| Objective To study the health literacy skills and current state of self-management and its influencing factors in patients with Chronic Obstructive Pulmonary Disease, exploring the relationships between health literacy skills and self-management among patients.Methods The inpatients with chronic obstructive pulmonary disease (COPD) treated in the respiratory departments of three affiliated hospitals of Central South University and Hunan Provincial People’s hospital between September2011and May2012were selected, and surveyed by questionnaires. The health literacy skill was evaluated by Chronic Obstructive Pulmonary Disease knowledge Questionnaire (COPD-Q) and the self-management level of inpatients assessed by Self-management scale. The data was imported by Epidata software (version3.1) and processed by SPSS software package (version16.0).Results1. A total of274questionnaires were issued,269(98.2%) questionnaires recycled effectively. The forms of sample are as follows: men211(78.4%) and women58(21.6%); age between32and91, with an average of66.91±9.85.2. The lowest score of health literacy of269patients with COPD was0points and the highest score12points, with an average of (6.07± 2.41) points. The top three items were as follows:People with COPD may feel short of breath, using oxygen at home can help people with COPD live longer, people with COPD often have a cough that won’t go away, and the correct rate was82.2%,73.2%and68.8%respectively. The correct rates of other10items were less than60%. The bottom three items were as follows:item10(the medicine albuterol (inhaler) can be used anytime you are short of breath),7(stopping smoking will keep COPD from getting worse) and3(COPD medicines keep the disease from getting worse), the response rate23.4%,16.4%and15.6%, respectively.3. The lowest scores of self-management of269patients with COPD was59points, the highest score230points, with the average score of (145.76±32.25) points. The average scores of the five dimensions, daily life management, emotional management, information management and performance management were (21.48±6.12),(42.00±9.57),(35.74±9.63),(20.65±6.77) and (25.89±6.94) respectively.4. Multiple linear regression analysis showed that the factors affecting patients’ health literacy with COPD were education level, payment of medical expenses, smoking status. The higher the education level of patients with COPD, the better health literacy skills. The patients whose types of medical expenses payment was Medicare or publicly funded possessed higher health literacy skills than the patients with the types of medical expenses payments their own expense or others. With the smoking status of patients from never smoked, once smoked but had quit smoking to still smoking, the patients’ health literacy skills gradually reduced.5. Multiple linear regression analysis showed that the factors affecting the level of self-management of patients with COPD were education level, family income, whether go to hospitalization the past year aggravated due to COPD and smoking status. The higher the education level, the higher the family income, the higher the level of self-management of COPD patients. The patients who hospitalized due to acute exacerbations of COPD in the past year were lower than the patients who no hospitalized for acute exacerbations of COPD in the past year. With the smoking status of patients from never smoked, smoked but had quit smoking, still smoking, health literacy scores of patients with COPD gradually decreased. The decreasing order due to absolute values of the standardized regression coefficient was smoking status, increased hospitalization, education level, family income and smoking status having greatest impact on COPD patients’health literacy skills.6. The relationships between health literacy skills and self-management among patients:There are significantly related between health literacy skills and self-management and its dimensions in patients with COPD (P<0.05) by Pearson correlation analysis. Conclusion1. The level of health literacy skills in patients with chronic obstructive pulmonary disease was low. There are three factors, education level, type of medical expenses payment and smoking status, which affect the levels of health literacy of patients with COPD.2. The level of self-management of patients with COPD was not high. There are four factors, education level, family income, whether hospitalization in the past year due to COPD exacerbations and smoking status, that affect the levels of self-management of patients with COPD3. The relationship between health literacy and self-management is a positive correlation among COPD patients. |
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