閱讀心得
In this study, health literacy is conceived as the extent to which people are able to seek, understand and share health information, with a view to health maintenance and promotion across the lifetime in different contexts(11). In this health literacy perspective, people are not passive health information receivers, but serve as their protagonists in all social interaction spheres(9,11).
"在這項研究中，健康素養是被定義為在不同環境下個體整個生命週期能夠尋求、了解和分享健康信息以期健康維護和促進的程度（11）。在這種健康素養的角度看，人不是被動的信息接收者的健康，但作為他們的主角在所有社會交往領域（9,11）。"
此處所定義的健康素養，與健康適應能力有著相同的意函，
健康素養一詞有時被用作同義詞的健康教育。這是兩個不同但相關的概念雖然。在更廣泛的概念，涉及健康教育的策略用來使人們做出決定對他們的健康，健康知識為一體的結果（11）。因此，健康教育，因此，健康素養幫助人們做出決定對他們的生活（12）。
不同的參考框架，對健康素養已提出。其中，功能性，互動性和批判性的方法脫穎而出。在功能的方法，健康素養是指掌握信息的健康風險和健康服務的使用。互動式的方法包括個人技能，允許擴大人民和社區的能力獨立行事。關鍵健康素養是指人們和社區的能力，涉及評估的信息為基礎的行動對社會和經濟的健康決定因素和機會，以促進政治和組織的變化（3）。
ABSTRACT
OBJECTIVE: To describe the process of adaptation of an instrument that analyzes the health literacy of older people.
METHODS: The adaptation consisted of steps to determine conceptual equivalence of items, operationally and semantically.
RESULTS: The stages of conceptual and item equivalence showed that the items and concepts of this Canadian instrument was suitable for use in Brazil. The steps of initial translation, back translation, expert committee review and pre-test performed during evaluation of semantic equivalence have resulted in alterations to some items and rewording of some questions. Regarding operational equivalence, the interview was appropriate to local realities.
CONCLUSION: The steps of transcultural adaptation, generally adopted for validation of measurement tools, were used and allowed researchers to adequately conduct this research study.
Keywords: Validation study; Health education; Health of the elderly
摘要
目的：描述過程適應的儀器，分析了老年人的健康素養。
方法：適應包括步驟，以確定項目的等價概念，運作和語義。
結果：該階段的概念和項目等價表明，項目和概念本儀器是加拿大適合使用在巴西。這些步驟的初始翻譯，回譯，專家委員會的審查和預評估測試執行過程中的語義等價的改變導致了一些項目和措詞的一些問題。關於操作等價，採訪了適合當地實際情況。
結論：該步驟的跨文化適應，普遍採用的測量工具進行驗證，並允許研究人員使用了充分進行這項研究。
關鍵詞：驗證研究;健康教育，健康老人
INTRODUCTION
Health literacy is a relatively new concept in health promotion and has not been investigated yet in Brazil. In the international context, health literacy has been studied in different developed countries, including Canada, Israel, Australia and the United States(1-4), and also more specifically involving elderly people(5-7).
Population aging is a global phenomenon that does not happen similarly in different countries. In developed countries, the elderly population gradually increased, when its citizens had already reached other basic aspects of life. In developing countries, on the other hand, the demographic transition occurred fast and progressively, in a context of social and economic inequalities(8). Thus, it should be highlighted that some population groups can be considered marginalized in terms of health literacy, such as elderly people and people with low education and income levels(9). In Brazil, the challenge is greater in comparison with other countries. Despite the increased life expectancy, most elderly people live in unfavorable conditions, with low socioeconomic, high education and high prevalence levels of chronic illnesses(8,10). The phenomenon affects and generates new demands for health services, entailing the need to (re)organize care models to attend to this population group's health needs.
Health literacy of elderly people is the research problem in one of the projects that is part of the baseline research "Healthy aging in the South of Brazil: facing challenges and developing opportunities for health professionals and elderly people". The aim is to face the challenges of elderly people's access and care in primary health care services and to develop opportunities for health professionals, in order to prepare them to enhance active aging. This is a partnership between the School of Nursing at Universidade Federal do Rio Grande do Sul and the IAPI Health Center in Porto Alegre, Rio Grande do Sul, Brazil.
In this study, health literacy is conceived as the extent to which people are able to seek, understand and share health information, with a view to health maintenance and promotion across the lifetime in different contexts(11). In this health literacy perspective, people are not passive health information receivers, but serve as their protagonists in all social interaction spheres(9,11).
The term health literacy is sometimes used as a synonym of health education. These are two distinct but related concepts though. In a broader conception, health education involves the strategies used to empower people to make decisions about their health, with health literacy as one of the results(11). Thus, health education and, consequently, health literacy help people to make decisions about their lives(12).
