重庆市居民健康素养状况调查研究
|
摘要
目的:本研究通过对重庆市居民健康知识与态度、健康生活方式与行为、健康技能等三个方面进行调查,拟了解重庆市居民健康知识与态度、健康生活方式与行为及健康技能等三个方面现状及分布特征,并分析其各自的影响因素;通过收集健康素养相关指标数据,对个体或人群的健康素养水平进行综合评估,分析影响居民健康素养水平的影响因素,从而建立我市公民健康素养基础信息库;进而为开展健康素养监测、制定健康促进与健康教育策略或标准提供参考依据。
方法:采用多阶段分层随机人民币的抽样方法确定监测对象,利用《中国公民健康素养-基本知识与技能》试行中提供的调查问卷,以入户访谈的形式,进行健康知识与态度、健康生活方式与行为、健康技能等三个方面的调查,收集重庆市居民健康素养的有关指标数据。对居民在知识、行为等健康要素方面的状况进行描述性分析,运用符号秩和检验、K-W检验和多元线性回归等分析方法,对影响居民健康知识、行为和技能的因素进行分析;运用秩和比综合评价法对居民健康素养进行综合评估,并进行影响因素分析。
结果:重庆市居民在健康知识、健康生活方式与行为及健康技能这三个方面均表现为总体知晓情况较好,但在某些特殊问题上知晓情况不容乐观;在评分方面均表现为城市居民优于农村居民,且随着文化程度、家庭平均月收入的增高,其评分越高;不同的是,在健康知识方面,男性评分略低于女性,而在健康生活方式与行为方面,女性优于男性,性别对健康技能评分无影响;从年龄分布来看,除了对生活方式与行为评分没有影响外,在知识及技能方面均表现为随着年龄的增长,其评分呈下降趋势。经秩和比综合评价发现,健康素养处于中等水平的居民最多,占到总人数的45.13%;年龄、文化程度及平均月收入为影响健康素养水平的积极因素,地域为消极因素;且在影响程度上,从大到小排列依次为文化程度、地域、平均月收入及年龄。
结论:居民健康知识掌握不够全面,健康生活方式与行为习惯不够合理,健康技能不够完善,健康素养水平一般,应加大健康教育与健康促进工作的力度,并为公众营造一个健康的支持环境,提高公众的健康素养水平;文化程度、年龄、收入等严重影响居民的健康素养水平,应该有针对性的开展健康教育,提高弱势群体的健康素养;城市居民健康素养水平明显高于农村居民,健康教育工作的重点应该放在农村。
Objective: In order to know the present situation and distribution characteristics about health knowledge and attitude, health lifestyle and behavior and healthy skills, this article conduct an investigation from these three respects to analyze their respective factors. We establish the civic information database based on health literacy through collection of relevant indicators of health literacy data, comprehensive assessment of the level of health literacy about both individual and group, factors analysis of the residents′health literacy level to provide reference frame for carrying out monitoring of health literacy, formulating health promotion and health education strategies or standards.
Methods: We use the stratified, multistage, random-sampling RMB design to draw samples, with the questionnaires provided by the《Chinese Citizens’Healthy Literacy-Basic Knowledge and Skills》.Also we use the form of home interview to investigate health knowledge and attitude, health lifestyle and behavior and health skills of our residents through which we can gather the related data of health literacy. Through descriptive analysis about the health knowledge and behavior, and we use Wilcoxon rank sum test, K-W test and MLR to analyze the factors which affect residents′health knowledge, behavior and skills. We use RSR comprehensive evaluation to give a comprehensive evaluation about the residents’health literacy and analyze the effect factors.
Result: Chongqing residents display a good overall knowledge of the situation in health knowledge, health life style and behavior and health skills. But in certain special questions, it’s unoptimistic. The city residents have a better performance than the countryside residents in rating aspects and who have a better education or higher family average month incomes can get a high score. What is different, in the health knowledge aspect, masculine grading slightly is lower than the female, but in the health life style and behavior aspect, the female surpasses the male. The gender does not have influence on health skills grading. Looking from the age distribution, besides having no effect on the life style and behavior grading, the knowledge and skills display a declining trend with the age growth. After comprehensive evaluation, we can find that residents whose health literacy is in the medium level are the most, occupied the total number of people 45.13%.The age, education and average month income are the positive factor while the region are the negative factors. In the impact, the big to small in descending order are education, region, the average monthly income and age.
