Research On The Construction And Application Of Intervention Programs For Surgical Patients With Low Health Literacy

Objective: Choose a rapid assessment tool for health literacy suitable for the clinical environment,clarify the current health literacy level of surgical patients and related influencing factors,construct an evidence-based nursing practice plan that improves the health literacy level of surgical patients,analyze the application effect of the intervention plan,and thus through this research to improve patients’ health literacy level,promote the improvement of health outcomes,and provide references for health literacy assessment of clinical routine and construction of similar intervention projects.Methods:Phase one: Compare the application effects of two rapid health literacy assessment tools in surgical patient groups.202 surgical patients were admitted from May 2019 to December 2019 in a comprehensive tertiary hospital in Bengbu City,Anhui Province.The patient general information questionnaire,the Chinese version of the comprehensive health literacy measurement scale(C-AAHLS)and the Health Literacy Screening Scale(BHLS)with briefly were used to conduct on-site questionnaire surveys,and SPSS25.0 and Med Calc(medical statistical software)were used to input data and compare the consistency of the measurement results of the two evaluation tools.Phase two: Current surveys on the health literacy of surgical patients.C-AAHLS was used to evaluate the health literacy level of 402 surgical patients,and the differences of the health literacy level and its influencing factors of patients with different demographic characteristics were analyzed.Phase three: Constructions and evaluations of intervention effects of the evidence-based programs for low-level health literacy.Taking the "evidence-based continuous quality improvement model map" as the theoretical framework,through the establishment of an evidence-based research practice plan to build a team and retrieve documents to obtain evidence and evaluate it’s quality,pre-grading and evaluating the extracted evidence,and preliminarily constructing a plan and expert letter inquiries,collect and integrate expert feedback suggestions for the recommended items at all levels in the primary program,clarify the resistible or irresistible factors encountered in the practical application of the intervention program,and propose corresponding treatment methods to determine the ultimate improvement of surgical patients Intervention programs for health literacy levels.A comprehensive Grade A hospital in Bengbu City,Anhui Province was selected to apply C-AAHLS to screen 60 patients with knee/hip replacement at a low health literacy level who were admitted to the hospital from September 2020 to November2020.They were randomly divided into control group and intervention group.The intervention group implemented the intervention in accordance with the evidence-based nursing practice plan.The C-AAHLS and the Orthopedics Functional Exercise Compliance Scale were used to evaluate the patients’ health literacy score and exercise compliance score respectively.Results: 1.The Bland-Altman chart shows that within the consistency limit,the average measurement results of C-AAHLS and BHLS are 1.824,and the maximum difference is1.68<1.824(average).The average value of the difference is close to 0,and the result has a relatively high consistency(P<0.0001).2.402 surgical patients used C-AAHLS to measure the total health literacy score(23.16±4.00),and the overall score was at a medium level.Among them,the interactive health literacy score was the highest(2.35±0.49),and the critical health literacy score was the lowest(1.80±0.59).The results of multiple linear regression analysis showed that: long-term residence,source of hospitalization expenses,and understanding of the hospital’s We Chat platform are the main factors affecting the health literacy of surgical patients.3.The evidence-based intervention plan for surgical patients with low health literacy level includes 4 modules of team management,screening and evaluation,specific measures and health education,with a total of 17 items,of which 12 are recommended for level A and 5 are recommended for level B.4.After the implementation of the evidence-based nursing practice program intervention,the health literacy scores of the control group and the intervention group were improved compared with those before the intervention((18.60±2.28)vs(16.83±3.00),P=0.002;(22.70 ± 3.56)vs(16.70 ± 3.51),P<0.001),and the intervention group had a higher score than the control group((22.70±3.56)vs(18.60±2.28),P<0.001);the intervention group had higher functional exercise compliance scores than the control group((39.27±6.94)vs(29.00±3.32)),P<0.001;the differe-nces were statistically significant.Conclusions: 1.The results of C-AAHLS and BHLS measuring health literacy are consistent.It is recommended that clinical medical staff choose appropriate evaluation tools for health literacy assessment according to the actual situation.2.The health literacy level of surgical patients is affected by many related factors such as long-term residence,hospitalization expense source,past hospitalization experience and understanding of the hospital’s We Chat platform.The overall health literacy level of surgical patients still needs to be improved,especially the ability to evaluate and apply health information in critical health literacy.3.Incorporating the health literacy assessment of surgical patients into the routine nursing assessment items will help clinical nursing staff to construct targeted intervention programs for patients with different dimensional health literacy levels.