Effects of HELP on Medication Safety at Home for Family Caregivers with Low-level Health Literacy of Neonate

doi:10.12114/j.issn.1007-9572.2018.00.292

Abstract

Abstract: Background　The health literacy level of the parents with correct drug administration was 6 times that of the parents with wrong drug administration，and 79.2% of the parents of discharged children with medicine have low health literacy level.Low health literacy is a major risk factor for medication errors occurred.Prescription medication errors family events will have serious adverse consequences for children，so there is an urgent need to through the intervention of health literacy of children caregivers，improve children family medication safety level.Objective　To explore the effects of health education and literacy for parents（HELP）on medication safety at home for newborn caregivers with low-level health literacy.Methods　A total of 100 neonatal caregivers with low-level health literacy went to NICU of Anhui Provincial Hospital in 2017 were selected as research subjects by using convenient sampling method，with 50 neonatal caregivers from January to June 2017 as control group and 50 from July to December 2017 as intervention group by time grouping method.The control group received conventional health education and intervention group received 2-week HELP intervention.The content of HELP included medication instruction and log sheets，teach-back method，and provision of a standardized dosing instrument.Chinese version of Newest Vital Sign（NVS），doses of medication，Safe Medicine Knowledge Scale，Morisky Medication Adherence Scale were used before and after intervention to evaluate the level of health literacy，difference of dosage，understanding of medication and medication compliance.Results　Calculating ability，reading comprehension ability and Chinese version of NVS total score of neonatal caregivers in intervention group were higher than those in control group，and the incidence of dosage difference was lower than that in the control group.The basic knowledge of drugs，the characteristics and principles of medication in children，the understanding and treatment of adverse drug reactions，drug compliance，quality identification and storage score and the total score of Safe Medicine Knowledge Scale in intervention group were higher than those in control group（P<0.05）.After intervention，calculating ability，reading comprehension ability and Chinese version of NVS total score of neonatal caregivers in intervention group were higher than those before intervention.In control group and intervention group，the incidence of drug dose difference among newborn caregivers and the quality identification and storage score of control group were lower than those before intervention.The basic knowledge of drugs，the characteristics and principles of medication for children，the understanding and treatment of adverse drug reactions，drug compliance，the quality indentification and storage score and the total score of Safe Medicine Knowledge Scale in intervention group were higher than those before the intervention （P<0.05）．Sixteen cases （32.0%） in intervention group and 6 cases （12.0%） in control group had good drug compliance.The drug compliance in intervention group was better than that in control group（χ2=5.828，P=0.016）．Conclusion　HELP can improve medication security and health literacy level.

Key words: Health literacy；Health education and literacy for parents；Infant, newborn；Medication safety at home

摘要： 背景　正确给药父母的健康素养水平是错误给药父母的6倍，79.2%的出院带药患儿父母的健康素养水平低下。低健康素养水平是发生药疗差错主要危险因素。处方药家庭药疗差错事件会对患儿产生严重的不良后果，因此目前迫切需要通过干预患儿照顾者的健康素养水平，改善其家庭用药安全水平。目的　评价健康教育和健康素养计划（HELP）在低健康素养水平新生儿照顾者家庭用药安全的应用效果。方法　采用方便抽样法，选取2017年度安徽省立医院新生儿重症监护室（NICU）收治的低健康素养水平新生儿照顾者100例为研究对象，采用时间分组法将2017年1—6月入选的50例作为对照组，2017年7—12月入选的50例作为干预组。对照组采用常规出院带药宣教，干预组实施HELP，主要包括3个核心元素，象形图指南、回授法、提供标准化的剂量工具，干预时间2周。干预前后采用中文版最新关键指标测量量表（NVS）评价健康素养水平，记录用药剂量差别，采用用药知识水平测试问卷评价用药理解，采用Morisky用药依从性问卷评价用药依从性。结果　干预后，干预组新生儿照顾者计算能力、阅读理解能力及中文版NVS总分较对照组升高，用药剂量差别发生率较对照组降低，药物基本认识、儿童用药特点及原则、药物不良反应的认识及处理、遵医嘱用药、药物的质量鉴定及贮藏评分、用药知识水平测试问卷总分较对照组升高（P<0.05）；干预后干预组新生儿照顾者计算能力、阅读理解能力及中文版NVS总分较干预前升高，对照组和干预组新生儿照顾者用药剂量差别发生率较干预前降低，对照组药物的质量鉴定及贮藏评分较干预前降低，干预组新生儿照顾者药物基本认识、儿童用药特点及原则、药物不良反应的认识及处理、遵医嘱用药、药物的质量鉴定及贮藏评分、用药知识水平测试问卷总分较干预前升高（P<0.05）。干预组新生儿用药依从性好16例（32.0%），对照组新生儿用药依从性好6例（12.0%），干预组新生儿用药依从性优于对照组（χ2=5.828，P=0.016）。结论　HELP可提高低健康素养水平新生儿照顾者的健康素养水平和新生儿的家庭用药安全。

关键词: 健康素养；健康教育和健康素养计划；婴儿, 新生；家庭用药安全

LU Qi,NI Qianqian,WANG Liping, et al. Effects of HELP on Medication Safety at Home for Family Caregivers with Low-level Health Literacy of Neonate　[J]. Chinese General Practice, 2019, 22(8): 983-993. DOI: 10.12114/j.issn.1007-9572.2018.00.292.
鲁琦,倪倩倩,汪丽平等. 健康教育和健康素养计划对低健康素养水平新生儿照顾者家庭用药安全的效果评价[J]. 中国全科医学, 2019, 22(8): 983-993. DOI: 10.12114/j.issn.1007-9572.2018.00.292.

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