Health literacy and patient empowerment: separating con-joined twins in the context of chronic low back pain.

Anne-Linda Camerini,Peter J Schulz,Alessandro Antonietti

doi:10.1371/journal.pone.0118032

Anne-Linda Camerini, Peter J Schulz + Show 1 more

Open Access

https://doi.org/10.1371/journal.pone.0118032

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Journal: PloS one	Publication Date: Feb 13, 2015
Citations: 56	License type: CC BY 4.0

Affiliation: Università della Svizzera italiana

Abstract

ObjectivesWhile health literacy has been widely considered key to patient empowerment, an alternative approach separates both concepts and distinguishes between dif-ferent types of patients according to their levels of health literacy and empowerment. These types are deemed to vary in their health-related actions and outcomes. In this study, we exam-ine the relationship between health literacy and patient empowerment and compare socio-demographic characteristics, health-related activities, and health outcomes in four types of pa-tients suffering from chronic low back pain (cLBP).MethodsIn a cross-sectional study, 273 cLBP patients from four Swiss can-tons (Vaud, Geneva, Fribourg, Ticino) and Lombardy (Italy) were invited by their healthcare providers to complete a self-administered paper-and-pencil questionnaire which assessed pa-tients’ health literacy, empowerment, involvement in the medical encounter, medication non-adherence, and perceived pain and functionality as a measure of health outcomes.ResultsHealth literacy and patient empowerment were not significantly correlated with each other, r(271) = .09, p > .05, allowing to differentiate be-tween four types of patients based on their levels of health literacy and patient empowerment. Subsequent chi-square tests and analyses of variances revealed significant differences among patients that could, however, only be attributed to health literacy, as in the case of age and ed-ucational attainment, or patient empowerment, as in the case of patients’ involvement in the medical encounter. No significant differences were evident for gender, medication non-adherence, and health outcomes.ConclusionThe study provides empirical evidence for the need to consider health literacy and patient empowerment as independent concepts in the context of cLBP but calls for further studies to be able to conclude on how the two concepts interact and determine health-related activities and outcomes.

Highlights

The prevalence of chronic low back pain is rising [1] with significant impact on the individual and societal level: on the individual level, cLBP causes physical impairment and psychological distress reducing patients’ and their families’ quality of life [2, 3]
We exam-ine the relationship between health literacy and patient empowerment and compare socio-demographic characteristics, health-related activities, and health outcomes in four types of patients suffering from chronic low back pain
Health literacy and patient empowerment were not significantly correlated with each other, r(271) = .09, p > .05, allowing to differentiate be-tween four types of patients based on their levels of health literacy and patient empowerment

Summary

Introduction

The prevalence of chronic low back pain (cLBP) is rising [1] with significant impact on the individual and societal level: on the individual level, cLBP causes physical impairment and psychological distress reducing patients’ and their families’ quality of life [2, 3]. Effective therapies of cLBP include multimodal treatments with pharmacological, physical, and psychological actions requiring patients to take an active role in the management of their disease [7]. Along with this active role comes the need to have both the knowledge and skills as well as the intrinsic motivation to effectively manage the disease. While knowledge and skills are attributed to patients’ health literacy, motivation is associated with patient empowerment [8]. Health literacy and patient empowerment are considered key concepts in the health context and more so in the context of chronic disease management [9,10,11]. Before we examine the relationship between health literacy and patient empowerment and their significance in the context of cLBP, we briefly introduce both concepts and illustrate conflicting views on how they are related to each other and thought to determine health-related decisions and actions

Objectives

Results

Conclusion