Health literacy, pain-related interference and pain-related distress of patients with musculoskeletal pain

Abstract

Summary The present study aimed to compare pain-related interference and pain-related distress in patients with musculoskeletal pain and differing levels of health literacy. A cross-sectional study was conducted among 243 patients with chronic musculoskeletal pain. Short Test of Functional Health Literacy in Adults classified the level of health literacy. Outcome measures included pain-related interference (pain intensity and functional limitation) and pain-related distress (psychosocial factors). Analysis of variance methods were used. One hundred twenty-three (50.62%) participants were classified as adequate, 24 (9.88%) as marginal and 96 (39.50%) as inadequate health literacy. Patients with inadequate health literacy had higher values of pain severity compared to the other groups, when controlled for age. The group adequate health literacy showed less kinesiophobia compared to their counterparts. Functional limitations and other psychosocial factors were similar among groups. Pain severity and kinesiophobia had disadvantageous findings in participants with inadequate health literacy. Still, the results of pain severity must be approached cautiously because the differences were observed when controlled for age solely.

Association of health literacy with chronic pain and pain-related distress.

“…Among all individuals at baseline, those with lower health literacy reported greater pain severity, pain catastrophizing, and depressive symptoms. This was consistent with prior work that showed that lower health literacy may be related to higher pain severity (Bittencourt et al, 2021; Lacey et al, 2018) but also extended upon prior work to show the relationship of health literacy status to pain catastrophizing and depression. It is possible that those with health literacy may have different beliefs or knowledge about their pain (Kim et al, 2022), which could lead to increased pain catastrophizing and depression.…”

“…This relationship may exist due to limited patient understanding of pain management and coping skills (Kim et al, 2022; Mackey et al, 2019) or because of a lack of provider understanding of the patient’s health literacy level, which could result in information being delivered at an inappropriate level (Murugesu et al, 2022). Though one study suggested that literacy status may not be related to depression or pain catastrophizing (i.e., exaggeration of the negative effects of pain), these variables were assessed with brief screening measures (i.e., two questions to assess depression and catastrophizing; Bittencourt et al, 2021). Using full measures specific to assessing depressive symptoms and pain catastrophizing may better assess variability in these constructs and elucidate whether there is a relationship with health literacy.…”

“…A newer definition of health literacy also places some of the responsibility on health care providers, as it recognizes that health care systems should provide information to patients that is accessible and understandable (Santana et al, 2021). Among individuals with chronic pain, lower health literacy status is associated with higher pain intensity (Bittencourt et al, 2021; Lacey et al, 2018). This relationship may exist due to limited patient understanding of pain management and coping skills (Kim et al, 2022; Mackey et al, 2019) or because of a lack of provider understanding of the patient’s health literacy level, which could result in information being delivered at an inappropriate level (Murugesu et al, 2022).…”

Relationship between health literacy and health-related quality of life in Korean adults with chronic diseases

“…Health literacy has been shown to be inversely associated with pain intensity among patients with musculoskeletal pain [ 61 ] and those with chronic pain [ 62 ]. One possible explanation for the relationship points to the role of health literacy in better pain management [ 62 ].…”

Health literacy and pain neuroscience education in an interdisciplinary pain management programme: a qualitative study of patient perspectives

“…Tailoring the information in PNE with consideration for patients' health literacy levels, information needs, and learning strategies is important. Lessons can be learned from the extensive literature on health literacy and patient education: decrease the complexity of the information by using plain language; be specific and limit the information ("askme3" questions: (1) what their main problem is, (2) what they need to do, and (3) why it is important to them), and make sure that a patient has understood the information given (apply the teach-back method). 6,11,13,34,38,42…”