郑州市某三甲医院结直肠癌患者健康素养与决策冲突的关系

Relationship of Health Literacy and Decision-making Conflict Among Patients with Colorectal Cancer in a Grade-A Tertiary Hospital in Zhengzhou

目的:探讨结直肠癌患者健康素养与决策冲突的关系,分析参与能力和参与态度在二者之间的作用,为降低结直肠癌患者决策冲突水平提供参考。方法:采用全面健康素养量表、患者参与能力量表、参与态度量表和决策冲突量表对郑州市某三甲医院结直肠癌患者进行问卷调查,并构建结构方程模型。结果:共得到226份有效问卷。结直肠癌患者健康素养与决策冲突得分分别为(24.40±2.10)分、(42.70±17.11)分。患者健康素养与参与能力(r=0.536,P<0.01)、参与态度(r=0.369,P<0.01)呈正相关;患者决策冲突与参与能力(r=0.529,P<0.01)、参与态度(r=0.423,P<0.01)呈负相关。健康素养可负向预测决策冲突(β=0.27,P<0.001);参与能力和参与态度在结直肠癌患者健康素养与决策冲突之间起链式中介作用(β=0.26,P<0.001)。结论:健康素养可负向预测结直肠癌患者的决策冲突,也可通过参与能力和参与态度的中介效应间接作用于决策冲突;提高结直肠癌患者的健康素养,增强患者的参与能力和参与态度,对降低患者决策冲突水平具有重要意义。

Objective:To investigate the relationship between health literacy and decision-making conflict in patients with colorectal cancer,and to analyze the effects of participation ability and attitude between them,so as to provide reference for reducing the decision-making conflict level of colorectal cancer patients.Methods:A questionnaire survey was conducted among patients with colorectal cancer in a grade-A tertiary hospital in Zhengzhou by using all aspects of health literacy scale,patient participation competence scale,patient involvement attitude scale and decisional conflict scale,and the structural equation modeling was constructed.Results:A total of 226 valid questionnaires were obtained.The scores of health literacy and decision-making conflict of patients with colorectal cancer were(24.40±2.10)and(42.70±17.11).The health literacy of patients was positively correlated with participation ability(r=0.536,P<0.01)and participation attitude(r=0.369,P<0.01).The decision-making conflict of patients was negatively correlated with participation ability(r=0.529,P<0.01)and attitude(r=0.423,P<0.01).The health literacy negatively predicted the decision-making conflict(β=0.27,P<0.001).Participation ability and attitude had a chain mediating effect between health literacy and decision conflict of patients with colorectal cancer(β=0.26,P<0.001).Conclusion:Health literacy can directly predict the decision-making conflict of patients with colorectal cancer and indirectly act on the decision-making conflict through mediating effects of participation ability and attitude.Improving the health literacy of patients with colorectal cancer and enhancing their participation ability and attitude are of great significance for reducing the decision conflict level of patients.