低識字率の患者教育ツールを使用して,肺炎球菌ワクチン接種率を向上させる. ランダム化された制御試験です
T A Jacobson1, D M Thomas, F J Morton
1Department of Medicine, Emory University School of Medicine, Grady Health System, Atlanta, GA 30303, USA. tjaco02@emory.edu
JAMA
|October 12, 1999
まとめ
低識字率の単純なツールは,高齢の低識字率の患者の肺炎球菌ワクチン接種に関する議論と率を大幅に高めました. この教育的介入により,患者と医師の対話が改善され,脆弱な集団における予防接種の普及が改善されました.
科学分野:
- 公衆衛生は公衆衛生である.
- 健康に関する識字能力
- 予防医学は,予防的な医療です.
背景:
- 高齢者および高リスク者の肺炎球菌予防接種率は,米国公衆衛生局の目標である60%を大幅に下回っています.
- 高齢者人口のかなりの部分に影響を与える限られたまたは限界の識字は,低ワクチン接種率に寄与する要因である可能性があります.
研究 の 目的:
- 低識字率の教育ツールが,肺炎球菌ワクチン接種に関する患者と医師のコミュニケーションを向上させることができるかどうかを評価する.
- この介入によって,標的集団における肺炎球菌免疫率が増加するかどうかを判断する.
主な方法:
- ランダム化比較試験は,都市にある公立教科病院の ambulatory care 診療所で実施されました.
- 参加者は,予防接種を受けていない433人の高齢者や慢性疾患の患者で,介入グループ (予防接種に関する低識字者手帳) または対照グループ (栄養に関する低識字者手帳) に割り当てられました.
- 測定されたアウトカムには,文書化されたワクチン接種率と,医師とのワクチン接種に関する自己報告された議論が含まれています.
主要な成果:
- 低識字率の教育ツールを受けた患者は,肺炎球菌ワクチン接種について医師と話し合う可能性が4倍でした.
- 介入グループは,対照群と比較して,肺炎球菌ワクチン接種率の5倍以上を示した.
- 多変量分析は,介入グループ割り当てのみが,議論と予防接種の増加と有意に関連していることを確認しました.
結論:
- 単純で低識字の教育資料は,肺炎球菌ワクチンの接種率を効果的に増加させました.
- このツールは,肺炎球菌ワクチンに関する患者と医師の対話を大幅に改善しました.
- この介入は,サービス不足,低識字,高齢者のワクチン接種率を向上させるための成功した戦略を示しています.
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