Conclusion: We need pay more attention to health education and health promotion, create a health support environment to improve the residents′health literacy level because the residents don’t know the health knowledge very well, have a reasonable health lifestyle and behavior and not very good health skills. As the education、age and income have a significant influence on the health literacy level, we need a targeted health education to improve the level of vulnerable groups. As the city people have a higher level than the countryside resident, health education should focus on rural areas.
方法:采用多阶段分层随机人民币的抽样方法确定监测对象,利用《中国公民健康素养-基本知识与技能》试行中提供的调查问卷,以入户访谈的形式,进行健康知识与态度、健康生活方式与行为、健康技能等三个方面的调查,收集重庆市居民健康素养的有关指标数据。对居民在知识、行为等健康要素方面的状况进行描述性分析,运用符号秩和检验、K-W检验和多元线性回归等分析方法,对影响居民健康知识、行为和技能的因素进行分析;运用秩和比综合评价法对居民健康素养进行综合评估,并进行影响因素分析。
结果:重庆市居民在健康知识、健康生活方式与行为及健康技能这三个方面均表现为总体知晓情况较好,但在某些特殊问题上知晓情况不容乐观;在评分方面均表现为城市居民优于农村居民,且随着文化程度、家庭平均月收入的增高,其评分越高;不同的是,在健康知识方面,男性评分略低于女性,而在健康生活方式与行为方面,女性优于男性,性别对健康技能评分无影响;从年龄分布来看,除了对生活方式与行为评分没有影响外,在知识及技能方面均表现为随着年龄的增长,其评分呈下降趋势。经秩和比综合评价发现,健康素养处于中等水平的居民最多,占到总人数的45.13%;年龄、文化程度及平均月收入为影响健康素养水平的积极因素,地域为消极因素;且在影响程度上,从大到小排列依次为文化程度、地域、平均月收入及年龄。
结论:居民健康知识掌握不够全面,健康生活方式与行为习惯不够合理,健康技能不够完善,健康素养水平一般,应加大健康教育与健康促进工作的力度,并为公众营造一个健康的支持环境,提高公众的健康素养水平;文化程度、年龄、收入等严重影响居民的健康素养水平,应该有针对性的开展健康教育,提高弱势群体的健康素养;城市居民健康素养水平明显高于农村居民,健康教育工作的重点应该放在农村。
Objective: In order to know the present situation and distribution characteristics about health knowledge and attitude, health lifestyle and behavior and healthy skills, this article conduct an investigation from these three respects to analyze their respective factors. We establish the civic information database based on health literacy through collection of relevant indicators of health literacy data, comprehensive assessment of the level of health literacy about both individual and group, factors analysis of the residents′health literacy level to provide reference frame for carrying out monitoring of health literacy, formulating health promotion and health education strategies or standards.
Methods: We use the stratified, multistage, random-sampling RMB design to draw samples, with the questionnaires provided by the《Chinese Citizens’Healthy Literacy-Basic Knowledge and Skills》.Also we use the form of home interview to investigate health knowledge and attitude, health lifestyle and behavior and health skills of our residents through which we can gather the related data of health literacy. Through descriptive analysis about the health knowledge and behavior, and we use Wilcoxon rank sum test, K-W test and MLR to analyze the factors which affect residents′health knowledge, behavior and skills. We use RSR comprehensive evaluation to give a comprehensive evaluation about the residents’health literacy and analyze the effect factors.
Result: Chongqing residents display a good overall knowledge of the situation in health knowledge, health life style and behavior and health skills. But in certain special questions, it’s unoptimistic. The city residents have a better performance than the countryside residents in rating aspects and who have a better education or higher family average month incomes can get a high score. What is different, in the health knowledge aspect, masculine grading slightly is lower than the female, but in the health life style and behavior aspect, the female surpasses the male. The gender does not have influence on health skills grading. Looking from the age distribution, besides having no effect on the life style and behavior grading, the knowledge and skills display a declining trend with the age growth. After comprehensive evaluation, we can find that residents whose health literacy is in the medium level are the most, occupied the total number of people 45.13%.The age, education and average month income are the positive factor while the region are the negative factors. In the impact, the big to small in descending order are education, region, the average monthly income and age.
