Health literacy and quality of life following rectal resections for cancer
DOI:
https://doi.org/10.18203/2349-2902.isj20184065Keywords:
Health literacy, Quality of life, Rectal cancerAbstract
Background: Health literacy can be a stronger predictor of an individual’s health status than income, employment status, education level, and racial or ethnic group. The prevalence and impact of low health literacy in the rectal cancer patient population has received little attention. This study is a cross-sectional population survey to determine if there is a relationship between health literacy and quality of life in rectal cancer patients.
Methods: All rectal cancer patients having a clinical encounter with the Colorectal Unit at Westmead Hospital will be invited to participate in the study. Two validated health literacy screens (REALM-SF and NVS) were administered along with the EORTC QLQ-C30 quality of life assessment. The association between health literacy and quality of life will be examined using Spearman regression.
Results: 92 patients were recruited between March 2015 and July 2016. A significant proportion of our patients were found to have low health literacy (29.3 percent and 54.5 percent as measured by the REALM-SF and NVS, respectively). The mean QLQ-C30 summary score was 71.5 and the mean global health score was 69.4 (SD 23.3). There appeared to be no statistically significant correlation between health literacy and quality of life in our study. There was a moderately positive correlation between the NVS and REALM-SF (rho = 0.36, P <0.001).
Conclusions: A significant proportion of our patients that have had rectal resections for cancer have low health literacy. We have not been able to demonstrate an obvious association between health literacy and quality of life in the present study.
References
Institute of Medicine. Health literacy: a prescription to end confusion. Institute of Medicine. Washington DC: The National Academies Press. Retrieved from Health literacy: A prescription to end confusion. 2004. Available at https://www.nap.edu/catalog/10883/health-literacy-a-prescription-to-end-confusion. Accessed 22 June 2018
Baker DW, Parker RM, Williams MV, Clark WS, Nurss J. The relationship of patient reading ability to self- reported health and use of health services. Am J Public Health. 1997;87:1027-30.
Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, et al. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006;21:806-12.
Schwartzberg JG, VanGeest JB, Wang CC. Understanding health literacy: implications for medicine and public health. Atlanta GA: American Medical Association Press. 2005.
Davis TC, Dolan NC, Ferreira MR, Tomori C, Green KW, Sipler AM, et al. The role of inadequate health literacy skills in colorectal cancer screening. Cancer Invest. 2001;19(2):193-200.
Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. JAMA. 2002;288(4):475-82.
Australian Institute of Health and Welfare and Australasian Association of Cancer Registries. Cancer in Australia: an overview, 2012. Australian Institute of Health and Welfare Australasian Association of Cancer Registries Canberra: AIHW; 2012. Available at https://www.aihw.gov.au/reports/cancer/cancer-in-australia-an-overview-2014/contents/table-of-contents
Bryant CL, Lunniss PJ, Knowles CH, Thaha MA, Chan CL. Anterior Resection Syndrome. The Lancet Oncol. 2012;13(9):e403-8.
Bretagnol F, Rullier E, Laurent C, Zerbib F, Gontier R, Saric J. Comparison of functional results and quality of life between intersphincteric resection and conventional coloanal anastomosis for low rectal cancer. Dis Colon Rectum. 2004;47(6):832-8.
Arozullah AM, Yarnold PR, Bennett CL, Soltysik RC, Wolf MS, Ferreira RM, et al. Development and validation of a short-form, rapid estimate of adult literacy in medicine. Med Care. 2007;45(11):1026-33.
Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: the newest vital sign. Fam Med. 1993;3(6):514-522.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365-76.
Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A, on behalf of the EORTC Quality of Life Group. QLQ-C30 Scoring Manual: 1st Edition, Brussels, Brussels: EORTC. 1995.
Giesinger JM, Kieffer JM, Fayers PM, Groenvold M, Petersen MA, Scott NW, et al. EORTC Quality of Life Group. Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust. J Clin Epidemiol. 2016;(69):79-88.
Curran D, Aaronson N, Standaert B, Molenberghs G, Therasse P, Ramirez A, et al. Summary measures and statistics in the analysis of quality of life data: an example from an EORTC-NCIC-SAKK locally advanced breast cancer study. Eur J Cancer. 2000;36(7):834-44.
King MT. The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual Life Res. 1996;(5):555-67.
Australian Bureau of Statistics. Health Literacy. Australian Social Trends. 2009;4102.0.
DeWalt DA, Hink A. Health literacy and child health outcomes: a systematic review of the literature. Pediatr. 2009;123(3):S265-74.
Baker DW. The meaning and the measure of health literacy. J Gen Intern Med. 2006;21(8):878-83.
Shigaki CL, Kruse RL, Mehr DR, Ge B. The REALM vs. NVS: A comparison of health literacy measures in patients with diabetes. Ann Behavioral Sci Med Education. 2012;18(1):9-13.
Osborn CY, Weiss BD, Davis TC, Skripkauskas S, Rodrigue C, Bass PF, et al. Measuring adult literacy in health care: performance of the newest vital sign. Am J Health Behav. 2007;31:S36-46.
Scott NW, Fayers PM, Aaronson NK, Bottomley A, de Graeff A, Groenvold M, et al on behalf of the EORTC Quality of Life Group. EORTC QLQ-C30 Reference Values Manual (2nd ed.) Brussels, Belgium: EORTC Quality of Life Group. 2008.
Mrabti H, Amziren M, ElGhissassi I, Bensouda Y, Berrada N, Abahssain H, et al. Quality of life of early stage colorectal cancer patients in Morocco. Gastroenterol. 2016;16(131):2-10.
Wallace LS, Rogers ES, Weiss BD. Relationship between health literacy and health-related quality of life among Tennesseans. Tenn Med. 2008;101(5):35-9.
Macabasco-O'Connell A, DeWalt DA, Broucksou KA, Hawk V, Baker DW, Schillinger D, et al. Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. J General Int Med. 2011;26(9):979-86.
Song L, Mishel M, Bensen JT, Chen RC, Knafl GJ, Blackard B, et al. How does health literacy affect quality of life among men with newly diagnosed clinically localized prostate cancer? Findings from the North Carolina-Louisiana prostate cancer project (PCaP). Cancer. 2012;118(15):3842-51.
Couture ÉM, Chouinard MC, Fortin M, Hudon C. The relationship between health literacy and quality of life among frequent users of health care services: a cross-sectional study. Health and Quality of Life Outcomes. 2017;15(137).
