Heilsulæsi : þróun matslista og mat á heilsulæsi eldri Íslendinga

Abstract

Tilgangur rannsóknarinnar var í fyrsta lagi að þróa íslenska útgáfu af Evrópska heilsulæsislistanum HLS-EU-Q16 með því að þýða og staðfæra hann, auk þess að kanna innri áreiðanleika. Í öðru lagi að afla þekkingar á heilsulæsi eldri einstaklinga á Íslandi og kanna áhrif ýmissa bakgrunnsbreyta á það.Aðferðir rannsóknar: Eftir þýðingu og bakþýðingu matslistans voru teknar tvær umferðir af ígrunduðum samtölum. Til að prófa matslistann og afla upplýsinga um heilsulæsi var gerð þversniðsrannsókn og úrtakið valið (N=210) með lagskiptri, slembaðri úrtaksaðferð (aldur, kyn, búseta: höfuðborg/landsbyggð) af Íslendingum 65 – 85 ára. Matslistinn var lagður fyrir þátttakendur í póst- og símakönnun. Matslistinn samanstendur af 16 spurningum og þeim er svarað á fjögurra þrepa raðkvarða, hærra skor þýðir betra heilsulæsi.Niðurstöður: Ígrunduð samtöl voru tekin við 17 manns, fulltrúa almennra borgara á aldrinum 20 – 74 ára. Orðalag 11 spurninga af 16 breyttist og svarendur komu með færri athugasemdir og voru fljótari að svara þeim í seinni umferðinni. Svarhlutfall í þversniðsrannsókninni var 64% (N=124). Meðalaldur var 72,65 (±=5,96) ár og fleiri konur (n=71) tóku þátt í rannsókninni en karlmenn (n=53). Stig heilsulæsis á skalanum 0 – 16 var 13,4 (±2,69) og á skalanum 0 – 50, 39,07 (±=7,04). Meðaltal spurninga matslistans á kvarðanum 1 – 4 var 3,34 (±0,45). Almennt höfðu þátttakendur fullnægjandi heilsulæsi. Óháð t-próf sýndi að konur hafa betra heilsulæsi en karlar og þeir sem bjuggu einir höfðu betra heilsulæsi heldur en þeir sem bjuggu með öðrum. Innri áreiðanleiki lokaútgáfu matslistans var 0,87.Ályktanir: Mikilvægt er að hafa notendasamráð t.d. í formi ígrundaðra samtala við þróun matstækja. Heilsulæsislistinn reyndist áreiðanlegur til þess að meta heilsulæsi íslenskumælandi eldri einstaklinga. Heilsulæsi þátttakenda var að jafnaði fullnægjandi og betra en í rannsóknum meðal eldra fólks í Finnlandi og Þýskalandi. Lykilorð: Heilsulæsi, eldra fólk, aldraðir, ígrunduð samtöl, staðfærsla HLS-EU-Q16-IS spurningalista.

The aim of the study was firstly to develop an Icelandic version of the European Health Literacy Questionnaire HLS-EU-Q16 by translation and cross-cultural adaption, as well as to assess internal reliability. Secondly, to acquire knowledge of health literacy of older Icelanders and to study the effects of various demographic and socioeconomic factors that may affect it.Methods: After the translation and back-translation of the questionnaire, two rounds of cognitive interviews were conducted. A cross-sectional study was carried out to test the questionnaire and obtain information on health literacy. Stratified random sampling method (age, gender, residence: urban/rural) was used to obtain the study sample of 210 Icelandic individuals, 65 – 85 years old. The questionnaire was mailed to the participants and telephone interviews were conducted. The questionnaire contains 16 questions and are answered on a four-step scale, where a higher score means better health literacy.Results: Cognitive interviews were conducted with 17 individuals that represent ordinary citizens aged 20 – 74 years old. Wording of 11 questions out of 16 was changed and participants made fewer comments and were quicker to answer in the second round of the interviews. The response rate in the cross-sectional study was 64% (N=124). The mean age was 72,65 (±=5,96) years and more women (n=71) participated in the study than men (n=53). The level of health literacy on a scale 0 – 16 was 13,4 (±2,69) and on scale of 0 – 50, 39,07 (±=7,04). The mean value of the questions in the questionnaire on a scale of 1 – 4 was 3,34 (±0,45). In general, participants have adequate health literacy. Independent t-test showed that woman had better health literacy than men and those who lived alone had better health literacy than those who lived with others. The internal reliability of the final version of the questionnaire was 0,87.Conclusion: It is important to have user consultation, e.g. in the form of cognitive interviews during the development of assessment tools. The health literacy questionnaire is proved to be reliable for assessing the health literacy of Icelandic-speaking older individuals. Participants’ health literacy was generally adequate and better than in studies among older people in Finland and Germany with same questionnaire.Keywords: Health literacy, older people, cognitive interviews, translation and cross-cultural adaption of HLS-EU-Q16 Questionnaire.