Keles Ahmet, Somun Umit Furkan, Kose Muhammed, Arikan Ozgur, Culpan Meftun, Yildirim Asif
School of Medicine, Department of Urology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Fahrettin Kerim Gökay Cd., Istanbul, 34720, Turkey.
World J Urol. 2025 Jan 30;43(1):94. doi: 10.1007/s00345-025-05463-1.
Given the increasing significance of digital health literacy (DHL) and health literacy (HL) in promoting informed decision-making and healthy behaviors, this study aimed to assess the influence of self-reported HL and DHL on treatment adherence and quality of life among patients who underwent transurethral resection of bladder tumors (TUR-BT) for primary non-muscle invasive bladder cancer (NMIBC).
MATERIALS & METHODS: This single-center observational study involved patients who underwent TUR-BT for NIMBC at a tertiary hospital from May 2022 to February 2024. Before the procedure, the patients' DHL and HL were evaluated using the European Health Literacy Survey Questionnaire short version and the eHealth Literacy Scale. Six months after surgery, we surveyed patients' QoL using the EORTC QLQ-C30. In line with recommendations from the European Association of Urology guidelines, adherence to the treatment plan was assessed along with a follow-up cystoscopy examination for each patient.
Multivariate analysis revealed that poorer DHL and HL were significantly associated with older age (p < 0.001), lower educational attainment (p < 0.001), and lack of internet access (p < 0.001). Conversely, higher DHL and HL levels were positively correlated with increased treatment adherence, as measured by cystoscopy completion (p < 0.001). Additionally, logistic regression analysis demonstrated significant associations between improved DHL and HL scores and better global health status (DHL, p = 0.022; HL, p = 0.008), higher emotional status (p < 0.001 for both), and social functioning (p < 0.001 for both). Notably, there were no significant differences in the symptom scale scores between the DHL and HL groups.
To the best of our knowledge, this is the first study to explore the specific effect of HL/DHL on QoL and adherence in this patient population. Our research suggests that there may be a link between self-reported levels of DHL/HL and treatment adherence as well as QoL among patients with NIMBC.
鉴于数字健康素养（DHL）和健康素养（HL）在促进明智决策和健康行为方面的重要性日益增加，本研究旨在评估自我报告的HL和DHL对接受经尿道膀胱肿瘤切除术（TUR-BT）治疗原发性非肌层浸润性膀胱癌（NMIBC）患者的治疗依从性和生活质量的影响。
这项单中心观察性研究纳入了2022年5月至2024年2月在一家三级医院接受TUR-BT治疗NIMBC的患者。在手术前，使用欧洲健康素养调查问卷简版和电子健康素养量表评估患者的DHL和HL。术后六个月，我们使用欧洲癌症研究与治疗组织QLQ-C30问卷对患者的生活质量进行调查。根据欧洲泌尿外科学会指南的建议，评估每位患者对治疗计划的依从性以及进行随访膀胱镜检查。
多变量分析显示，较差的DHL和HL与年龄较大（p < 0.001）、教育程度较低（p < 0.001）以及无法上网（p < 0.001）显著相关。相反，较高的DHL和HL水平与通过膀胱镜检查完成情况衡量的治疗依从性增加呈正相关（p < 0.001）。此外，逻辑回归分析表明，DHL和HL得分的提高与更好的总体健康状况（DHL，p = 0.022；HL，p = 0.008）、更高的情绪状态（两者均p < 0.001）和社会功能（两者均p < 0.001）之间存在显著关联。值得注意的是，DHL和HL组之间的症状量表得分没有显著差异。
据我们所知，这是第一项探讨HL/DHL对该患者群体生活质量和依从性具体影响的研究。我们的研究表明，自我报告的DHL/HL水平与NIMBC患者的治疗依从性以及生活质量之间可能存在联系。
