Busch Evan L, Martin Christopher, DeWalt Darren A, Sandler Robert S
Department of Medicine, University of North Carolina at Chapel Hill, 27599-7555.
Cancer Control. 2015 Jan;22(1):95-101. doi: 10.1177/107327481502200112.
Functional health literacy is essential for the self-management of chronic diseases and preventive health behaviors. Patients with cancer who have a low level of health literacy may be at greater risk for poor care and poor outcomes.
We assessed health literacy using the Short Test of Functional Health Literacy in Adults in 347 participants with colorectal cancer who were nested within a prospective observational study of system, health care provider, and participant characteristics influencing cancer outcomes.
Having adequate health literacy increased the likelihood that participants with stage 3/4 disease received chemotherapy (odds ratio, 3.29; 95% confidence interval, 1.23-8.80) but had no effect on cancer stage at diagnosis or vital status at last observation during postenrollment follow-up. No difference was seen in health literacy status regarding participant beliefs and preferences about chemotherapy among those with stage 3/4 disease, nor in participant roles in deciding whether to receive chemotherapy.
Patients with lower levels of health literacy were less likely to receive chemotherapy compared with participants with higher levels of health literacy. Therefore, clear communication related to key health care decisions may lead to fewer disparities due to a patient's level of health literacy.
功能性健康素养对于慢性病的自我管理和预防性健康行为至关重要。健康素养水平较低的癌症患者可能面临护理质量差和预后不良的更大风险。
我们在一项关于影响癌症结局的系统、医疗服务提供者和参与者特征的前瞻性观察研究中，对347名结直肠癌参与者使用成人功能性健康素养简短测试来评估健康素养。
具备足够的健康素养增加了3/4期疾病参与者接受化疗的可能性（优势比，3.29；95%置信区间，1.23 - 8.80），但对诊断时的癌症分期或入组后随访期间最后一次观察时的生命状态没有影响。在3/4期疾病患者中，关于化疗的参与者信念和偏好方面的健康素养状况没有差异，在决定是否接受化疗的参与者角色方面也没有差异。
与健康素养水平较高的参与者相比，健康素养水平较低的患者接受化疗的可能性较小。因此，与关键医疗决策相关的清晰沟通可能会减少因患者健康素养水平导致的差异。
