结核病患者健康素养与结核病防治核心知识和社会支持的相关性

doi:10.3969/j.issn.1000-6621.2020.11.015

摘要/Abstract

摘要：

目的探讨结核病患者健康素养水平在结核病防治核心知识掌握和社会支持中的作用。方法选取2019年5—6月在成都市公共卫生临床医疗中心住院的225例结核病患者作为研究对象,其中男151例(67.1%),女74例(32.9%);年龄范围18~84岁,年龄中位数(四分位数)[M(Q₁,Q₃)]为45.0(25.0,60.0)岁。调查研究对象结核病防治核心知识(肺结核的主要症状、严重性、预防措施、传播途径、免费政策)、健康素养(包括信息获取能力、交流互动能力、改善健康意愿、经济支持意愿)、社会支持(包括客观支持、主观支持、对社会支持的利用度)水平,并分析研究对象的社会支持、健康素养与结核病防治核心知识的相关性。结果 225例研究对象结核病防治核心知识得分[M(Q₁,Q₃)]为30.0(20.0,40.0)分,总知晓率为61.0%(686/1125);健康素养得分为(85.84±15.14)分,具备健康素养者占26.2%(59/225),73.8%(166/225)不具备;社会支持得分[M(Q₁,Q₃)]为36.0(31.0,43.0)分,处于中等水平者占52.4%(118/225),低等水平者占47.6%(107/225)。Spearman相关性分析显示,研究对象健康素养得分与结核病防治核心知识得分呈正相关(r=0.947,t=38.818,P<0.01);健康素养得分与社会支持得分呈正相关(r=0.485,t=23.027,P<0.01);结核病防治核心知识得分与社会支持得分呈正相关(r=0.469,t=19.890,P<0.01)。健康素养在结核病防治核心知识和社会支持之间存在中介作用[β(95%CI)值=0.415(0.282~0.550)]。结论健康素养在结核病防治核心知识和社会支持两者间起中介作用,提示在提高结核病防治知识掌握水平较低的结核病患者的社会支持时,应同时注重提高其健康素养水平。

关键词: 结核, 健康素养, 社会支持, 问卷调查, 数据说明,统计

Abstract:

Objective To explore how tuberculosis (TB) patients’ health literacy plays a role in the correlation between the knowledge level on control and prevention of TB and the social support. Methods A total of 225 pulmonary tuberculosis patients hospitalized in the Public Health Clinical Center of Chengdu from May to June in 2019 were selected as study subjects with the median age (quartile, M(Q₁,Q₃)) of 45.0 (25.0, 60.0) (range, 18-84 years), 151 (67.1%) were male and 74 (32.9%) were female. Core knowledge of TB prevention and control (including main symptoms and severity, precautions, transmission routes, public policies), the health literacy (such as the ability of knowledge acquisition, communicative interaction, the willingness to improve health and provide economic support), and social support level (objective & subjective support and their availability) were investigated. Results The core knowledge score (M(Q₁,Q₃)) of the 225 subjects was 30.0 (20.0,40.0), and the awareness rate was 61.0% (686/1125). The health literacy score was 85.84±15.14, it showed that 26.2% (59/225) of TB patients had health literacy, while 73.8% (166/225) did not. The social support score (M(Q₁,Q₃)) was 36.0 (31.0, 43.0), with 52.4% (118/225) of the TB patients in the middle level and 47.6% (107/225) in the lower level. Using Spearman correlation analyses, the score of health literacy was positively correlated with the score of TB control core knowledge (r=0.947, t=38.818, P<0.01) and the social support score (r=0.485, t=23.027, P<0.01). There was a positive correlation between core knowledge of TB control and social support (r=0.469, t=19.890, P<0.01). Health literacy was the intermediary factor between core knowledge of TB control and social support (β(95%CI)=0.415 (0.282-0.550)). Conclusion Health literacy played a positive mediation role between the core knowledge of TB control and social support, indicating that when trying to improve the social support of TB patients with low level knowledge of TB prevention and control, improving the health literacy should also be enhanced.

Key words: Tuberculosis, Health literacy, Social support, Questionnaires, Data interpretation,statistical

余巧林, 雷丽梅, 万彬, 付莉, 赵霞, 曾琼, 王燕. 结核病患者健康素养与结核病防治核心知识和社会支持的相关性[J]. 中国防痨杂志, 2020, 42(11): 1227-1231. doi: 10.3969/j.issn.1000-6621.2020.11.015

YU Qiao-lin, LEI Li-mei, WAN Bin, FU Li, ZHAO Xia, ZENG Qiong, WANG Yan. Correlation between health literacy of tuberculosis patients and core knowledge and social support of tuberculosis control[J]. Chinese Journal of Antituberculosis, 2020, 42(11): 1227-1231. doi: 10.3969/j.issn.1000-6621.2020.11.015

图/表 2

表1

表2

结核病防治核心知识、健康素养和社会支持之间的中介效应检验

项目	β(95%CI)值	s $x ˉ$ 值	t值	P值
第1步:检验路径
核心知识→社会支持	0.469(0.423~0.519)	0.025	19.890	0.001
第2步:检验路径
核心知识→健康素养	0.947(0.887~1.016)	0.003	38.818	0.001
第3步:检验路径
健康素养→社会支持	0.415(0.282~0.550)	0.070	7.091	0.001
核心知识→社会支持	0.076(-0.064~0.213)	0.072	1.273	0.297

表2

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调查项目	条目(个)	分值[M(Q₁,Q₃)]	标准分[%,M(Q₁,Q₃)]
结核病防治核心知识	5	30.0(20.0,40.0)	60.0(40.0,80.0)
健康素养	24	85.84±15.14^a	71.54±12.62^a
经济支持意愿	2	8.0(6.0,8.0)	80.0(60.0,80.0)
改善健康意愿	4	16.0(16.0,20.0)	80.0(80.0,100.0)
交流互动能力	9	29.0(24.0,34.0)	64.4(53.3,75.6)
信息获取能力	9	35.0(27.0,39.0)	77.8(60.0,86.7)
社会支持	10	36.0(31.0,43.0)	54.6(47.0,65.2)
客观支持	3	10.0(8.0,14.0)	31.3(25.0,44.9)
主观支持	4	20.0(17.0,22.0)	91.0(78.8,100.0)
社会支持利用度	3	7.0(5.0,9.0)	56.9(41.7,74.6)