The association between cancer care coordination and quality of life is stronger for breast cancer patients with lower health literacy: A Greater Plains Collaborative study

Effects of social support and self-efficacy on eHealth literacy in Korean women undergoing breast cancer treatment: A secondary analysis

Objective

Patients with breast cancer need to seek out and understand relevant health information to make informed decisions about long-term and complicated illnesses. With the increased use of interventions using online health information, research on eHealth literacy should be expanded. However, existing studies on the factors affecting eHealth literacy in patients with breast cancer are currently lacking. This study, therefore, conducts a secondary analysis of a previous study that surveyed the quality of life of patients with breast cancer. The primary study found a significant correlation between eHealth literacy, social support, and self-efficacy. In this secondary analysis study, we specifically examine eHealth literacy among patients with breast cancer undergoing treatment, and how patient demographic characteristics, breast cancer-specific self-efficacy, and social support contribute to their eHealth literacy.

Methods

A total of 143 women receiving outpatient treatment or were hospitalized for breast cancer at a cancer hospital in South Korea participated in the study from January to November 2022. The eHealth Literacy Scale (eHEALS), Multidimensional Social Support Scale, and Breast Cancer Survivors Scale were utilized in the analysis. The data were analyzed using a multiple regression analysis.

Results

Full-time employment (β ​= ​0.19, P ​= ​0.006), a monthly family income of over 4 million won (3600 USD) (β ​= ​0.14, P ​= ​0.042), completing a high school education (β ​= ​0.52, P ​< ​0.001), completing college level or higher education (β ​= ​0.54, P ​< ​0.001), age (β ​= ​-0.23, P ​= ​0.003), and social support (β ​= ​0.21, P ​= ​0.002) were predictors of eHealth literacy, explaining 40.2% of the total variance (F ​= ​14.63, P ​< ​0.001).

Conclusions

Social support was identified as a new factor influencing eHealth literacy among patients with breast cancer undergoing treatment. Therefore, nursing interventions to strengthen social support should be developed to improve eHealth literacy.

The Role of Cognitive Dysfunction and Health Literacy on the Quality of Life in Cancer Survivors

Background: Cancer disease is considered one of the basic health problems in the world, which threatens the health of human life. It causes numerous personal, family and social damages in physical, psychological, and social dimensions. Objectives: The present study aimed at investigating health literacy and cognitive dysfunction on the quality of life of cancer survivors to make better decisions for the daily functioning, quality of life, and work capacity of cancer survivors so that their lives can be spent with more peace and less stress. Methods: With a descriptive correlational design, 350 cancer survivors of the Cancer Research Center of Shahid Beheshti University of Medical Sciences (Shohaday Tajrish Hospital) from September to November 2021, who had been treated for at least one year, volunteered online and in person. Cognitive failure (Broadbent et al., 1982), cancer health literacy test (Dumenci et al., 2014), and quality of life of adults surviving cancer (Avis et al, 2005). Results: Pearson correlation showed a negative relationship between cognitive dysfunction and quality of life; so, path analysis showed that 25% of the quality of life is explained by cognitive dysfunction, but cancer health literacy was not correlated with the quality of life of cancer survivors. Conclusions: According to the findings, the optimization of cognitive functions after treatment was emphasized to increase the quality of life of cancer survivors.

The Relationship Between e-Health Literacy and Breast Cancer Literacy Among Saudi Women

Breast cancer is the most common cancer in women and represents a significant burden among women worldwide. The concept of health literacy is relatively new to the Gulf states, particularly to Saudi Arabia. Research on this topic is scarce, and no study has empirically explored the influence of e-health literacy on breast cancer literacy. The purpose of this study was to measure the impact of e-health literacy on breast cancer literacy among Saudi women in Riyadh city, Saudi Arabia. A cross-sectional survey was conducted online in a cohort of 336 women and disseminated via social media using the e-Health Literacy Scale (eHEALS) and Breast Cancer Literacy Assessment Tool (Breast-CLAT). Multiple regression analysis was executed to identify the sociodemographic factors that influence the e-health literacy and breast cancer literacy of participants. The participants showed high level of e-health literacy with total eHEALS score of 28.79, and better breast cancer literacy with total Breast-CLAT score of 23.44. This study yielded three significant findings: (1) e-health literacy is influenced by age and education which implies that youngest participants showed higher eHEALS scores than their older counterparts and that having increased education level reflected increased eHEALS scores, (2) breast cancer literacy is predicted by education and income which suggests that those who have higher levels of education and higher monthly incomes have increased levels of breast cancer literacy, and (3) breast cancer literacy and e-health literacy were associated which shows that participants with higher eHEALS scores were more likely have increased level of breast cancer literacy. The study revealed that the participants had high level of e-health literacy which correlated to their increased level of breast cancer literacy. The study findings implied that it is important for Saudi women to possess high levels of e-health literacy about breast cancer as more breast cancer educational resources are online nowadays.

