Effects of Demographics and Caregiver Health Literacy on Patient Trauma Outcome

以人口學特性探討照顧者的健康素養對外傷病人預後的影響

董政城(Cheng-Cheng Tung) ； 李東炎(Tung-Yen Lee) ； 藍守仁(Shou-Jen Lan)

《The Changhua Journal of Medicine》 15卷4期 (2017/12) Pp. 194-203

https://doi.org/10.6501/CJM.1504.003

摘要

The purpose of this study was to examine the effects of demographic variables and caregiver health literacy on patient trauma outcome. This study was of a prospective design, with 258 cases enrolled. The determinants were caregiver health literacy, as measured using the Mandarin Health Literacy Scale (MHLS), and patient trauma outcome, as assessed according to the injury severity score (ISS), length of hospital stay, and number of complications. The effects of caregiver demographics on caregiver health literacy and patient trauma outcome, in addition to the effects of patient demographics on patient trauma outcome, were analyzed. A structural equation model (SEM) validated the results. The structural equation model was built through first-order confirmatory factor analysis (CFA), which included the offending estimate test, model fit assessment, and tests of construct reliability (CR), convergent validity, and discriminant validity. Significant direct effects (p ＜ 0.001) of caregiver gender (0.49), education level (0.38) and occupation (0.14) on caregiver health literacy were observed, and patient age (0.57) and caregiver health literacy (-0.41) were found to affect patient trauma outcome. Female caregivers were willing to focus more strongly on learning how to care for their injured family member. Caregivers with a higher level of education and a more senior occupation had a better health literacy. Older patients were found to have a poor trauma prognosis, and the ISS was correlated with old age. Enhancing health literacy can result in reduction of the ISS, duration of hospital stay and number of complications. The government should enhance the health literacy of citizens in order to improve trauma outcome.

關鍵字

caregiver ； health literacy ； trauma outcome ； structural equation model

並列摘要

目標：這項研究的目的是驗證人口學變項和主要照顧者的健康素養對外傷患者預後的影響。方法：本研究是前瞻性的研究，共收集258例。經由華人健康素養量表來測量主要照顧者的健康素養；透過傷害嚴重性評分，住院天數和併發症來測量患者的外傷預後。該研究架構是針對主要照顧者的人口學變項對其健康素養的影響；主要照顧者和患者的人口學變項與主要照顧者的健康素養對患者的外傷預後的影響。使用結構方程式模型驗證此研究架構。結果：顯著的直接效應是主要照顧者的性別(0.49)，教育(0.38)和職業(0.14)對主要照顧者的健康素養的影響。與患者年齡(0.57)和主要照顧者的健康素養(-0.41)對患者的外傷預後的影響。結論：女性照顧者願意關注與學習如何照顧他們受傷的家人。受過高等教育程度和擁有高階職業的照顧者擁有較好的健康素養。老年外傷患者的外傷預後不良。傷害嚴重性評分與老年人相關。提升健康素養會改善外傷預後。建議政府應提升全體公民的健康素養，以改善外傷的預後。

並列關鍵字

主要照顧者 ； 健康素養 ； 外傷預後 ； 結構方程式模型