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Health literacy impacts self-management, quality of life and fear of recurrence in head and neck cancer survivors

Lookup NU author(s): Professor Linda Sharp


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© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.Purpose: Little is known about whether health literacy is associated with affects certain key outcomes in head and neck cancer (HNC) survivors. We investigated (i) the socio-demographic and clinical profile of health literacy and (ii) associations among between health literacy and self-management behaviours, health-related quality of life (HRQL) and fear of recurrence (FoR) in HNC survivors. Methods: A population-based survey was conducted in Ireland. Health literacy was assessed using a validated single-item question. Socio-demographic, clinical and psychosocial outcome variables (FoR, self-management behaviours, HRQL) were collected. Multivariable linear regression was performed to estimate associations between health literacy and each psychosocial outcome. Results: Three hundred ninety-five (50%) individuals responded to the survey. Inadequate health literacy was evident among 47% of the sample. In adjusted models, HNC survivors with inadequate health literacy had significantly lower levels of self-management behaviours in the domains of health-directed behaviour, positive and active engagement in life, self-monitoring and insight, constructive attitudes and approaches and skills and technique acquisition. Inadequate health literacy was independently associated with lower functional well-being and HNC disease-specific HRQL. FoR was also significantly higher among those with inadequate health literacy. Conclusions: HNC survivors with inadequate health literacy have lower levels of self-management behaviours, lower functional HRQL and increased FoR compared to those with adequate health literacy. Implications for Cancer Survivors: Clinicians, healthcare providers and those developing interventions should consider how inadequate health literacy among HNC survivors might affect post-treatment outcomes when developing services and providing support for this group.

Publication metadata

Author(s): Clarke N, Dunne S, Coffey L, Sharp L, Desmond D, O'Conner J, O'Sullivan E, Timon C, Cullen C, Gallagher P

Publication type: Article

Publication status: Published

Journal: Journal of Cancer Survivorship

Year: 2021

Volume: 15

Pages: 855-865

Online publication date: 09/01/2021

Acceptance date: 03/12/2020

ISSN (print): 1932-2259

ISSN (electronic): 1932-2267

Publisher: Springer


DOI: 10.1007/s11764-020-00978-5


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