母親のヘルスリテラシーを測定している尺度に関する文献検討

目的：近年，健康や医療に関する情報を入手，理解，評価，活用して健康に結びつく意思決定ができる力であるヘルスリテラシーが健康を決める力として注目されている．本研究では，母親の育児に関するヘルスリテラシーを把握できる尺度の必要性を検討するため，国内外で母親のヘルスリテラシーを測定している尺度について，その特徴と関連する要因について明らかにすることにした． 方法：2018年10月にPubMed，医学中央雑誌の２データベースを使用し，MeSH Termsを用いて1990年から2018年の母親のヘルスリテラシーに焦点をあてた文献を検索した． 結果：16件の英語文献が抽出された．米国における研究が14件で最も多く，日本人を対象とした研究はなかった．多く用いられていた測定尺度は，母親を対象に開発された尺度ではなく，広く成人を対象に用いられている尺度であり，基本的な識字能力をみる機能的リテラシーを測定する尺度であった．母親のヘルスリテラシーの関連要因として，母親の年齢や教育，社会経済的状態など先行研究と同様の結果と子どもへの薬の投薬方法，子どもの睡眠状況や疾患の症状，重症度など子どもの健康に関連する特徴的な結果が得られた． 考察：本研究の結果，母親のヘルスリテラシーを高めることの必要性が示唆された．しかし，母親のヘルスリテラシーを測定していた尺度は，元々それを測定するために開発されたものではなく，どのような対象でも汎用性がある尺度であった．そこで，一定の社会保障が確保され，識字率が高い日本の母親を対象とした信頼性と妥当性のあるヘルスリテラシー測定尺度の開発が必要である．また，今後は健康や医療に関する情報はもちろん，子どもとのつながりを重視した育児に焦点をあてた母親の育児に関するヘルスリテラシーを適切に把握できる尺度の開発が必要であると考える．Objective: In recent years, health literacy – which empowers people to make better health decisions through the reception, understanding, evaluation, and utilization of information about health and medicine – is garnering attention as a driver of health. This study aimed to investigate the need for measures that assess health literacy regarding child rearing in mothers and to clarify the characteristics of current health literacy measures in Japan and abroad, as well as factors related to health literacy. Method: In October 2018, we conducted a search for studies focused on health literacy in mothers published between 1990 to 2018 using Medical Subject Heading (MeSH) terms in two databases, PubMed and Igaku Chuo Zasshi. Results: The search returned 16 studies in English. Most (n=14) were from the United States and none were conducted on Japanese subjects. The measures used in these studies were not specifically developed for mothers, but functional literacy measures widely used on adults to assess basic literacy. With regards to factors related to health literacy in mothers, the studies supported results from previous work (e.g. mother’s age, education, socioeconomical status) as well as identified characteristic factors related to child health (e.g. children’s sleep conditions, symptoms and severity of disease). Discussion: The results suggested the necessity to improve health literacy in mothers. However, the measures used to examine health literacy in mothers were not originally designed for that purpose; instead, they were versatile measures applicable for a wide range of subjects. Therefore, it is necessary to develop a health literacy measurement scale with reliability and adequacy for Japanese mothers with a certain level of social security and high literacy rate. In addition to distributing information on health and medicine, developing measures for grasping health literacy appropriately regarding child rearing in mothers – particularly with emphasis on the importance of the connection with the child – is a crucial area of future work

Communication and health literacy in Dien Bien Province, Vietnam: experiences and perceptions of primary health care professionals and ethnic minority women

Background: An important element of improving patient-centred communication in resource-poor settings is improving health literacy. There has been little research about communication and health literacy in such settings. Ethnic minorities in Vietnam experience poor communication with health professionals, and there are considerable inequities in health outcomes. This thesis aims to investigate the communication experiences, and the factors underlying communication, between ethnic minority women with limited health literacy and primary health care professionals in the maternal health setting in a remote province of Vietnam. Methods: This qualitative study used a focused ethnography methodology. Data was generated from in-depth interviews with health professionals (n=22) and focus group discussions with ethnic minority women (n=42). Results: Primary health services were likely to be underutilised and were perceived to be of low quality. Health professionals perceived communication to be a one-way path for delivering information and perceived communication problems to be due to patient factors, placing the burden for improvement on patients. Ethnic minority women experienced communication with health professionals as didactic and paternalistic, with health professionals often relying on written information. Discussion: This thesis adds new knowledge to the limited amount of research exploring health literacy and communication in low and middle-income countries. This research applies a health literacy lens to thinking patient/health professional communication, and how communication can be improved. There is evidence to suggest that patient-centred approaches to communication can be successfully implemented in Vietnam. Adopting more patient-centred approaches to health communication with women from diverse ethnic backgrounds in Vietnam could help to increase the use of maternal health services and reduce inequities in maternal health outcomes

Increasing Health Literacy of Parents of Children Age 0 to 5 Regarding Oral Health and Immunizations

Health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions� (U.S. Department of Health and Human Services [USDHHS], n.d., para. 1). Low health literacy impacts patients and healthcare systems alike. Increasing parental health literacy of both vaccines and oral health can improve childhood health outcomes. This project utilized a Quick Response (QR) code placed on the back of age-appropriate Reach Out and Read books that providers distribute at well-child visits. Parents scanned the QR code, which led them to an educational website about oral health and immunizations for children from birth to five years of age. Website views and analytics were tracked along with responses from a voluntary survey found on the website. Data showed 236 unique views of the site with repeat traffic from November 1, 2020 until April 30, 2021. Parental survey responses were positive for learning, intent to change health habits, and intent to share the information they learned with others. Additionally, another organization has already duplicated the project to increase pediatric oral hygiene habits, and a North Carolina regional Area Health Education Center (AHEC) is in the process of adopting this project. With positive outcomes, this project will continue to expand and develop in the future.D.N.P

PREPARAÇÃO PARA O PARTO E PARENTALIDADE – A SUA INFLUÊNCIA NA EXPERIÊNCIA DE TRABALHO DE PARTO E PARTO

Relatório de estagio apresentado para obtenção do grau de Mestre em Enfermagem de Saúde Materna e ObstetríciaOs programas de preparação para o parto e parentalidade (PPP), surgem como uma mais-valia para as mulheres grávidas, uma vez que lhe proporcionam conhecimento, habilidades e experiências, para que estas possam gerir o seu trabalho de parto (TP) e parto, garantindo uma experiência de parto satisfatória e uma parentalidade positiva. No sentido de mapear evidência científica sobre de que forma a PPP capacita a parturiente no TP e parto, foi realizada uma scoping review. Através da evidência científica foi possível concluir que a PPP dirigida pelo Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica, permite um maior envolvimento das parturientes na tomada de decisão sobre aspetos relacionados com o seu TP e parto, dando-lhes um papel ativo, através dos momentos de educação para a saúde durante o período pré-natal, individuais ou em grupo; partilha de experiências; empowerment; cuidados humanizados entre outros.The preparation for childbirth and parenting programs (PPP) appear as an added value for pregnant women, since they provide them with knowledge, skills and experiences, so that they can manage their labor (TP) and delivery , ensuring a satisfactory birth experience and positive parenting. In order to map scientific evidence on how the PPP empowers the parturient in labor and childbirth, a scoping review was carried out. Through the scientific evidence, it was possible to conclude that the PPP directed by the Specialist Nurse in Maternal and Obstetric Health Nursing, allows a greater involvement of parturients in decision-making on aspects related to their labor and childbirth, giving them an active role, through moments of health education during the prenatal period, individually or in groups; sharing experiences; empowerment; humanized care among others.N/