How does health literacy affect quality of life among men with newly diagnosed clinically localized prostate cancer?

Findings from the North Carolina-Louisiana Prostate Cancer Project (PCaP)

Authors

  • Lixin Song PhD,

    Corresponding author
    1. School of Nursing, University of North Carolina, Chapel Hill, North Carolina
    2. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
    • University of North Carolina-Chapel Hill, Carrington Hall, Chapel Hill, NC 27599-7460

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    • Fax: (919) 843-9900

  • Merle Mishel PhD,

    1. School of Nursing, University of North Carolina, Chapel Hill, North Carolina
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  • Jeannette T. Bensen PhD, MS,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
    2. Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina
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  • Ronald C. Chen MD, MPH,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
    2. Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
    3. Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina
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  • George J. Knafl PhD,

    1. School of Nursing, University of North Carolina, Chapel Hill, North Carolina
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  • Bonny Blackard MSPH,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
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  • Laura Farnan MS,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
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  • Elizabeth Fontham PhD,

    1. Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana
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  • L. Joseph Su PhD,

    1. National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, Maryland
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  • Christine S. Brennan PhD,

    1. Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana
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  • James L. Mohler MD,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
    2. Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
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  • Paul A. Godley MD, PhD

    1. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
    2. Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina
    3. Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina
    4. Division of Hematology/Oncology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
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Abstract

BACKGROUND:

Health literacy deficits affect half of the US overall patient population, especially the elderly, and are linked to poor health outcomes among noncancer patients. Yet little is known about how health literacy affects cancer populations. The authors examined the relation between health-related quality of life (HRQOL) and health literacy among men with prostate cancer.

METHODS:

Data analysis included 1581 men with newly diagnosed clinically localized prostate cancer from a population-based study, the North Carolina-Louisiana Prostate Cancer Project (PCaP). Participants completed assessment of health literacy using Rapid Estimate of Adult Literacy in Medicine (REALM) and HRQOL using the Short Form-12 General Health Survey (SF12). Bivariate and multivariate regression was used to determine the potential association between REALM and HRQOL, while controlling for sociodemographic and illness-related variables.

RESULTS:

Higher health literacy level was significantly associated with better mental well-being (SF12-Mental Component Summary [MCS]; P < .001) and physical well-being (SF12-Physical Component Summary [PCS]; P < .001) in bivariate analyses. After controlling for sociodemographic (age, marital status, race, income, and education) and illness-related factors (types of cancer treatment, tumor aggressiveness, and comorbidities), health literacy remained significantly associated with SF12-MCS scores (P < .05) but not with SF12-PCS scores.

CONCLUSIONS:

Among patients with newly diagnosed localized prostate cancer, those with low health literacy levels were more vulnerable to mental distress than those with higher health literacy levels, but physical well-being was no different. These findings suggest that health literacy may be important in patients managing prostate cancer and the effects of treatment, and provide the hypothesis that supportive interventions targeting patients with lower health literacy may improve their HRQOL. Cancer 2012. © 2011 American Cancer Society.

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