What role does health literacy play in patients' involvement in medical decision-making?

Anne E M Brabers,Jany J D J M Rademakers,Peter P Groenewegen,Judith D De Jong,Liset Van Dijk,Andre M N Renzaho

doi:10.1371/journal.pone.0173316

Abstract

Patients vary in their preferences towards involvement in medical decision-making. Previous research, however, gives no clear explanation for this observed variation in their involvement. One possible explanation might be health literacy. Health literacy refers to personal characteristics and social resources needed for people to access, understand and use information to make decisions about their health. This study aimed to examine the relationship between health literacy and self-reported patient involvement. With respect to health literacy, we focused on those competences relevant for medical decision-making. We hypothesized that people with higher health literacy report that they are more involved in medical decision-making. A structured questionnaire was sent to members of the Dutch Health Care Consumer Panel in May 2015 (response 46%, N = 974). Health literacy was measured using five scales of the Health Literacy Questionnaire. A regression model was used to estimate the relationship between health literacy and self-reported involvement. In general, our results did not show a relationship between health literacy and self-reported involvement. We did find a positive significant association between the health literacy scale appraisal of health information and self-reported involvement. Our hypothesis was partly confirmed. The results from this study suggest that higher order competences, that is to say critical health literacy, in particular, are important in reporting involvement in medical decision-making. Future research is recommended to unravel further the relationship between health literacy and patient involvement in order to gain insight into whether health literacy might be an asset to enhance patient participation in medical decision-making.

Highlights

Patients are increasingly expected to be in charge of their health and to be involved in decisions about their health [1,2,3]
About half (51%) had a middle level of Gender Male Female Age Level of education Low Middle High Ethnicity Non-migrant Western migrant Non-western migrant Self-reported general health Excellent/very good Good Fair/bad Questionnaire Post Internet Involvement in medical decision-making health literacy questionnaire (HLQ) Having sufficient information to manage my health Appraisal of health information Ability to actively engage with health care providers Ability to find good health information Understanding health information well enough to know what to do doi:10.1371/journal.pone.0173316.t001
We focused on a broad concept of health literacy instead of only on functional health literacy

Summary

Introduction

Patients are increasingly expected to be in charge of their health and to be involved in decisions about their health [1,2,3]. This is partly because of the recognition of the ethical imperative to involve patients properly in decision-making about their health, and due to the PLOS ONE | DOI:10.1371/journal.pone.0173316. Role of health literacy in medical decision-making This is partly because of the recognition of the ethical imperative to involve patients properly in decision-making about their health, and due to the PLOS ONE | DOI:10.1371/journal.pone.0173316 March 3, 2017

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