关键词: 结核, 健康素养, 问卷调查, 因素分析,统计学

Abstract: Objective: The purpose of this study was to ascertain the level of health literacy among tuberculosis patients in the demonstration areas of Jiangsu Province and to analyze the factors influencing their health literacy, to provide a reference for advancing health literacy related to tuberculosis. Methods: A survey was conducted from July 3 to July 24, 2020, using the “2020 National Health Literacy Monitoring Survey Questionnaire (Tuberculosis)” to investigate 988 tuberculosis patients in the demonstration areas of Jiangsu Province (Danyang, Taixing, and Zhangjiagang). A total of 988 questionnaires were distributed and effectively retrieved. In the assessment of health literacy, the study adopted indicators of three domains of general health literacy, namely, fundamental health knowledge and conceptual literacy, health-promoting lifestyle and behavioral literacy, and essential skills literacy, as well as six categories of health issue-specific literacy(literacy of scientific health perspectives, infectious disease prevention and control, chronic disease management, safety and emergency response, basic medical care, and health information comprehension). Multivariable logistic regression analysis was employed to identify the factors affecting the health literacy of tuberculosis patients. Results: In the demonstration areas, 36.2% (358/988) of the patients possessed health literacy. The proportions of patients with literacy in the three health aspects, from highest to lowest, were as follows: basic health knowledge and concept literacy (47.5% (469/988)), healthy lifestyle and behavior literacy (40.9% (404/988)), and basic skills literacy (33.4% (330/988)). The proportions of patients with literacy in the six health issues, from highest to lowest, were as follows: safety and first aid literacy (65.9% (651/988)), scientific health view literacy (62.2% (615/988)), health information literacy (49.5% (489/988)), chronic disease prevention literacy (44.2% (437/988)), basic medical care literacy (34.2% (338/988)), and infectious disease prevention literacy (28.5% (282/988)). The multivariable logistic analysis indicated that, compared to the 15-44 age group, the proportions of patients with health literacy in 45-64 age group (OR=0.527, 95%CI:0.371-0.748) and in 65 and above age group (OR=0.406, 95%CI:0.268-0.615) were lower. Compared to Danyang, the proportions of patients with health literacy were higher in Taixing (OR=1.612, 95%CI:1.127-2.306) and Zhangjiagang (OR=1.539, 95%CI:1.080-2.195). Regarding educational levels, compared to those with primary school education or below, the proportions of patients with health literacy were higher among those with junior high school, senior high school/professional high school/technical school (OR=2.872, 95%CI:1.909-4.320), and those with a junior college education/bachelor’s degree or higher (OR=8.050, 95%CI:4.502-14.395). Conclusion: The overall level of health literacy among tuberculosis patients in the demonstration areas of Jiangsu Province is relatively high, yet the literacy level for infectious disease prevention is low. It is essential to strengthen health promotion and education for middle-aged and elderly patients over the age of 45 and those with lower educational levels, particularly in the area of infectious disease prevention and control education.

Key words: Tuberculosis, Health literacy, Questionnaire survey, Factors analysis, statistical