Conclusion: We need pay more attention to health education and health promotion, create a health support environment to improve the residents′health literacy level because the residents don’t know the health knowledge very well, have a reasonable health lifestyle and behavior and not very good health skills. As the education、age and income have a significant influence on the health literacy level, we need a targeted health education to improve the level of vulnerable groups. As the city people have a higher level than the countryside resident, health education should focus on rural areas.
引文
[1] World Health Organization. The Bangkok Charter for Health Promotion in a Globalized World[EB].http://www.who.int/healthpromotion/,2007-12-31
[2]肖瓅,陶茂萱.中国公众健康素养调查及评价指标体系建立[D].北京.中国疾病预防控制中心.2008
[3] Parker PM, Baker DW, Williams MV, et al. The Test of Functional Health in Adults: a new instrument for measuring patient′s literacy skills[J]. Journal of General Internal Medicine, 1995, 10(10):537-541
[4] Bakel DW, Parker RM, Williams MV. Healthy literacy and the risk of hospital admission [J]. Gen Intern Med,1998,13:791—98
[5] Kutner M, Greenberg E, Jin Y, et al. The health literacy of America’s adults, results from the 2003 national assessment of adult literacy (NCES 2006-483) [M]. Washington, DC: National Center for Education Statistics, 2006. iii-v
[6]易静,周燕荣,康军,等.我国全面建设小康社会的健康素质指标体系及标准研究[J].现代预防医学, 2005, 32 (10):1289-1290
[7]李新华.《中国公民健康素养———基本知识与技能》的界定和宣传推广简介[J].中国健康教育,2008,24(5):385-388
[8]王卓甫,张怡.基于熵权加权法的工程评标模型[J].科技管理研究.2010,3:47-48
[9]易静,周燕荣.大气污染健康效应综合评价中权数的比较研究[J].中国卫生统计. 2000,17(5)
[10]易静,周燕荣,王润华,等.信息权数在行为方式健康效应综合评价中的应用[J].中国公共卫生,2003,19(4)
[11]张建国.综述评价中确定客观权重的一类方法.[A]卫生统计学术研讨会论文集,张家界, 1997
[12]杨红平,马大川.信息系统投资的最优组合赋权法研究[J].科学学与科学技术管理, 2004(2):48~51
[13]孙振球,王乐三.医学综合评价方法及其应用[M].第二版.北京:化学工业出版社,2006:518-512
[14]吴春容.健康及健康问题的整体观[J].中国全科医学杂志.2003,9:303一305
[15]杨红英.做好社区慢性病防治工作,促进人群健康[J].重庆医学,2009,38(13): 1700-1701
[16]刘剑君,姜世闻,成诗明.中国结核病控制现状分析及对策[J].中国防痨杂志. 2003:25(3)
[17] World Health Organization WHO Report“2001 Global Tuberculosis Control" Geneva:WHO,2001
[18]钮肖茜.浅谈健康教育工作的地位、作用及实施战略[J].江苏卫生保健.2002,4(3):101
[19]裴明.高校医院应关注慢性病的预防和危险因素的干预[J].保健医学研究与实践.2007,4(1):85-86
[20]肖璨,程玉兰,陶茂宣等.Delphi法在筛选中国公众健康素养评价指标中的应用研究[J].中国健康教育.2008.24(2):81一84
[21]邱顺翼,张俊青,李多富等.合肥市2008年中国公民健康素养调查分析[J].健康教育与健康促进.2008.12:13一16
[22]深圳市健康教育研究所.市民健康素养教育工作巫待加强[J].开放导报.2008,3
[23] Parikh NS, Parker RM, Nurss JR. Shame and health literacy: the unspoken connection[J]1 Patient Education and Counseling,1996,27:33-39
[24] Schillinger D, Grumbach K, Piette J. Association of health literacy with diabetes outcomes[J]1 JAMA,2002,J2884:475-482
[25] Shoou-Yih DL, Deborah EB, Rafael R. Development of an Easy-to-Use Spanish health literacy assessment tool [EB] http://www.Academy health.org/2004/ppt/lee 1ppt.2004-12-01
[26]黄远霞,李毅琳,李俊林等.建筑业男性农民工健康知识和行为影响因素分析[J].中国卫生事业管理,2008,3:199-200
[27]郭欣,王克安.健康素养研究进展[J].中国健康教育,2005,21(8):590-593
