Assessment of functional health literacy in Brazilian carers of older people

ABSTRACT. Individuals with low health literacy have less knowledge of their own health condition. Carers play a key role in older people’s activities of daily living. Objective: to evaluate the performance of carers of older people using the S-TOFHLA (Short Test of Functional Health Literacy in Adults) and to identify caregiver characteristics associated with low functional health literacy. Methods: a cross-sectional study was conducted. The S-TOFHLA, a sociodemographic instrument, the Mini-Mental State Exam and the Patient Health Questionnaire-2 were applied to 80 carers of older patients routinely followed by doctors from the Primary Health Care Sector of the City of Botucatu, São Paulo. The multivariate analysis used an ordinal logistic regression model with test (S-TOFHLA) scores as the dependent variable. The level of statistical significance adopted was 0.05. Results: the individuals had a mean age of 54.6 (± 11.7); 27% of the carers evaluated had inadequate levels of health literacy (S-TOFHLA ≥54). A higher proportion of individuals with low education had inadequate or marginal health literacy (p<0.001). Conclusion: nearly 1/3 of the carers had marginal or inadequate levels of health literacy. These results highlight the difficulties of many carers in understanding health information.

摘要。健康素养低下人群对自身健康状况的认知更为匮乏。照护者在老年人的日常生活活动中扮演关键角色。研究目的：采用成人功能性健康素养简短测试（Short Test of Functional Health Literacy in Adults, S-TOFHLA）评估老年照护者的健康素养水平，并识别与功能性健康素养低下相关的照护者特征。研究方法：本研究为横断面研究。向圣保罗州博图卡图市初级卫生保健机构常规接诊的80名老年患者照护者，施测了S-TOFHLA、社会人口学问卷、简易精神状态检查量表（Mini-Mental State Exam, MMSE）以及患者健康问卷-2（Patient Health Questionnaire-2, PHQ-2）。多变量分析采用有序logistic回归模型，以测试得分作为因变量，设定统计学显著性水平为0.05。研究结果：本次研究对象的平均年龄为54.6岁（±11.7）；27%的受访照护者存在健康素养不足的情况（S-TOFHLA得分≥54）。受教育程度较低的人群中，健康素养不足或边缘水平的占比更高（p<0.001）。研究结论：近三分之一的照护者存在健康素养边缘或不足水平。该结果凸显了众多照护者在理解健康信息方面所面临的困境。