郑州市慢性心力衰竭患者、照护者健康素养水平及其相关性的调查研究

Health Literacy Status and Correlation between Patients with Chronic Heart Failure and Their Caregivers in Zhengzhou

背景慢性心力衰竭(CHF)患者的健康素养水平可独立预测心力衰竭结局,对缓解患者症状、改善其生活质量及远期预后具有重要意义,因此足够的健康素养水平对于CHF患者来说是必不可少的。目的分析郑州市CHF患者、照护者的健康素养水平及其相关性。方法采用方便抽样法选取2019年3—11月在阜外华中心血管病医院、河南省人民医院及河南中医药大学第一附属医院住院的CHF患者及其照护者为调查对象。采用自行设计的一般资料问卷、中文版心力衰竭特异性健康素养量表及2009中国公民健康素养调查问卷由调查员在患者入院48 h内对其进行调查。患者健康素养总分与一般资料和患者健康素养各维度评分及其总分与照护者健康素养各维度评分及其总分间的相关性分析采用Pearson相关分析或Spearman秩相关分析。结果本研究共发放问卷516份,回收有效问卷500份,有效回收率为96.9%。CHF患者健康素养总分(29.3±7.1)分,功能性得分(12.4±2.9)分,互动性得分(10.5±3.0)分,批判性得分(6.6±2.7)分。照护者健康素养总分(25.1±3.6)分,基本健康知识得分(12.8±2.0)分,健康生活方式与行为得分(9.3±1.4)分,健康技能得分(3.1±0.7)分。Spearman秩相关分析结果显示,患者健康素养总分与受教育程度、家庭人均月收入、居住环境呈正相关(rs=0.488、0.630、0.644,P值均<0.001),与饮食习惯呈负相关(rs=-0.482,P<0.001)。照护者的基本健康知识得分、健康生活方式与行为得分、健康技能得分、健康素养总分分别与患者功能性得分(r值分别为0.622、0.456、0.428、0.605)、互动性得分(r值分别为0.626、0.353、0.481、0.598)、批判性得分(r值分别为0.432、0.266、0.412、0.450)及健康素养总分(r值分别为0.689、0.424、0.515、0.662)呈正相关(P<0.001)。结论郑州市CHF患者健康素养水平总体偏低,具备健康素养的照护者占69.4%,且患者的健康素养水平与其受教育程度、家庭人均月收入、居住环境、饮食习惯及其照护者健康素养水平均有关。

Background Health literacy of patients with chronic heart failure(CHF)can independently predict the outcome of heart failure,which is of great significance to reduce the burden of symptoms,improve their quality of life and long-term prognosis.Therefore,adequate health literacy is essential for CHF patients.Objective To analyze the health literacy status and correlation between patients with CHF and their caregivers in Zhengzhou.Methods By means of convenient sampling method,CHF patients and their caregivers in Fuwai Central China Cardiovascular Hospital,Henan Provincial People's Hospital and the First Affiliated Hospital of Henan University from March to November 2019 were selected as the research objects.In addition,the self-designed general information questionnaire,Chinese version of HF-SHLS,and 2009 Chinese citizen health literacy questionnaire were issued by investigator within 48 hours of the patients'admission.Pearson correlation analysis or Spearman rank correlation analysis was used to analyze the correlation between total score of the patients'health literacy and general information,and the correlation between the score of each dimension of the patients'health literacy and its total score and the score of each dimension of caregivers'health literacy and its total score.Results A total of 516 questionnaires were gave out,and 500 valid questionnaires were recovered,the effective recovery rate was 96.9%.The total score of CHF patients'health literacy was(29.3±7.1),functional score was(12.4±2.9),interactive score was(10.5±3.0),and critical score was(6.6±2.7);while the total score of caregivers'health literacy was(25.1±3.6),score of basic health knowledge was(12.8±2.0),score of healthy lifestyle and behavior was(9.3±1.4),and score of health skill was(3.1±0.7).Spearman rank correlation analysis results showed that,health literacy of CHF patients were positively correlated with the education level,the monthly household income and living environment(rs=0.488,0.630,0.644,P<0.001);health literacy of CHF patients was negatively correlated with eating habits(rs=-0.482,P<0.001).The score of basic health knowledge,healthy lifestyle and behavior,health skill,and the total score of health literacy of caregivers was positively correlated with the functional score(r=0.622,0.456,0.428,0.605),interactive score(r=0.626,0.353,0.481,0.598),critical score(r=0.432,0.266,0.412,0.450),and total score(r=0.689,0.424,0.515,0.662)of health literacy of CHF patients,respectively(P<0.001).Conclusion The health literacy level of CHF patients in Zhengzhou is generally low,69.4%caregivers have health literacy level.In addition,health literacy level of CHF patients is related to their education level,monthly household income,living environment,eating habits and the health literacy level of their caregivers.