[28] Patrick Kelly. Health literacy: a silent crisis [EB].http://mediwire.sky scape.com/main/Default.asp,2005-10-26
[29] Partnership for Clear Health Communication Steering Committee Eradicating low healthy literacy: the first public health movement of the 21st century overview white paper[EB].http://www.1aameda.org/Member Services/Exec/Articles/sum03 /Eradicating Low Health care Literacy.pdf.2003-03
[30] Weiss, B. D, Coyne, C. Communicating with patients who can not read[J]. New England Journal of Medicine, 1997,337(4):272-274
[31] Baker, D. W., Parker, R. M., Clark, W. S. Health literacy and the risk of hospital admission[J]. Journal of General Internal Medicine, 1998, 13(12):791-798
[32] Rima E. Rudd, Lindsay Rosenfeld and Victoria Gall. Health literacy and arthritis research and practice.[J]Epidemiology and health-related services.2007,19:97-100
[33]肖璨,马昱,李英华,等.中国城乡居民健康素养状况及影响因素研究[J].中国健康教育.2009,25(5):323-326
[34]刘德柱.山村农民健康教育干预5年效果观察[J].中国农村卫生事业管理, 2001, 21(3): 41-43
[35]杨菊贤.健康行为的建立[J].医学与哲学.2001.22(3):37一39
[36] Office of Disease Prevention and Health Promotion,U.S. Department of Health and Human Services. Healthy People 2010[EB].httP://www.health people.gov/,2005 -05-12
[37] J. Thomas Butler. Principles of health education and health promotion[M]. Wadsworth: Thomson Learning,2001.145一181
[38] Lynn Nielsen Bohlman, Allison M. Panzer. Health literacy: a prescription to end confusion[M].Washington, DC: The National Academies Press,2004.21一58
[39] Michael Villaire,MSLM, and Gloria Mayer,RN,EdD,FAAN.Low Health Literacy the Impact on Chronic Illness Management.[J]Professional Case Management. 2007,12(4):231-216
[40]佟丽,胡俊峰,侯培森.健康素质和健康素养[J]中国健康教育,2006,22(4):293-295
[41]曾桂群.知信行理论对334名农村妇女健康教育的影响[J].中国卫生统计,2007. 24(3):285—286
[42]李杰.媒体健康传播对提升全民健康素养的意义.知网
[43]刘妹倩.利用大众媒体开展健康教育效果评价[J].中国健康教育2003,(6)
[44]重庆:中国城乡二元结构的缩影[N].京江晚报, 2009-1-3. http://www.jsw.com.cn/site3/jjwb/html/2009-01/03/content_1368820.htm.
[1]佟丽,胡俊峰,侯培森.健康素质和健康素养[J].中国健康教育,2006,22(4):293-295
[2] Carolyn Speros.Health literacy: concept analysis [J].Journal of Advanced Nursing, 2005(6):633-640
[3] Lynn Nielsen-Bohlman,A1lison M.Panzer.Health literacy:a prescription to end confusion[M].Washington,DC:The National Academies press,2004:21-58
[4]郭欣,王克安.健康素养研究进展.中国健康教育,2005,21(8):590-593
[5] The Bangkok Charter for Health Promotion in a Globalized World, the 6 th Global Conference on Health Promotion, Bangkok, Thailand, August 2005, World Health Organization
[6] J.Thomas Butler.Principles of health education and health promotion[M]. Wadsworth:Thomson Learning,2001.145—181
[7] Eileen Sullivan.Health literacy[EB].http://nnlm.gov/scr/conhlth/Hlthlit.htm. 2005-10-26
[8] Lenox D.What is health literacy? [EB].http://www.chcs.org.2005-03-01
[9] Pleasant A,Kuruvilla S.A tale of two health literacies:public health and clinical approaches to health literacy[J].Health Promotion International,2008,23 (2): 152-159
[10]肖瓅,陶茂萱.健康素养研究进展与展望[J].中国健康教育,2008,24(5):361-364.
