Chronic pain health literacy: A scoping review of existing instruments

Abstract

Patient self-management is considered one of the preconditions for successful control of chronic conditions (including chronic pain), and health literacy is a relevant factor that can affect patient outcomes. The aim was to conduct a scoping review to synthesize studies within the healthcare context that have dealt with chronic pain in adults and measured literacy, and also to explore what literacy instruments were used. Methods: After determining clear inclusion and exclusion criteria, 8 electronic databases were searched for relevant articles; additional articles were obtained through reference lists of the obtained articles. Of the 56 records that were screened, 14 were included for data abstraction. Results: Most (n = 11) obtained studies were quantitative and most were based on a definition of literacy that focused on individuals, i.e. either on their reading level or on their abilities to access, read, understand, appraise, and act on health information. Correspondingly, most (n = 10) instruments measured individual-level characteristics; they did so mainly to examine the relationship between health literacy and various pain-related variables. Most studies were conducted in the USA and Germany. Conclusions: Chronic pain health literacy is a topic with emerging research. However, most instruments are generic and are oriented mainly towards individuals. Thus, chronic pain-specific instruments should be developed, and the existing instruments should be expanded to include contextual factors as well. Research is urgently needed in non-Western countries, especially given the current and predicted future global trends concerning chronic pain.