Different reference frameworks on health literacy have been proposed. Among these, the functional, interactive and critical approaches stand out. In the functional approach, health literacy refers to the mastery of information on health risks and health service use. The interactive approach involves personal skills that permit broadening people and communities' capacity to act independently. Critical health literacy refers to people and communities' empowerment and involves the assessment of information-based actions on social and economic determinants of health and opportunities to promote political and organizational changes(3).
The study of health literacy rests on a research by Canadian researchers and uses an instrument with open and closed questions that analyzes, based on a recently experienced health/disease situation, how elderly people seek, understand and share health information to make decisions about their health and their life(11).
As this instrument was elaborated in another language, with a view to its effective use in a different context, the researchers decided to accomplish a cross-cultural adaptation process, so as to go beyond a literal translation of words and phrases, covering the target population's different contexts and lifestyles(13). This study used the conceptual, item, semantic and operational equivalence phases(14-15).
The use of a health literacy assessment instrument in Brazil can offer support for care planning to the elderly population, as it is important to identify aspects of its health literacy, so that professionals are apt to enhance health education for this population group, according to its characteristics. For nursing, obtaining this kind of instrument aims to contribute to the elaboration and development of health education actions that involve elderly people.
The goal of this paper is to describe the cross-cultural adaptation process of the health literacy instrument, which analyzes health literacy among elderly people.
引言
健康素養是一個比較新的概念，健康促進，並沒有被查處但在巴西。在國際背景下，健康素養進行了研究，在不同的發達國家，包括加拿大，以色列，澳大利亞和美國（1-4），也比較具體，涉及老人（5-7）。
人口老齡化是一個全球性現象，不會發生類似在不同的國家。在發達國家，老年人口逐漸增加，當其公民已經達成的其他方面的基本生活。在發展中國家，另一方面，人口結構發生快速轉變，並逐步在上下文的社會和經濟不平等（8）。因此，應該強調指出，某些群體可以被視為邊緣化的健康素養方面，如老人和人民的教育和收入水平低（9）。在巴西，更大的挑戰是與其他國家比較。儘管預期壽命延長，大多數老年人生活在不利的條件下，低社會經濟，高學歷，高層次的慢性疾病患病率（8,10）。這種現象影響，並產生了新的要求對醫療服務，帶來的需要（重新）組織醫護模式，以照顧到這一群體的健康需求。
健康素養的老人是研究問題，其中一個項目是部分基線研究“健康的老齡化在南巴西：面臨的挑戰和發展機遇的衛生專業人員和老人”。其目的是要面對的挑戰老人的訪問和護理初級衛生保健服務，並為衛生專業人員開發的機遇，以培養他們積極加強老化。這是一種夥伴關係的護理學院在聯邦大學做南里奧格蘭德州和IAPI健康中心在阿雷格里港，南里奧格蘭德州，巴西。
在這項研究中，健康素養是設想為在何種程度上人們能夠尋求，了解和分享健康信息，以期健康維護和促進整個生命週期在不同環境下（11）。在這種健康素養的角度看，人不是被動的信息接收者的健康，但作為他們的主角在所有社會交往領域（9,11）。
健康素養一詞有時被用作同義詞的健康教育。這是兩個不同但相關的概念雖然。在更廣泛的概念，涉及健康教育的策略用來使人們做出決定對他們的健康，健康知識為一體的結果（11）。因此，健康教育，因此，健康素養幫助人們做出決定對他們的生活（12）。
不同的參考框架，對健康素養已提出。其中，功能性，互動性和批判性的方法脫穎而出。在功能的方法，健康素養是指掌握信息的健康風險和健康服務的使用。互動式的方法包括個人技能，允許擴大人民和社區的能力獨立行事。關鍵健康素養是指人們和社區的能力，涉及評估的信息為基礎的行動對社會和經濟的健康決定因素和機會，以促進政治和組織的變化（3）。
這項研究的健康素養建立在一個由加拿大研究人員的研究和使用的工具與開放式和封閉式的問題，分析的基礎上，最近經歷健康/疾病的情況下，如何尋求老人，理解和分享健康信息作出決策對自己的健康和他們的生活（11）。
由於本儀器在闡述了另一種語言，以期有效使用在不同的背景下，研究人員決定實現一個跨文化適應的過程，這樣才能超越字面翻譯的單詞和詞組，覆蓋目標人群的不同背景和生活方式（13）。本研究使用的概念，項目，語義和操作等價階段（14-15）。
一個健康的使用掃盲評估儀器在巴西可以提供支持照顧老年人口計劃，因為它是重要的，以確定其健康方面的知識，使專業人士很容易加強健康教育這一群體，根據其特徵。對於護理，取得這種儀器的目的是促進制定和發展的健康教育行動涉及的老人。
本文的目的是描述跨文化適應過程中的健康素養儀器，分析健康素養的老人。