[11] Office of Disease Prevention and Health Promotion, U. S. Department of Health and Human Services. Healthy People 2010 [EB].http://www. Healthy people. gov/, 2007-03-12
[12] Linda Murphy-Knoll, MN. Low Health Literacy Puts Patients at Risk: The Joint Commission Proposes Solutions to National Problem. Journal of Nursing Care Quality,2007,22(3):205-209
[13]李新华.《中国公民健康素养———基本知识与技能》的界定和宣传推广简介[J].中国健康育,2008,24(5):385-388
[14]左佰常,朱建平,赵晓明.从科学素养调查谈健康话题[J].健康博览,2007,(5):4-7
[15] Barry D.Weiss.Health literacy:an important issue for communicating healthinformation to patients[J].Chinese Medical Journal,2001,64:603-608
[16] Weiss, B. D. Coyne, C. Communicating with patients who can not read[J]. New England Journal of Medicine, 1997,337(4):272-274
[17] Baker, D. W., Parker, R. M., Clark, W. S. Health literacy and the risk of hospital admission[J]. Journal of General Internal Medicine, 1998, 13(12):791-798
[18] Rima E. Rudd, Lindsay Rosenfeld and Victoria Gall. Health literacy and arthritis research and practice.[J]Epidemiology and health-related services.2007,19:97-100
[19]王利明,狄玉峰.河北省大学生健康知识、态度和行为的调查分析.职场研究[EB].维普资讯http://www.cqvip.com
[20] Kirsch I,Jungeblut A,Jenkins K.Adult literacy in America:a first look at the findings of the national adult literacy survey MJ.Washington.DC:Nations Center for Education Statistics,US Department of Education.1993.1—20
[21] Rima ER,Barbara AM,Tayla CC.Health and literacy[M].New York:Jossey-Bass,1999-5-18
[22] Hoffman R R,Crandall B,Shadbolt N.Use of the critical decision method to elicit expert knowledge:A case study in the methodology of cognitive task analysis[J]. Human Factors,1998,40:254-277
[23] Safran J,D,Greenberg I, S,Rice I,N.Integrating psychotherapy research and practice:Modeling the change process[J].Psychotherapy,1988,25:l - l7
[24] Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients′knowledge of their chronic disease: a study of patients with hypertension or diabetes[J]. Arch Intern Med,1998,158:166-172
[25]裴明.高校医院应关注慢性病的预防和危险因素的干预[J].保健医学研究与实践,2007,4(1):85-86
[26]肖璨,程玉兰,陶茂宣,等.Delphi法在筛选中国公众健康素养评价指标中的应用研究[J].中国健康教育.2008.24(2):81-84
[27]邱顺翼,张俊青,李多富,等.合肥市2008年中国公民健康素养调查分析[J].健康教育与健康促进.2008.12:13-16
[28]深圳市健康教育研究所.市民健康素养教育工作巫待加强[J].开放导报.2008,3
[29] Baker I)W,Parker R M,Williams M V,Clark W S.Health literacy and the risk of hospital admission[J].Journal of General Internal Medicine,2001,13 (12):791-798
[30]卫生部统计信息中心.中国卫生服务调查研究一第三次国家卫生服务调查分析报告[M].北京:中国协和医科大学出版社,2004:102,115,,179,181
[31] Peggy Eastman. Reports: Low Health Literacy Preventing Millions of Americans from Getting Best Care[J]. NEWS CENTER.2004(10):38
[32]曾桂群.知信行理论对334名农村妇女健康教育的影响[J].中国卫生统计,2007, 24(3):285-286
[33] Davis, TC, Crouch, MA, Long, SW, et al. Rapid assessment of literacy levels of adult primary care patients [J]. Family Medicine,1991, 23(6):433-435
[34] Giselle Parker. WRAT3: wide range achievement test [J].Journal of Occupational Psychology, Employment and Dsability,2002, 5(1):61-66
