臺灣健康知能量表之初探性研究

A Preliminary Study of Taiwan Health Literacy Scale(THLS):

健康知能泛指個人在健康上之認知與社交以維持並促進其健康的技能總和。台灣在這個議題上一直被忽略，落後了歐美近15年，目前尚沒有適合本土的健康知能量表。本研究目的為建構一套本土健康知能量表，由5位專家從衛生署國民健康局的網站篩選出125個當代廣泛使用之健康相關詞彙。本研究以立意取樣方式採屏東地區某醫院門診病人、大專學生、公園與社區居民為樣本，共訪問776例，採Likert scale 5分法測量民眾對於健康知能詞彙的了解程度，共取得有效問卷686例，成功率88.4％。量表從125項健康詞彙中依極端值法與獨立樣本t-檢定選出66項，分為藥名、重症病名、一般疾病名、器官名稱、生理用詞、檢查步驟、治療處置、症狀、表徵等9組。每組內部一致性信度都在0.89以上。量表初步命名為台灣健康知能量表。除專家效度外，並檢測建構效度，與健康知識的關聯效度。初步發現，健康知能與教育程度、女性、中風者家屬、病人照顧經驗及醫護相關職業相關。本研究同時建議一些本量表在政策、學術、實務上之應用方式，並期許未來更多資源與更具代表性樣本之後續理論與應用研究。

Research in health literacy has long been ignored in this country. Measurement available in other countries such as those in U.S.A. and Europe may not be appropriate for use in Taiwan due to different language systems as well as many cultural and political contextual factors. Purpose of this research was to initially develop a Health Literacy Scale specific for Taiwan and to test its initial reliability and validity. Five expert clinic physicians, healthcare administrators and scholars identified 125 common health-related Chinese phrases from major medical knowledge sources that easy accessible to the public. Five-point Likert scale is adapted to measure the targeted population’s understanding on these health-related phrases. Such measurement is then validated with respondents’ health knowledge levels. Samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. Independent t-test was used to examine each individual phrase. Phrases with highest significance were then identified and retained to compose this scale. At last, the Taiwan Health Literacy Scale (THLS) with 66 health-related phrases is established with nine divisions. Cronbach’s alpha of each division at the satisfactory level of 89% and above. Factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study. Some public, academic, and managerial implications as well as future research directions are also discussed.