The Relationship Between Patient-Physician Agreement in Asthma Control Perception and Health Literacy: A Cross-Sectional Study from Türkiye

Öz

This study aimed to evaluate the agreement between patients and physicians in the assessment of asthma control and examined the association between this agreement and health literacy. This prospective cross-sectional study was conducted at the Karadeniz Technical University Faculty of Medicine between October 2023 and March 2025 and included 197 patients with a physician-confirmed diagnosis of asthma. Asthma control was assessed using the Asthma Control Test (ACT), completed independently by both the patient and the physician. The Global Initiative for Asthma (GINA) symptom score and the Turkish Health Literacy Scale-32 (TSOY-32) were also administered. The median age of the participants was 42 years (Q1–Q3: 29–52), and 82.2% were female. Among them, 34% had a university degree and 28.4% had limited health literacy. A moderate level of agreement was observed between patient and physician ACT scores (kappa = 0.434, p <0.001). The greatest disagreement occurred on ACT item 4 (frequency of reliever inhaler use), where 54.8% of patients rated lower scores than their physicians, especially among female patients (p = 0.03). Agreement was 2.3 times more likely in university graduates compared to those with only primary education (p = 0.03). Patients with problematic-limited health literacy had 2.8 times higher odds of agreement compared to those with inadequate health literacy (p = 0.03). However, these associations were not statistically significant in the multivariate logistic regression analysis (p >0.05). Our findings suggest that patient-physician concordance in asthma control assessment is influenced by health literacy and educational level. Considering these factors in clinical practice may improve communication and enable more accurate evaluation of asthma control.

Anahtar Kelimeler

• Asthma control test
• GINA symptom score
• Health literacy

Astım Kontrol Algısında Hasta-Hekim Uyumunun Sağlık Okuryazarlığı ile İlişkisi: Türkiye’den Kesitsel Bir Çalışma

Öz

Çalışmanın amacı, astım kontrol düzeyine ilişkin hasta ve hekim değerlendirmeleri arasındaki uyumu incelemek ve bu uyumun sağlık okuryazarlığı ile ilişkisini değerlendirmektir. Ekim 2023-Mart 2025 tarihleri arasında Karadeniz Teknik Üniversitesi Tıp Fakültesi’nde yürütülen bu prospektif kesitsel çalışmaya, astım tanısı almış 197 hasta dahil edilmiştir. Astım kontrolü hem hasta hem de hekim tarafından uygulanan Astım Kontrol Testi (AKT) ile değerlendirilmiştir. Ayrıca GINA semptom skoru ve Türkiye Sağlık Okuryazarlığı-32 (TSOY-32) ölçekleri kullanılmıştır. Katılımcıların yaş ortancası 42 (Q1-Q3; 29-52) yıl olup, %82.2’si kadındı. Hastaların %34’ü üniversite mezunu, %28.4’ü ise sınırlı sağlık okuryazarlığına sahipti. Hasta ve hekim değerlendirmeleri arasında orta düzeyde bir uyum saptandı (kappa=0.434, p<0.001). Özellikle AKT'nin dördüncü sorusunda (rahatlatıcı inhaler kullanım sıklığı), hastaların %54.8’i doktorlara göre daha düşük puan verdi; bu farkın kadın hastalarda daha belirgin olduğu görüldü (p = 0.03). Üniversite mezunlarında uyum olasılığı ilkokul mezunlarına göre 2.3 kat daha fazla idi (p = 0.03). Sorunlu-sınırlı sağlık okuryazarlığına sahip bireylerde uyum olasılığı yetersiz okuryazarlığa göre 2.8 kat daha yüksekti (p = 0.03). Ancak multiple lojistik regresyon analizinde bu ilişkiler anlamlılığını kaybetti (p >0.05). Bulgularımız, astım yönetiminde hasta-hekim iletişimini güçlendirmek ve kontrol değerlendirmelerini doğru yapabilmek için sağlık okuryazarlığının dikkate alınması gerektiğini göstermektedir.

Anahtar Kelimeler

• Astım kontrol testi
• GINA semptom skoru
• Sağlık okuryazarlığı

Kaynakça

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