健康素养、大肠癌筛查知信行与肠镜顺应性相关性

Assoiciations of health literacy, knowledge/attitude on colorectal cancer screening with colonoscopy compliance among middle-aged and elder residents positive for colorectal cancer preliminary screening

目的探讨大肠癌筛查相关知信行、健康素养等因素与肠镜检查顺应性的相关性,为改善居民肠镜顺应性提出针对性的建议。方法结合上海市重大公共卫生项目大肠癌筛查,对2015-2016年参加大肠癌筛查且初筛判定为阳性的1959名居民采用大肠癌筛查知信行问卷、健康素养量表进行综合评估,并追踪其肠镜检查情况。结果大肠癌筛查初筛阳性居民的健康素养量表的总分为109.44分,各维度平均得分差异有统计学意义(P<0.001);大肠癌知信行问卷条目的总体平均得分为61.55分,态度和信念的平均得分高于知识得分(P<0.001)。健康素养得分与大肠癌筛查相关知信行得分之间存在线性相关,相关系数为0.410(P<0.001),肠镜检查组与未进行肠镜检查组居民健康素养总得分和大肠癌筛查知信行总得分的差异有统计学意义,总得分越高,肠镜顺应性越高。结论健康素养总得分、大肠癌筛查知信行总得分与肠镜检查顺应性存在相关,提高居民健康素养以及大肠癌筛查相关知识是改善肠镜顺应性低的有效手段。

Objective To examine correlations between health literacy, knowledge/attitude on colorectal cancer screening and colonoscopy compliance among middle-aged and elder residents positive for colorectal cancer preliminary screening in Shanghai city for improving colonoscopy compliance among community residents.Methods We conducted a questionnaire survey and follow-up for colonoscopy result among 1 959 residents aged ≥ 50 years and with positive results of colorectal cancer preliminary screening in Major Public Health Projects of Shanghai city in 2015 and 2016. Health Literacy Management Scale (HeLMS) Chinese version and a self-modified questionnaire on knowledge, attitude and practice (KAP) about colorectal cancer were adopted in the study.Results The overall health literacy score was 109.44 and the dimension scores of health literacy were significantly different from each other (P < 0.001) among all the participants. The overall average score of KAP about colorectal cancer screening was 61.55 and the average score of attitude and belief items was significantly higher than that of knowledge (P < 0.001). There was a significant linear correlation between the overall health literacy score and the score of KAP about colorectal cancer screening, with a correlation coefficient of 0.226 (P < 0.001). Significant differences in the overall score of health literacy and total score of KAP about colorectal cancer screening were observed between the participants with and without colonoscopy and there was a positive correlation between total score of KAP about colorectal cancer screening and colonoscopy compliance among the participants.Conclusion The overall health literacy score and total score of KAP about colorectal cancer screening correlate with colonoscopy compliance among middle-aged and elder residents positive for colorectal cancer preliminary screening and the results suggest that improving health literacy and the KAP about colorectal cancer screening could promote coloscopy compliance in the residents.