School of Psychology, Dublin City University, Dublin, Ireland.
Department of Psychology and Assisting Living and Learning Institute, Maynooth University, Maynooth, Co. Kildare, Ireland.
J Cancer Surviv. 2021 Dec;15(6):855-865. doi: 10.1007/s11764-020-00978-5. Epub 2021 Jan 9.
Little is known about whether health literacy is associated with affects certain key outcomes in head and neck cancer (HNC) survivors. We investigated (i) the socio-demographic and clinical profile of health literacy and (ii) associations among between health literacy and self-management behaviours, health-related quality of life (HRQL) and fear of recurrence (FoR) in HNC survivors.
A population-based survey was conducted in Ireland. Health literacy was assessed using a validated single-item question. Socio-demographic, clinical and psychosocial outcome variables (FoR, self-management behaviours, HRQL) were collected. Multivariable linear regression was performed to estimate associations between health literacy and each psychosocial outcome.
Three hundred ninety-five (50%) individuals responded to the survey. Inadequate health literacy was evident among 47% of the sample. In adjusted models, HNC survivors with inadequate health literacy had significantly lower levels of self-management behaviours in the domains of health-directed behaviour, positive and active engagement in life, self-monitoring and insight, constructive attitudes and approaches and skills and technique acquisition. Inadequate health literacy was independently associated with lower functional well-being and HNC disease-specific HRQL. FoR was also significantly higher among those with inadequate health literacy.
HNC survivors with inadequate health literacy have lower levels of self-management behaviours, lower functional HRQL and increased FoR compared to those with adequate health literacy.
Clinicians, healthcare providers and those developing interventions should consider how inadequate health literacy among HNC survivors might affect post-treatment outcomes when developing services and providing support for this group.
关于健康素养是否与头颈部癌症（HNC）幸存者的某些关键结局有关，目前知之甚少。我们调查了（i）健康素养的社会人口学和临床特征，以及（ii）健康素养与自我管理行为、健康相关生活质量（HRQL）和复发恐惧（FoR）之间的相关性。
在爱尔兰进行了一项基于人群的调查。使用经过验证的单项问题评估健康素养。收集社会人口学、临床和心理社会结局变量（FoR、自我管理行为、HRQL）。采用多变量线性回归估计健康素养与每个心理社会结局之间的关联。
395 名（50%）个体对调查做出了回应。在样本中，有 47%的人存在健康素养不足的情况。在调整后的模型中，健康素养不足的 HNC 幸存者在健康导向行为、积极主动参与生活、自我监测和洞察力、建设性态度和方法以及技能和技术获取等领域的自我管理行为水平明显较低。健康素养不足与较低的功能健康幸福感和 HNC 疾病特异性 HRQL 独立相关。FoR 在健康素养不足的人群中也显著更高。
与健康素养充足的 HNC 幸存者相比，健康素养不足的 HNC 幸存者的自我管理行为水平较低、功能 HRQL 较低且 FoR 较高。
临床医生、医疗保健提供者和那些制定干预措施的人在为这一群体制定服务和提供支持时，应考虑 HNC 幸存者的健康素养不足可能如何影响治疗后的结局。
