患儿家长健康素养与儿科急诊就诊率关系的系统评价

摘要

Objective To evaluate the relationship between parental health literacy and emergency department utili-zation,and if can reduce the rate of emergency department utilization for parents with low health literacy eliminate illiteracy in-tervention.Methods The related literature were searched in PubMed,CINAHL,CNKI.Literatures were screening and the date were extracted in accordance with inclusion criteria.Statistical analyses were performed by Stata 12.0.Results A total of 17 articles met the full criteria and were included for review,a median of 30% (range 10.5% -48.8%)of parents in the ED possesses low health literacy.Low health literacy of parents of patients with asthma was associated with a higher number of ED visits in children.Meta analysis showed it was effectively that low literacy interventions targeted at parents with low health literacy.DerSimonian and Laird test revealed significant heterogeneity (Chi-square =427.76,df=5,P <0.001).A pooled OR was calculated using a random effects model,given the heterogeneity (OR =0.35,95% CI:0.15 -0.81).Conclusion 1 in 3 parents with their children at the ED have low health literacy,influence their ability to process,make medical deci-sions,and understand for their children.A relationship exists between low health literacy and increased ED utilization.Low lit-eracy interventions targeted at parents who have low health literacy result in decreased ED utilization.%目的：评价患儿家长健康素养与儿科急诊就诊率关系，以及针对低健康素养患儿家长的扫盲干预能否降低急诊就诊率。方法检索 PubMed、CINAHL、CNKI 等数据库中相关文章，按照纳入和排除标准进行文献筛选，提取纳入研究的特征信息。数据分析采用 Stata 12.0软件。结果17篇文献符合纳入标准文献，患儿家长低健康素养发生率在10.5％～48.8％，中位数在30％；哮喘患儿家长低健康素养与急诊就诊有关；Meta 分析显示针对低健康素养患儿家长的扫盲干预有效，随机效应模型检测显示差异明显（Chi-square ＝427.76，df＝5，P ＜0.001），合并优势比显示有差异（OR ＝0.35，95％ CI：0.15～0.81）。结论1／3患儿家长存在低健康素养，影响患儿家长医疗决策、处理和理解力；低健康素养与患儿急诊就诊率增加有关；针对低健康素养患儿家长的扫盲干预可减少急诊就诊率。