社区卫生技术人员信息素养的培养

分析了社区卫生技术人员信息素养现状,提出了提高社区卫生技术人员信息素养的重要性和方法。     

Developing visual images for communicating information aboutantiretroviral side effects to a low-literate population

The side effects of antiretroviral (ARV) therapy are linked to altered quality of life and adherence. Poor adherence has also been associated with low health-literacy skills, with an uninformed patient more likely to make ARV-related decisions that compromise the efficacy of the treatment. Low literacy skills disempower patients in interactions with healthcare providers and preclude the use of existing written patient information materials, which are generally written at a high reading level. Visual images or pictograms used as a counselling tool or included in patient information leaflets have been shown to improve patients’ knowledge, particularly in low-literate groups. The objective of this study was to design visuals or pictograms illustrating various ARV side effects and to evaluate them in a low-literate South African Xhosa population. Core images were generated either from a design workshop or from posed photos or images from textbooks. The research team worked closely with a graphic artist. Initial versions of the images were discussed and assessed in group discussions, and then modified and eventually evaluated quantitatively in individual interviews with 40 participants who each had a maximum of 10 years of schooling. The familiarity of the human body, its facial expressions, postures and actions contextualised the information and contributed to the participants’ understanding. Visuals that were simple, had a clear central focus and reflected familiar body experiences (e.g. vomiting) were highly successful. The introduction of abstract elements (e.g. fever) and metaphorical images (e.g. nightmares) presented problems for interpretation, particularly to those with the lowest educational levels. We recommend that such visual images should be designed in collaboration with the target population and a graphic artist, taking cognisance of the audience's literacy skills and culture, and should employ a multistage iterative process of modification and evaluation.     

Comparative analysis of print and multimedia health materials: A review of the literature

Objective

Evaluate the evidence regarding the relative effectiveness of multimedia and print as modes of dissemination for patient education materials; examine whether development of these materials addressed health literacy.

Methods

A structured literature review utilizing Medline, PsycInfo, and the Cumulative Index to the Nursing and Allied Health Literature (CINAHL), supplemented by reference mining.

Results

Of 738 studies screened, 30 effectively compared multimedia and print materials. Studies offered 56 opportunities for assessing the effect of medium on various outcomes (e.g., knowledge). In 30 instances (54%), no difference was noted between multimedia and print in terms of patient outcomes. Multimedia led to better outcomes vs. print in 21 (38%) comparisons vs. 5 (9%) instances for print. Regarding material development, 12 studies (40%) assessed readability and 5 (17%) involved patients in tool development.

Conclusions

Multimedia appears to be a promising medium for patient education; however, the majority of studies found that print and multimedia performed equally well in practice. Few studies involved patients in material development, and less than half assessed the readability of materials.

Practice implications

Future research should focus on comparing message-equivalent tools and assessing their effect on behavioral outcomes. Material development should include explicit attention to readability and patient input.     

Health literacy and asthma

The report "Healthy people" from the US Department of Health and Human Services defines health literacy (HL) as follows: "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." The same report identifies asthma as a public health problem of high priority. Unfortunately, impaired HL is prevalent in our society, and patients with low HL and asthma face multiple challenges as they attempt to manage their disease. Indeed, the National Asthma Education and Prevention Program's current guidelines require patients to have considerable HL and self-management skills. Numerous studies have linked inadequate literacy with poor health outcomes. Unlike many sociodemographic variables, HL can potentially be addressed in the health care setting. The purpose of this review is to raise awareness of the problem, summarize the current evidence linking HL and asthma, and offer strategies to strengthen the communication between patients and health care providers to decrease asthma health disparities. In addition, we discuss potential future directions for research in this field.     

Internet skill-related problems in accessing online health information

Purpose

Despite the amount of health information available online, there are several barriers that limit the Internet from being adopted as a source of health information. The purpose of this study was to identify individual skill-related problems that users experience when accessing the Internet for health information and services.

Methods

Between November 2009 and February 2010, 88 subjects participated in a performance test in which participants had to complete health-related assignments on the Internet. Subjects were randomly selected from a telephone book. A selective quota sample was used and was divided over equal subsamples of gender, age, and education. Each subject was required to complete nine assignments on the Internet.

Results

The general population experiences many Internet skill-related problems, especially those related to information and strategic Internet skills. Aging and lower levels of education seemed to contribute to the amount of operational and formal skill-related problems experienced. Saving files, bookmarking websites, and using search engines were troublesome for these groups of people. With respect to information skills, the higher the level of educational attainment, the less problems the participants experienced. Although younger subjects experienced far less operational and formal skill-related problems, it was revealed that older subjects were less likely to select and use irrelevant search results and unreliable sources. Concerning the strategic Internet skills it was revealed that older subjects were less likely to make inappropriate decisions based on information gathered.

Conclusions

The amount of online health-related information and services is consistently growing; however, it appears that the general population experiences many skill-related problems, particularly those related to information and strategic Internet skills, and they become very important when it comes to health. These skills are also problematic for younger generations who are often seen as skilled Internet users. The results of the study call for policies that account for low levels of Internet skills.     

社区糖尿病患者疾病相关健康素养对血糖控制的影响

目的 确认社区2型糖尿病患者的健康素养现状,探讨其与糖化血红蛋白(HbAlc)的关系.方法 采用分层抽样法对延吉市160例社区2型糖尿病患者的健康素养进行问卷调查,并按操作规范对其进行体格检查和相关实验室检查.结果 有40％的2型糖尿病患者健康素养处于低水平.不同HbA1c水平组,其民族、年龄、文化程度、健康素养、病程间差异均有统计学意义;三酰甘油(TG)、空腹血糖(FPG)与HbAlc呈正相关,高密度脂蛋白(HDL-C)与HbAlc呈负相关.在控制了一般资料和疾病资料的影响下,健康素养对HbAlc仍有显著影响.结论 社区2型糖尿病患者中的低健康素养现象普遍存在,血糖控制状况不理想,受多种因素影响.护理人员应注重提高糖尿病患者的健康素养,以促进其进行有效的血糖控制.     

决策树与Logistic回归在高血压患者健康素养预测中的应用

目的探讨和评价决策树与Logistic回归用于预测高血压患者健康素养中的可行性与准确性。方法利用Logistic回归分析和Answer Tree软件分别建立高血压患者健康素养预测模型,利用受试者工作曲线(ROC)评价两个预测模型的优劣。结果Logistic回归预测模型的灵敏度(82.5%)、Youden指数(50.9%)高于决策树模型(77.9%,48.0%),决策树模型的特异性(70.1%)高于Logistic回归预测模型(68.4%),误判率(29.9%)低于Logistic回归预测模型(31.6%);决策树模型ROC曲线下面积与Logistic回归预测模型ROC曲线下面积相当(0.813vs 0.847)。结论利用决策树预测高血压患者健康素养效果与Logistic回归模型相当,根据决策树模型可以确定高血压患者健康素养筛选策略,数据挖掘技术可以用于慢性病患者健康素养预测中。     

我国初中生健康素养现状及其影响因素分析

目的 探索我国初中生健康素养的现状及其影响因素。方法 采用二阶段整群抽样方法,对全国25个省、市的2 616名初中生进行问卷调查,应用SPSS 13.0软件进行统计学分析。 结果 初中生健康素养在不同性别、不同教学模式、不同地域间差异均有统计学意义(P<0.05);初中生健康素养总体平均分76.11±8.65,健康素养及格率为35.5%,其中基本知识与理念素养及格率26.6%,健康生活方式与行为素养及格率59.2%。 结论 初中生健康素养亟待改善,而学校健康教育将是改善学生健康素养的有效途径。