Table_5_Effectiveness of health literacy interventions on anxious and depressive symptomatology in primary health care: A systematic review and meta-analysis.pdf

BackgroundAffective disorders are a debilitating and very prevalent problem throughout the world. Often these are associated with the onset of comorbidities or a consequence of chronic diseases. Anxiety and depression are associated with poor social and personal relationships, compromised health. We aimed to synthesize evidence from studies measuring the impact of a health literacy (HL) intervention on the improvement of affective disorders.
MethodsFor this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, Web of Science, Ibecs, Cuiden, Scielo, Science Direct and Dialnet for exclusively randomized controlled trial studies (RCTs) published between 1 Jan 2011, and 31 May 2022. The search terms employed were “health literacy,” “health knowledge,” “anxiety,” “anxiety disorder,” “depression,” “depressive disorder,” and “adult.” The risk of bias assessment was performed using the Cochrane Collaboration Revised Risk of Bias tool (RoB2). We conducted random-effects meta-analyses and explored heterogeneity using meta-regression and a stratified survey.
ResultsOf 2,863 citations found through the initial screening, 350 records were screened by the title and abstract for their themes and relevance. Finally, nine studies complied with the inclusion criteria for the meta-analysis. 66.66% of studies (n = 6) were rated as having a low risk of bias and 33.33% (n = 3) were judged to raise some concerns. The health literacy interventions were associated with −1.378 reduction in depression and anxiety questionnaires scores [95% CI (−1.850, −0.906)]. Low mood disorder scores are associated with better mental health and wellbeing.
ConclusionOur findings demonstrate that an HL intervention in relation to the symptoms associated with affective disorders improves the emotional state of patients in PHC, with a moderately positive effect in reducing depression and anxiety.

背景：情感障碍（Affective disorders）是一类具有致残性且在全球范围内极为高发的疾病。此类障碍常与共病的发生相关，或是慢性疾病的继发结局。焦虑与抑郁往往会破坏社交与人际关系，并损害身体健康。本研究旨在整合相关研究证据，分析健康素养（health literacy, HL）干预对改善情感障碍的作用效果。
方法：本研究为系统综述与荟萃分析，我们检索了PubMed/MEDLINE、Embase、Web of Science、Ibecs、Cuiden、Scielo、Science Direct及Dialnet数据库，筛选2011年1月1日至2022年5月31日期间发表的随机对照试验（randomized controlled trial, RCTs）。本次检索使用的关键词包括："health literacy"、"health knowledge"、"anxiety"、"anxiety disorder"、"depression"、"depressive disorder"及"adult"。偏倚风险评估采用Cochrane协作组修订版偏倚风险评估工具（RoB2）完成。本研究开展了随机效应模型荟萃分析，并通过元回归与分层分析探究异质性来源。
结果：初始检索共获取2863条引文，经标题与摘要筛选后，有350条记录因主题与相关性进入下一步评估。最终共有9项研究符合荟萃分析的纳入标准。其中66.66%（n=6）的研究被评定为偏倚风险较低，33.33%（n=3）的研究则被判定为存在一定偏倚风险担忧。健康素养干预可使抑郁与焦虑量表评分降低1.378分[95%置信区间：-1.850, -0.906]。情绪障碍评分降低与更佳的心理健康及福祉水平显著相关。
结论：本研究结果显示，针对情感障碍相关症状实施健康素养干预，可改善初级卫生保健（Primary Health Care, PHC）患者的情绪状态，在缓解抑郁与焦虑症状方面具有中等程度的积极效应。