REALM) were administered for comparison, A Spanish version was also developed (TOFHLA-S).SETTING: Outpatient settings in two public teaching hospitals.PATIENTS: 256 English- and 249 Spanish-speaking patients were approached, 78% of the English- and 82% of the Spanish-speaking patients gave informed consent, completed a demographic survey, and took the TOFHLA or TOFHLA-S.RESULTS: The TOFHLA showed good correlation with the WRAT-R and the REALM (correlation coefficients 0.74 and 0.84, respectively). Only 52% of the English speakers completed more than 80% of the questions correctly. 15% of the patients could not read and interpret a prescription bottle with instructions to take one pill by mouth four times daily, 37% did not understand instructions to take a medication on an empty stomach, and 48% could not determine whether they were eligible for free care.CONCLUSIONS: The TOFHLA is a valid, reliable indicator of patient ability to read health-related materials. Data suggest that a high proportion of patients cannot perform basic reading tasks, Additional work is needed to determine the prevalence of functional health illiteracy and its effect on the health care experience.