论文部分内容阅读
目的了解上海社区血糖控制不佳的2型糖尿病患者的文字健康素养及数字运用能力,探讨健康素养与血糖控制水平的关联。方法 2015年2月至2016年3月期间,从上海市闵行区和长宁区8个社区中分别招募最近一次糖化血红蛋白(HbA1c)检测值≥7.5%或空腹血糖测量值≥10 mmol/L的2型糖尿病患者共800名,采用统一的调查表开展问卷调查,并进行身体测量和HbA1c检测。患者的文字健康素养评估采用经过汉化、修改以及信度和效度评估的健康素养管理量表(Health Literacy Management Scale,HeLMS),算术能力评估采用汉化修改后的糖尿病算术能力测试表(5-item version Diabetes Numeracy Test,DNT-5)。结果本次调查对象中,93.5%的患者具备一定的文字健康素养,HeMLS整体得分中位数为116(四分位数间距为108~120)。DNT-5整体答对率中位数为80%(四分位数间距为60%~100%)。患者的年龄、教育程度和职业类型与文字健康素养水平及算术能力均有显著关联,性别和收入水平与患者的文字健康素养水平关联密切。未发现患者HeMLS得分高低与HbA1c水平有显著关联(P=0.383),但DNT-5答对率越低、HbA1c值越高。DNT-5答对率最低组HbA1c中位数为8.3%(7.7%~9.4%),显著高于中间组的8.2%(IQR:7.5%~9.2%)和最高组的8.0%(7.5%~8.8%)(P=0.009)。结论本次上海社区血糖控制不佳的糖尿病患者的健康素养较高,且与年龄、性别、教育程度、工作类型以及收入水平有显著关联,算术能力可能是比文字健康素养更为重要的患者血糖控制状况影响因素。
Objective To understand the literacy and digital literacy skills of type 2 diabetes patients with poor glycemic control in Shanghai community and to explore the relationship between health literacy and glycemic control. Methods From February 2015 to March 2016, the latest HbA1c test ≥7.5% or fasting blood glucose test ≥10 mmol / L were recruited from 8 communities in Minhang District and Changning District of Shanghai respectively A total of 800 diabetic patients, using a unified questionnaire survey, and physical measurements and HbA1c detection. The patient’s literacy assessment was performed using the Health Literacy Management Scale (HeLMS), which was adapted, modified, and assessed for reliability and validity. The assessment of arithmetic ability was performed using a modified 5-item Diabetes Ability Test Table version Diabetes Numeracy Test, DNT-5). Results In this survey, 93.5% of the patients had certain literacy health literacy. The overall score of HeMLS was 116 (interquartile range was 108-120). The overall DNT-5 overall response rate was 80% (interquartile range 60% -100%). The patient’s age, education level and occupation type are significantly related to the level of literal health literacy and arithmetic ability. The level of gender and income is closely related to the level of literacy literacy of patients. No significant correlation was found between HeMLS score and HbA1c level (P = 0.383). However, the lower the response rate of DNT-5, the higher the HbA1c level. The median HbA1c was 8.3% (7.7% -9.4%) in the lowest DNT-5 group, significantly higher than the 8.2% (IQR: 7.5% -9.2%) in the intermediate group and 8.0% (7.5% -8.8% %) (P = 0.009). Conclusion The diabetes patients with poor glycemic control in Shanghai have a higher level of health literacy and are significantly associated with age, gender, educational attainment, type of work and income level, and their arithmetic ability may be blood sugar more important than literal health literacy Controlling factors affecting.