[35] Laura Owens, PhD, RN Debra Walden, MNSc, RN. Health Literacy The New Essential in Nursing Education[J].Nurse Educator.2007,32(6):238-239
[36] Parker, RM, Baker. DW, Williams. MV, et al.The test of functional health literacy in adults: a new instrument for measuring patients′literacy skills [J]. Journal of General Internal Medicine,1995,10(10):537-541
[37] David W. Baker, Mark V. Williams, et al. Development of a brief test to measure functional health literacy [J]. Patient Education and Counseling, 1999, 38:33-42
[38] Michael Villaire,MSLM,and Gloria Mayer,RN, EdD, FAAN.Low Health Literacy: The Impact on Chronic Illness Management.Professional Case Management, 2007,12(4):213-216
[39] U.S. Department of Education Institute of Education Sciences. Key concepts and features of the 2003 national assessment of adult literacy [R].Wanshington, DC: NCES. 2006.18
[40]沙莲香.论中国人的素质构成与社会发展[J].教学与研究.2000,12(7):25
[2]肖瓅,陶茂萱.中国公众健康素养调查及评价指标体系建立[D].北京.中国疾病预防控制中心.2008
[3] Parker PM, Baker DW, Williams MV, et al. The Test of Functional Health in Adults: a new instrument for measuring patient′s literacy skills[J]. Journal of General Internal Medicine, 1995, 10(10):537-541
[4] Bakel DW, Parker RM, Williams MV. Healthy literacy and the risk of hospital admission [J]. Gen Intern Med,1998,13:791—98
[5] Kutner M, Greenberg E, Jin Y, et al. The health literacy of America’s adults, results from the 2003 national assessment of adult literacy (NCES 2006-483) [M]. Washington, DC: National Center for Education Statistics, 2006. iii-v
[6]易静,周燕荣,康军,等.我国全面建设小康社会的健康素质指标体系及标准研究[J].现代预防医学, 2005, 32 (10):1289-1290
[7]李新华.《中国公民健康素养———基本知识与技能》的界定和宣传推广简介[J].中国健康教育,2008,24(5):385-388
[8]王卓甫,张怡.基于熵权加权法的工程评标模型[J].科技管理研究.2010,3:47-48
[9]易静,周燕荣.大气污染健康效应综合评价中权数的比较研究[J].中国卫生统计. 2000,17(5)
[10]易静,周燕荣,王润华,等.信息权数在行为方式健康效应综合评价中的应用[J].中国公共卫生,2003,19(4)
[11]张建国.综述评价中确定客观权重的一类方法.[A]卫生统计学术研讨会论文集,张家界, 1997
[12]杨红平,马大川.信息系统投资的最优组合赋权法研究[J].科学学与科学技术管理, 2004(2):48~51
[13]孙振球,王乐三.医学综合评价方法及其应用[M].第二版.北京:化学工业出版社,2006:518-512
[14]吴春容.健康及健康问题的整体观[J].中国全科医学杂志.2003,9:303一305
[15]杨红英.做好社区慢性病防治工作,促进人群健康[J].重庆医学,2009,38(13): 1700-1701
[16]刘剑君,姜世闻,成诗明.中国结核病控制现状分析及对策[J].中国防痨杂志. 2003:25(3)
[17] World Health Organization WHO Report“2001 Global Tuberculosis Control" Geneva:WHO,2001
[18]钮肖茜.浅谈健康教育工作的地位、作用及实施战略[J].江苏卫生保健.2002,4(3):101
[19]裴明.高校医院应关注慢性病的预防和危险因素的干预[J].保健医学研究与实践.2007,4(1):85-86
[20]肖璨,程玉兰,陶茂宣等.Delphi法在筛选中国公众健康素养评价指标中的应用研究[J].中国健康教育.2008.24(2):81一84
[21]邱顺翼,张俊青,李多富等.合肥市2008年中国公民健康素养调查分析[J].健康教育与健康促进.2008.12:13一16
[22]深圳市健康教育研究所.市民健康素养教育工作巫待加强[J].开放导报.2008,3
[23] Parikh NS, Parker RM, Nurss JR. Shame and health literacy: the unspoken connection[J]1 Patient Education and Counseling,1996,27:33-39
[24] Schillinger D, Grumbach K, Piette J. Association of health literacy with diabetes outcomes[J]1 JAMA,2002,J2884:475-482
[25] Shoou-Yih DL, Deborah EB, Rafael R. Development of an Easy-to-Use Spanish health literacy assessment tool [EB] http://www.Academy health.org/2004/ppt/lee 1ppt.2004-12-01
[26]黄远霞,李毅琳,李俊林等.建筑业男性农民工健康知识和行为影响因素分析[J].中国卫生事业管理,2008,3:199-200
