慢性心力衰竭患者健康素养现状及其影响因素分析
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摘要
目的 :调查慢性心力衰竭患者健康素养现状并分析其影响因素。方法 :采取便利抽样的方法选取2017年10月至2018年9月上海市3家综合性三级甲等医院180例门诊慢性心力衰竭患者为研究对象。采用一般资料调查表、社会支持评定量表及中文版心力衰竭特异性健康素养量表进行问卷调查。结果 :慢性心力衰竭患者健康素养得分为(28.72±9.36)分,批判性健康素养维度条目均分最低为(2.08±0.85)分;分层回归分析显示:年龄、居住地、学历、心功能分级以及社会支持是慢性心力衰竭患者健康素养及各维度的影响因素。结论 :慢性心力衰竭患者健康素养尤其是批判性健康素养有待提高;加强社会支持可提高慢性心力衰竭患者的健康素养水平;对年龄较大、农村、学历较低以及心功能较差的患者应重点关注。
Objective: To investigate the current status of health literacy and its influencing factors among patients with Chronic Heart Failure(CHF). Methods: totally 180 CHF patients were recruited by convenience sampling method from outpatient department in 3 tertiary general hospitals in Shanghai from October, 2017 to September, 2018. Self-designed demographic and health status questionnaire, Social Support Rating Scale and the Chinese version of Heart Failure Specific Health literacy scale were applied. Results: The mean score of health literacy was 28.72±9.36. The mean score of critical health literacy was 2.08±0.85. Multiple hierarchical regression analysis suggested that age, place of residence, education, NYHA class and social support were the main influencing factors of health literacy in CHF patients. Conclusion: Health literacy especially critical health literacy in CHF patients is relatively poor. Enhancing social support may improve CHF patients' health literacy. Health workers should pay more attention to CHF patients who are older, living in rural areas, less educated, and have poorer NYHA class.
Objective: To investigate the current status of health literacy and its influencing factors among patients with Chronic Heart Failure(CHF). Methods: totally 180 CHF patients were recruited by convenience sampling method from outpatient department in 3 tertiary general hospitals in Shanghai from October, 2017 to September, 2018. Self-designed demographic and health status questionnaire, Social Support Rating Scale and the Chinese version of Heart Failure Specific Health literacy scale were applied. Results: The mean score of health literacy was 28.72±9.36. The mean score of critical health literacy was 2.08±0.85. Multiple hierarchical regression analysis suggested that age, place of residence, education, NYHA class and social support were the main influencing factors of health literacy in CHF patients. Conclusion: Health literacy especially critical health literacy in CHF patients is relatively poor. Enhancing social support may improve CHF patients' health literacy. Health workers should pay more attention to CHF patients who are older, living in rural areas, less educated, and have poorer NYHA class.
引文
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[22]刘柳,田建丽,张红,等.中老年住院冠心病患者疾病相关健康素养与社会支持现状分析.护理管理杂志,2016,16(1):7-9.Liu L,Tian JL,Zhang H,et al.Health literacy and social support among the middle-aged and elderly hospitalized patients with coronary heart disease in Urumqi.Journal of Nursing Administration,2016,16(1):7-9.
[23]孟凯.中老年慢性病患者健康素养、社会支持与健康状况的相关性研究.延吉:延边大学,2016.Meng K.Relevant research among social support,health status and health literacy of the elderly patients with chronic diseases.Yanji:Yanbian University,2016.
[2]Jessup M,Marwick TH,Ponikowski P,et al.2016 ESC and ACC/AHA/HFSA heart failure guideline update-what is new and why is it important?.Nat Rev Cardiol,2016,13(10):623.
[3]Go AS,Mozaffarian D,Roger VL,et al.Heart disease and stroke statistics-2013 update.Circulation,2013,125(4):e18-e209.
[4]Bailey SC.The mechanisms linking health literacy to behavior and health status.American Journal of Health Behavior,2011,35(1):118.
[5]Nutbeam D.Health promotion glossary.Health Promot Int,1998(13):349-364.
[6]Berk man ND,Sheridan SL,Donahue K E,e t a l.Low health literacy and health outcomes:an updated systematic review.Ann Intern Med,2011,155(2):97.
