健康素养对老年营养不良患者临床结局的影响

Effect of Health Literacy on Clinical Outcomes of Elderly Patients with Malnutrition

摘要: 研究目的：通过对老年营养不良患者的健康素养进行评价，分析影响健康素养的因素及健康素养水平对其临床结局的影响。研究方法：纳入78名老年营养不良患者作为被调查者，采用国际公认的健康素养调查问卷对其进行健康素养评估，得到被调查者健康素养得分。根据被调查者健康素养得分中位数将其分为两组，分别收集临床结局相关指标，包括被调查者的身高、体质量测定，白蛋白等指标，Charlson合并症指数(Charlson Comorbility Index)，住院天数、观察期间并发症(包括压疮、跌倒等事件)的发生率及死亡率，自此次出院后6个月内的再入院率。研究结果：根据被调查者的健康素养得分可得出，不同年龄段及不同学历水平的被调查者健康素养得分存在显著性差异。不同性别间健康素养得分未见显著性差异；年龄及受教育程度与健康素养显著相关。根据健康素养得分将被调查者分为健康素养得分优(≤10分)及得分差(>10分)两组，发现健康素养得分优组的白蛋白平均水平明显高于得分差组，住院天数、CCI评分、并发症发生率、再入院率明显低于得分差组，二者存在显著差异。以是否发生并发症为因变量进行Logistic回归分析，得出年龄、CCI评分、疾病严重程度及健康素养得分(优或差)与其显著相关。研究结论：健康素养显著影响老年营养不良患者的临床结局，在评估老年营养不良患者的预后时应考虑健康素养。

Abstract: Objective: To analyze the factors influencing health literacy and the influence of health literacy on clinical outcomes by evaluating the health literacy of elderly malnutrition patients. Methods: 78 elderly malnutrition patients were included as respondents, and the health literacy was evaluated by the internationally recognized questionnaire of health literacy, and the scores of health literacy were obtained. According to the median of the respondents’ health literacy score, they were divided into two groups, and the related indicators of clinical outcomes were collected, including the height, body mass measurement, albumin and other indicators of the subjects, Charlson comorbidity index, hospitalization days, complications during observation (including pressure sore, falls and other events) and mortality, the rate of readmission within 6 months after discharge. Results: According to the respondents’ health literacy scores, there are significant differences in the health literacy scores of the subjects of different ages and different educational levels. There was no significant difference in the scores of health literacy among different genders; Age and education level were significantly related to health literacy. According to the score of health literacy, the subjects were divided into two groups: the best score (≤10) and the difference (>10 points). It was found that the average albumin level of the group with the best score of health literacy was significantly higher than that of the poor score group, and the hospitalization days, CCI score, complication incidence rate and readmission rate were significantly lower than those in the poor score group, and there were significant differences between them. The logistic regression analysis was carried out to determine whether complications occurred or not, and the age, CCI score, disease severity and health literacy score (good or bad) were significantly correlated with them. Conclusion: Health literacy significantly affects the clinical outcome of elderly malnutrition patients, and health literacy should be considered in evaluating the prognosis of elderly malnutrition patients.