中国公共卫生

目的了解中国门诊患者健康素养的具备情况及其影响因素,为提升患者的健康素养提供参考依据。方法于2021年1—5月采用随机整群抽样方法在中国东、中、西部地区14所二级或三级医院抽取2 808例门诊患者进行改良版《中国患者健康素养量表》电子问卷调查。结果中国门诊患者健康素养总分为(43.38±6.25)分,其中医学科学观念、疾病自我管理技能、医学常识、自我效能和医学信息认知维度得分分别为(10.24±3.17)、(9.20±2.12)、(7.55±1.54)、(9.03±2.10)和(7.36±2.21)分;中国2 808例门诊患者中,具备健康素养者1920例,健康素养具备率为68.38%;多因素非条件logistic回归分析结果显示,年龄≥35岁、文化程度高中/职高/中专及以上、职业为学生、月均家庭收入≥8 000元、平均日上网时间≥1 h、平时信息获取途径为医疗卫生人员、自评医患沟通情况好和非常好的中国门诊患者健康素养具备率较高,职业为专业技术人员和其他的中国门诊患者健康素养具备率较低。结论中国门诊患者健康素养具备率较高,年龄、文化程度、职业、月均家庭收入、平均日上网时间、医患沟通情况和平时信息获取途径是否为医疗卫生人员是我国门诊患者健康素养具备情况的主要影响因素。

Objective To explore current situation and influencing factors of health literacy of outpatients in China for providing evidences to improve health literacy in the population. Methods With random cluster sampling, totally 2 808 outpatient clinic attendees aged 15 years and above were recruited at 14 secondary and tertiary hospitals in 8 provinces across China and a network-based onsite survey was conducted among the outpatients during January – May 2021 using a modified Chinese Patient Health Literacy Scale developed by domestic researchers previously. Results Valid information were collected from all the participants. The average total score of the participants was 43.38 ± 6.25 for the health literacy scale scoring from 0 to 60 and the participants′ average dimension scores were 10.24 ± 3.17 for the concept of medical science,9.20 ± 2.12 for disease self-management skills, 7.55 ± 1.54 for self-efficacy, 9.03 ± 2.10 for general medical knowledge, and 7.36 ± 2.21 for cognition in medical information, respectively. Of all the participants, 68.38%(1 920) were assessed as with health literacy based on their total score of 41 and above. Multivariate binary logistic regression analysis showed that the participants with following characteristics were more likely to have a higher health literacy: aged ≥ 35 years, with the education of senior/vocational high school or technical secondary school and above, having a mean household monthly income of ≥ 8 000 RMB yuan, averagely spending one hour and more per day on surfing the internet, acquiring medical information generally from medical staff, and with a good or very good self-perceived doctor-patient communication; while,the participants engaging in professional techniques and other works were more likely to have a lower health literacy.Conclusion In Chinese outpatients, the health literacy is at relatively higher level and the literacy is influenced mainly by age, education, occupation, average monthly household income, mean daily time of internet use, doctor-patient communication, and the route of acquiring general medical information.