Influence of health literacy on health-related quality of life after total hip arthroplasty

Abstract

Introduction Personal knowledge about the own disease, a key component of health literacy (HL), may have a considerable impact on treatment outcomes. The purpose of this study was to investigate whether the patients’ knowledge about the surgical procedure, risks, and aftercare, as well as the satisfaction with the preoperative level of information, has an influence on the health-related quality of life (HRQoL) after primary total hip arthroplasty (THA). Materials and methods A total of 176 patients (68.3 ± 10.3 years, 60.8% female) were evaluated. HRQoL was assessed prior to surgery as well as one and twelve months after THA using the 12-item Short Form Questionnaire. Following standardized surgical informed consent, HL was assessed preoperatively using a self-constructed quiz score, while information satisfaction was measured with a single-item rating scale. Sociodemographic and clinical characteristics, including pain (VAS), functionality (WOMAC), and psychological distress (PHQ-4), were also assessed at baseline. Multiple linear regression analyses were performed to examine whether HL, satisfaction with information, age, social class, WOMAC, VAS, and PHQ-4 predict HRQoL at one and twelve months post-surgery. Results The average HL quiz score was 23 ± 5.1 out of a possible 33 points. Social class index significantly influenced HL (p < 0.001). A weak correlation between HL and age (r = 0.23, p = 0.01) and no correlation between HL and psychological distress (p = 0.868) were observed. One month after THA, physical HRQoL was significantly predicted by the WOMAC index (p = 0.031) and subjective satisfaction with information (p = 0.022), but not by HL. After twelve months, only the WOMAC was a significant predictor (p < 0.001) of physical HRQoL. Conclusion Although subjective satisfaction with the patient’s preoperative level of information had a significant effect on the physical HRQoL at one month after THA, the influence of osteoarthritis severity outweighed this effect after twelve months. HL had no direct influence on HRQoL. These results suggest that patient satisfaction, rather than knowledge, predicts HRQoL.

A Cross-Sectional Analysis of the Readability of Online Information Regarding Hip Osteoarthritis

“…Health literacy is defined as “the ability of an individual to obtain and translate knowledge and information to maintain and improve health in a way that is appropriate to the individual and system contexts” [ 4 ]. Personal knowledge about a disease is a key component of health literacy and has a significant impact on treatment outcomes [ 5 ]. Poor health literacy is associated with poor outcomes due to a reduced understanding of instructions [ 5 ].…”

“…Personal knowledge about a disease is a key component of health literacy and has a significant impact on treatment outcomes [ 5 ]. Poor health literacy is associated with poor outcomes due to a reduced understanding of instructions [ 5 ]. Examples of poor outcomes include re-presentations to the hospital, increased inpatient stay, increased post-operative morbidity and mortality, and reduced patient satisfaction [ 6 - 9 ].…”