[27]郭欣,王克安.健康素养研究进展[J].中国健康教育,2005,21(8):590-593
[28] Patrick Kelly. Health literacy: a silent crisis [EB].http://mediwire.sky scape.com/main/Default.asp,2005-10-26
[29] Partnership for Clear Health Communication Steering Committee Eradicating low healthy literacy: the first public health movement of the 21st century overview white paper[EB].http://www.1aameda.org/Member Services/Exec/Articles/sum03 /Eradicating Low Health care Literacy.pdf.2003-03
[30] Weiss, B. D, Coyne, C. Communicating with patients who can not read[J]. New England Journal of Medicine, 1997,337(4):272-274
[31] Baker, D. W., Parker, R. M., Clark, W. S. Health literacy and the risk of hospital admission[J]. Journal of General Internal Medicine, 1998, 13(12):791-798
[32] Rima E. Rudd, Lindsay Rosenfeld and Victoria Gall. Health literacy and arthritis research and practice.[J]Epidemiology and health-related services.2007,19:97-100
[33]肖璨,马昱,李英华,等.中国城乡居民健康素养状况及影响因素研究[J].中国健康教育.2009,25(5):323-326
[34]刘德柱.山村农民健康教育干预5年效果观察[J].中国农村卫生事业管理, 2001, 21(3): 41-43
[35]杨菊贤.健康行为的建立[J].医学与哲学.2001.22(3):37一39
[36] Office of Disease Prevention and Health Promotion,U.S. Department of Health and Human Services. Healthy People 2010[EB].httP://www.health people.gov/,2005 -05-12
[37] J. Thomas Butler. Principles of health education and health promotion[M]. Wadsworth: Thomson Learning,2001.145一181
[38] Lynn Nielsen Bohlman, Allison M. Panzer. Health literacy: a prescription to end confusion[M].Washington, DC: The National Academies Press,2004.21一58
[39] Michael Villaire,MSLM, and Gloria Mayer,RN,EdD,FAAN.Low Health Literacy the Impact on Chronic Illness Management.[J]Professional Case Management. 2007,12(4):231-216
[40]佟丽,胡俊峰,侯培森.健康素质和健康素养[J]中国健康教育,2006,22(4):293-295
[41]曾桂群.知信行理论对334名农村妇女健康教育的影响[J].中国卫生统计,2007. 24(3):285—286
[42]李杰.媒体健康传播对提升全民健康素养的意义.知网
[43]刘妹倩.利用大众媒体开展健康教育效果评价[J].中国健康教育2003,(6)
[44]重庆:中国城乡二元结构的缩影[N].京江晚报, 2009-1-3. http://www.jsw.com.cn/site3/jjwb/html/2009-01/03/content_1368820.htm.
[1]佟丽,胡俊峰,侯培森.健康素质和健康素养[J].中国健康教育,2006,22(4):293-295
[2] Carolyn Speros.Health literacy: concept analysis [J].Journal of Advanced Nursing, 2005(6):633-640
[3] Lynn Nielsen-Bohlman,A1lison M.Panzer.Health literacy:a prescription to end confusion[M].Washington,DC:The National Academies press,2004:21-58
[4]郭欣,王克安.健康素养研究进展.中国健康教育,2005,21(8):590-593
[5] The Bangkok Charter for Health Promotion in a Globalized World, the 6 th Global Conference on Health Promotion, Bangkok, Thailand, August 2005, World Health Organization
[6] J.Thomas Butler.Principles of health education and health promotion[M]. Wadsworth:Thomson Learning,2001.145—181
[7] Eileen Sullivan.Health literacy[EB].http://nnlm.gov/scr/conhlth/Hlthlit.htm. 2005-10-26
[8] Lenox D.What is health literacy? [EB].http://www.chcs.org.2005-03-01
[9] Pleasant A,Kuruvilla S.A tale of two health literacies:public health and clinical approaches to health literacy[J].Health Promotion International,2008,23 (2): 152-159
[10]肖瓅,陶茂萱.健康素养研究进展与展望[J].中国健康教育,2008,24(5):361-364.
