Levels of health literacy among Australians with chronic conditions engaging with healthcare providers and navigating the health system

Health
literacy plays an important role in improving person-centred care and
population health outcomes. With the rate of chronic conditions increasing
globally, it is important to understand the associations between levels of
health literacy and the ability to navigate and engage with the healthcare
system.

A
39-item survey was designed and distributed to Australian adults aged ≥ 18.
Participants were recruited between 29 November and 14 December 2018.

In
addition to researcher-devised and consumer-devised questions, items about
self-reported health status, health conditions and PHI were drawn from the
National Health Survey. Questions about financial stress were derived from the
Household, Income and Labour Dynamics in Australia (HILDA) survey. Questions
about care affordability were drawn from the Commonwealth Fund survey and
questions about accessibility were sourced from the Menzies-Nous surveys. Questions about diagnosed chronic conditions were
defined by the AIHW. Minor post-weighting
adjustments were made by age, sex and state to ensure the data accurately
reflected population distribution according to the Australian Bureau of
Statistics in June 2018. Data were analysed using descriptive and
inferential statistics (IBM SPSS Statistics V24). Weighting was undertaken
through a survey raking technique using the anesrake package in R.The full survey questions are included in file 2, and with codes that correspond to the datasheet.

健康素养(health literacy)在提升以患者为中心的照护(person-centred care)质量与人群健康结局方面发挥着关键作用。随着全球慢性病患病率持续攀升，明晰健康素养水平与熟练运用、参与医疗系统的能力之间的关联，具有重要的学术与实践价值。
本研究设计并向18岁及以上的澳大利亚成年人发放了一份含39个条目的调查问卷，调研对象的招募周期为2018年11月29日至12月14日。
问卷内容除研究者自主编制与服务使用者自行设计的问题外，涉及自我报告健康状况、健康问题及PHI的条目取自《全国健康调查》(National Health Survey)；有关经济压力的问题源自澳大利亚家庭、收入与劳动力动态调查(Household, Income and Labour Dynamics in Australia, HILDA)；医疗照护可负担性相关问题来自英联邦基金调研(Commonwealth Fund survey)，而医疗服务可及性相关问题则取材自孟席斯-努斯调研(Menzies-Nous surveys)。确诊慢性病的判定标准由澳大利亚卫生与福利研究所(Australian Institute of Health and Welfare, AIHW)制定。
研究团队按照年龄、性别与澳大利亚各州对数据进行了小幅事后加权调整，以确保数据能够准确匹配2018年6月澳大利亚统计局(Australian Bureau of Statistics)公布的人口分布结构。数据分析采用描述性统计与推断性统计方法，依托IBM SPSS Statistics V24软件完成。加权处理环节通过R语言的anesrake程序包，运用调查rake加权法(survey raking technique)实现。完整的调查问卷题目及对应数据表的编码信息详见文件2。