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Patient Educ Couns. 2019 May 15. pii: S0738-3991(19)30199-5. doi: 10.1016/j.pec.2019.05.015. [Epub ahead of print]

Multiple health literacy dimensions are associated with physicians' efforts to achieve shared decision-making.

Author information

1
"Cancer, Biomedicine & Society" group, SESSTIM, INSERM, IRD, Aix-Marseille Univ, Marseille, France.
2
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA.
3
Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research & South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia; Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, Australia.
4
"Cancer, Biomedicine & Society" group, SESSTIM, BIOSTIC, APHM, INSERM, IRD, Aix-Marseille Univ, Marseille, France. Electronic address: julien.mancini@ap-hm.fr.

Abstract

OBJECTIVES:

Shared decision-making (SDM) in health care is widely encouraged. However, for SDM to occur patients need to be able to obtain, understand and apply medical information. Our aim was to assess the relationship between health literacy (HL), numeracy and SDM (using French translations of validated measures).

METHODS:

A cross-sectional survey using a self-administered online questionnaire was proposed to all members of the Seintinelles association. Several scales were used to measure HL (FCCHL and 3HLQ/SILS), numeracy (SNS-3), the SDM process (CollaboRATE) and explore their inter-relationships.

RESULTS:

Data from 2 299 respondents (96.7% women, 46.1% with a history of cancer) were analysed. All measurement scales showed adequate psychometric properties. Functional HL, communicative HL and numeracy were positively associated with SDM while no significant relation was observed between critical HL and SDM. Furthermore, perceived difficulties in asking physicians' questions and deprivation were negatively associated with SDM.

CONCLUSION:

Patient support to reach SDM requires high levels of HL, particularly in the functional and communicative domains. Efforts must be made to improve access and understanding of health information.

PRACTICE IMPLICATIONS:

Brief self-reported measures could be used to screen for low levels of health literacy, tailor information accordingly and improve patient involvement in healthcare decision-making.

KEYWORDS:

CollaboRATE; Health literacy; Numeracy; Psychometrics; Shared decision-making; Validation studies

PMID:
31130338
DOI:
10.1016/j.pec.2019.05.015

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