[11] Office of Disease Prevention and Health Promotion, U. S. Department of Health and Human Services. Healthy People 2010 [EB].http://www. Healthy people. gov/, 2007-03-12
[12] Linda Murphy-Knoll, MN. Low Health Literacy Puts Patients at Risk: The Joint Commission Proposes Solutions to National Problem. Journal of Nursing Care Quality,2007,22(3):205-209
[13]李新华.《中国公民健康素养———基本知识与技能》的界定和宣传推广简介[J].中国健康育,2008,24(5):385-388
[14]左佰常,朱建平,赵晓明.从科学素养调查谈健康话题[J].健康博览,2007,(5):4-7
[15] Barry D.Weiss.Health literacy:an important issue for communicating healthinformation to patients[J].Chinese Medical Journal,2001,64:603-608
[16] Weiss, B. D. Coyne, C. Communicating with patients who can not read[J]. New England Journal of Medicine, 1997,337(4):272-274
[17] Baker, D. W., Parker, R. M., Clark, W. S. Health literacy and the risk of hospital admission[J]. Journal of General Internal Medicine, 1998, 13(12):791-798
[18] Rima E. Rudd, Lindsay Rosenfeld and Victoria Gall. Health literacy and arthritis research and practice.[J]Epidemiology and health-related services.2007,19:97-100
[19]王利明,狄玉峰.河北省大学生健康知识、态度和行为的调查分析.职场研究[EB].维普资讯http://www.cqvip.com
[20] Kirsch I,Jungeblut A,Jenkins K.Adult literacy in America:a first look at the findings of the national adult literacy survey MJ.Washington.DC:Nations Center for Education Statistics,US Department of Education.1993.1—20
[21] Rima ER,Barbara AM,Tayla CC.Health and literacy[M].New York:Jossey-Bass,1999-5-18
[22] Hoffman R R,Crandall B,Shadbolt N.Use of the critical decision method to elicit expert knowledge:A case study in the methodology of cognitive task analysis[J]. Human Factors,1998,40:254-277
[23] Safran J,D,Greenberg I, S,Rice I,N.Integrating psychotherapy research and practice:Modeling the change process[J].Psychotherapy,1988,25:l - l7
[24] Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients′knowledge of their chronic disease: a study of patients with hypertension or diabetes[J]. Arch Intern Med,1998,158:166-172
[25]裴明.高校医院应关注慢性病的预防和危险因素的干预[J].保健医学研究与实践,2007,4(1):85-86
[26]肖璨,程玉兰,陶茂宣,等.Delphi法在筛选中国公众健康素养评价指标中的应用研究[J].中国健康教育.2008.24(2):81-84
[27]邱顺翼,张俊青,李多富,等.合肥市2008年中国公民健康素养调查分析[J].健康教育与健康促进.2008.12:13-16
[28]深圳市健康教育研究所.市民健康素养教育工作巫待加强[J].开放导报.2008,3
[29] Baker I)W,Parker R M,Williams M V,Clark W S.Health literacy and the risk of hospital admission[J].Journal of General Internal Medicine,2001,13 (12):791-798
[30]卫生部统计信息中心.中国卫生服务调查研究一第三次国家卫生服务调查分析报告[M].北京:中国协和医科大学出版社,2004:102,115,,179,181
[31] Peggy Eastman. Reports: Low Health Literacy Preventing Millions of Americans from Getting Best Care[J]. NEWS CENTER.2004(10):38
[32]曾桂群.知信行理论对334名农村妇女健康教育的影响[J].中国卫生统计,2007, 24(3):285-286
[33] Davis, TC, Crouch, MA, Long, SW, et al. Rapid assessment of literacy levels of adult primary care patients [J]. Family Medicine,1991, 23(6):433-435
[34] Giselle Parker. WRAT3: wide range achievement test [J].Journal of Occupational Psychology, Employment and Dsability,2002, 5(1):61-66
[35] Laura Owens, PhD, RN Debra Walden, MNSc, RN. Health Literacy The New Essential in Nursing Education[J].Nurse Educator.2007,32(6):238-239
[36] Parker, RM, Baker. DW, Williams. MV, et al.The test of functional health literacy in adults: a new instrument for measuring patients′literacy skills [J]. Journal of General Internal Medicine,1995,10(10):537-541
[37] David W. Baker, Mark V. Williams, et al. Development of a brief test to measure functional health literacy [J]. Patient Education and Counseling, 1999, 38:33-42
[38] Michael Villaire,MSLM,and Gloria Mayer,RN, EdD, FAAN.Low Health Literacy: The Impact on Chronic Illness Management.Professional Case Management, 2007,12(4):213-216
[39] U.S. Department of Education Institute of Education Sciences. Key concepts and features of the 2003 national assessment of adult literacy [R].Wanshington, DC: NCES. 2006.18
[40]沙莲香.论中国人的素质构成与社会发展[J].教学与研究.2000,12(7):25