[7]Cajita MI,Cajita TR,Han H.Health literacy and heart failure:a systematic review.J Cardiovasc Nurs,2016,31(2):121-130.
[8]Matsuoka S,Kato N,Kayane T,et al.Development and validation of a Heart FailureSpecific Health Literacy Scale.J Cardiovasc Nurs,2016,31(2):131-139.
[9]肖水源.《社会支持评定量表》的理论基础与研究应用.临床精神医学杂志,1994(2):98-100.Xiao SY.The theoretical basis and research application of social support rating scale.Journal of Clinical Psychological Medicine,1994(2):98-100.
[10]刘继文,李富业,连玉龙.社会支持评定量表的信度效度研究.新疆医科大学学报,2008,31(1):1-3.Liu JW,Li FY,Lian YL.Investigation of reliability and validity of the social support scale.Journal of Xinjiang Medical University,2008,31(1):1-3.
[11]Yue M,Zhang L,Lu Y,et al.Translation and psychometric evaluation of the Chinese version of the Heart Failure-Specific Health Literacy Scale.Int J Nurs Sci,2016,3(4):342-346.
[12]Cordasco KM,Asch SM,Franco I,et al.Health literacy and English language comprehension among elderly inpatients at an urban safety-net hospital.J Health Hum Serv Adm,2009,32(1):30-50.
[13]Wu JR,Moser DK,Dewalt DA,et al.Health literacy mediates the relationship between age and health outcomes in patients with heart failure.Circ Heart Fail,2016,9(1):606-619.
[14]田青,姜亚芳,向晶,等.血液透析患者健康素养现状及其影响因素分析.中国护理管理,2018,18(4):492-496.Tian Q,Jiang YF,Xiang J,et al.The current status and influencing factors of health literacy among hemodialysis patients.Chinese Nursing Management,2018,18(4):492-496.
[15]国家心血管中心.中国心血管病报告2015.北京:中国大百科全书出版社,2015.National Center for Cardiovascular Diseases,China.Report of chinese cardiovascular disease in China 2015.Peking:Encyclopedia of China Publishing House,2015.
[16]Martinezdonate AP,Halverson J,Simon NJ,et al.Identifying health literacy and health system navigation needs among rural cancer patients:findings from the Rural Oncology Literacy Enhancement Study(ROLES).J Cancer Educ,2013,28(3):573-581.
[17]Moser DK,Robinson S,Biddle MJ,et al.Health literacy predicts morbidity and mortality in rural patients with heart failure:moser health literacy outcomes.J Card Fail,2015,21(8):612-618.
[18]Peterson PN,Shetterly SM,Clarke CL,et al.Health literacy and outcomes among patients with heart failure.JAMA,2011,305(16):1695-701.
[19]孟凯,李春玉.中老年患者慢性病健康素养现状及其影响因素研究.延边大学医学学报,2016(1):43-45.Meng K,Li CY.Study of status and influence factors of health literacy in middle and old aged patients with chronic diseases.Journal of Medical Science Yanbian University,2016(1):43-45.
[20]Kripalani S,Bengtzen R,Henderson LE,et al.Clinical research in low-literacy populations:using teach-back to assess comprehension of informed consent and privacy information.IRB:Ethics and Human Research,2008,30(2):13-19.
[21]黄丽,彭山玲.癌症患者健康素养现状及其影响因素.解放军护理杂志,2016,33(2):17-20.Huang L,Peng SL.The status and influencing factors of health literacy among cancer patients.Nursing Journal of Chinese People's Liberation Army,2016,33(2):17-20.
[22]刘柳,田建丽,张红,等.中老年住院冠心病患者疾病相关健康素养与社会支持现状分析.护理管理杂志,2016,16(1):7-9.Liu L,Tian JL,Zhang H,et al.Health literacy and social support among the middle-aged and elderly hospitalized patients with coronary heart disease in Urumqi.Journal of Nursing Administration,2016,16(1):7-9.
[23]孟凯.中老年慢性病患者健康素养、社会支持与健康状况的相关性研究.延吉:延边大学,2016.Meng K.Relevant research among social support,health status and health literacy of the elderly patients with chronic diseases.Yanji:Yanbian University,2016.