Health literacy, computer skills and quality of patient-physician communication in Chinese patients with cataract.

Xianchai Lin,Yongxin Zheng,Mei Wang,Yajing Zuo,Ecosse L Lamoureux,Xiaofeng Lin,Siping Zhu,Mingge Li,Minbin Yu,Andreas Wedrich

doi:10.1371/journal.pone.0107615

Abstract

PurposeThe aim of the study was to assess levels of health literacy and computer skills in Chinese patients with cataract, and their impact on the doctor-patient relationship.MethodsWe undertook a cross-sectional study of cataract patients scheduled for cataract extraction procedures in Guangdong Province, China. Generic health literacy was assessed using 3 established screening questions. Adequate computer skills was determined if patients had used a computer and routinely used search engines on the Internet. Socio-demographic measures (e.g., age, sex, education) were obtained from a standardized interview. Participants who indicated that they could not understand what their doctors mean were considered to have had poor patient-physician communications.ResultsOf the 211 participants, 92 (43.6%) had inadequate health literacy and 204 (96.7%) inadequate computer skills. In multivariate analysis, females were more likely to have inadequate health literacy (odds ratio = 2.5, 95% confidence intervals [CI]: 1.3 to 4.7). People with inadequately health literacy were more likely to have a poor patient-physician communication (odds ratio = 3.5, 95% CIs: 1.3 to 9.0). Similar associations were found for inadequate computer skills.ConclusionChinese elderly patients with cataract have inadequate health literacy and very limited computer skills, which place them at high risk of misunderstanding and mismanaging their ocular conditions. Patient education information other than online materials may improve the eye care and outcomes of these patients.

Highlights

According to the Institute of Medicine, health literacy is defined as ‘‘the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions’’. [1] Health literacy goes beyond the ability to read or write, and is more useful to reflect patient’s health care seeking ability than general literacy
91% of adults in China and 25% of adults in the USA lack the skills to fully comprehend verbal and written information in a healthcare setting. [2,3] Inadequate health literacy compromises health care, it accounts for up to 5% of health care costs annually according to a recent systematic review [4]
The objective of this study was to evaluate the levels of health literacy and computer skills among patients with cataract, and the influences of limited health literacy and computer skills on patient-physician communication in a Chinese population with cataract

Summary

Introduction

Cataract is the leading cause of blindness and visual impairment worldwide, and cataract surgery is considered as one of the most cost-effective interventions in healthcare. An adequate level of health literacy is critical in ensuring desirable surgical outcomes and proficiency in selfmanagement, whereas poor health literacy may undermine their health care. There is limited information about the levels of health literacy among patients with cataract. Given that there is no or negligible effect of passive dissemination of printed education materials for health promotion, [6] there is an increasing interest in the availability of online information, but it is unclear how many patients in China are equipped with adequate computer skills. The objective of this study was to evaluate the levels of health literacy and computer skills among patients with cataract, and the influences of limited health literacy and computer skills on patient-physician communication in a Chinese population with cataract

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Conclusion