Relationships between health literacy, having a cancer care coordinator, and long-term health-related quality of life among cancer survivors

PURPOSE

Care coordination is a strategy to reduce healthcare navigation challenges for cancer patients. The objectives of this study were to assess the association between having a cancer care coordinator (CCC) and long-term health-related quality of life (HRQoL), and to evaluate whether this association differed by level of health literacy.

METHODS

A population-based sample of survivors diagnosed with breast, prostate, or colorectal cancer in 2015 from the Iowa Cancer Registry participated in an online survey conducted in 2017-2018 (N = 368). Chi-squared tests and logistic regression were used to model the association between patient characteristics and having a cancer care coordinator. Linear regression was used to model the association between patient perception of having a cancer care coordinator and post-treatment physical or mental HRQoL by differing levels of health literacy while controlling for sociodemographic and clinical factors.

RESULTS

Most survivors (81%) reported having one healthcare professional who coordinated their cancer care. Overall, patient perception of having a coordinator was not significantly associated with physical HRQoL (p = 0.118). However, participants with low health literacy (21%) who had a coordinator had significantly higher physical HRQoL scores compared to those who did not (adjusted mean difference 5.2, p = 0.010), while not so for medium (29%) or high (51%) health literacy (p = 0.227, and p = 0.850, respectively; test for interaction p = 0.001). Mental HRQoL was not associated with having a coordinator in our analyses.

CONCLUSION

Findings suggest that care coordinators improved post-treatment physical HRQoL, particularly for participants with low health literacy. Care coordinators may be beneficial to the most vulnerable patients struggling to navigate the complex healthcare system during cancer treatment. Future research should focus on the mechanisms by which care coordination may affect post-treatment HRQoL.

Social and medical risk factors associated with supportive needs in the first year following localized prostate cancer treatment

Purpose:

Individuals who completed treatment for prostate cancer (PCa) often report poor coping and practical concerns when adapting to new roles in their lives—and strong patient-provider communication is critical for this period. However, there is limited research identifying factors associated with supportive needs after the completion of PCa treatment. This study aimed to identify the social and medical risk factors associated with supportive needs for adapting among individuals who completed treatment for localized PCa.

Methods:

Using baseline data from a study evaluating a web-based support system for patients in the first year following treatment for localized PCa, self-efficacy for re-entry (e.g., maintaining relationships, symptom management), medical interactions, and practical concerns (e.g., insurance, exercise) were assessed. Multivariable regression analyses were completed to identify risk factors for low readiness.

Results:

Participants (N=431) with lower health literacy or income, or with depressive symptoms had lower self-efficacy for re-entry, more negative interactions with medical providers, and more practical concerns (ps<.05). Lastly, Non-Hispanic White participants reported greater readiness compared to all other races (ps<.05).

Conclusions:

Multiple social and medical risk factors are associated with greater supportive needs when adapting to new roles after PCa treatment. Understanding the risk factors for supportive needs in this period is critical. Future research is needed to help providers identify and support individuals at risk for poorer coping and greater practical concerns after treatment completion.

Implications for Cancer Survivors:

Identifying individuals with greater supportive needs following treatment for localized PCa treatment will help ensure successful adaptation to new roles.

Delving deeper into disparity: The impact of health literacy on the surgical care of breast cancer patients

BACKGROUND

Breast surgical oncology is a unique field that involves complex cancer management and longstanding patient interactions with the healthcare system, making it potentially challenging for patients with low health literacy. The purpose of this review is to summarize the current knowledge regarding health literacy in breast cancer and identify future directions for research and potential intervention in breast surgical oncology.

DATA SOURCES

A search of relevant literature querying PubMed and Science Direct was performed and included the following keywords: health literacy, breast cancer, breast surgical oncology, surgery, outcomes, prevention, screening, healthcare utilization, chronic disease.

CONCLUSIONS

Limited health literacy may detrimentally affect understanding and outcomes in breast surgical oncology. Identifying ways providers can improve patient understanding and utilization of health information is important, and surgeons may have a pivotal role. Further studies addressing health literacy in breast surgical oncology is needed in order to better optimize care of patients.