Hsiu-Nien Shen1, Chia-Chen Lin2, Tammy Hoffmann3, Chia-Yin Tsai4, Wen-Hsuan Hou5, Ken N Kuo6. 1. Department of Intensive Care Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan. Electronic address: hsiunian@gmail.com. 2. Department of Physical Medicine and Rehabilitation, E-Da Hospital and I-Shou University, No. 1, Yida Rd., Yanchao District, Kaohsiung City, 82445, Taiwan. 3. Clinical Epidemiology, Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, Gold Coast, Qld, 4226, Australia. Electronic address: thoffman@bond.edu.au. 4. Department of Physical Medicine and Rehabilitation, E-Da Cancer Hospital and I-Shou University, No. 21, Yida Rd., Yanchao District, Kaohsiung City, 82445, Taiwan. Electronic address: 143009@h.tmu.edu.tw. 5. School of Gerontology Health Management and Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City, 11031, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, No. 252, Wuxing Street, Xinyi District, Taipei City, 11031, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City, 11031, Taiwan; Cochrane Taiwan, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City, 11031, Taiwan. Electronic address: houwh@tmu.edu.tw. 6. Cochrane Taiwan, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City, 11031, Taiwan. Electronic address: kennank@aol.com.
Abstract
OBJECTIVES: We explored the relationship between patient-perceived shared decision making (SDM) and three domains of health literacy (HL) in patients with breast cancer. METHODS: In this cross-sectional study, we prospectively recruited a convenience sample of 511 breast cancer patients from 3 hospitals in Taiwan. Patients completed questionnaires about HL and perceived SDM in a recent consultation. Sequential regressions, controlling for International Classification of Functioning, Disability and Health (ICF)-related factors) were conducted. Interactions of each HL domain with age or education were also assessed for the relationship with perceived SDM. RESULTS: Higher scores in the HL domains of healthcare and disease prevention, but lower scores in the health promotion domain, were significantly associated with a higher perceived level of SDM after controlling for ICF-related factors (R2 = 33.44%). The association of SDM with two domains of HL varied with age, while the relationship between the 3 HL domains and SDM differed across education levels. CONCLUSION: Each HL domain was significantly associated with perceived SDM after controlling for the ICF-related factors and across different age- and education-stratifications. PRACTICE IMPLICATIONS: Clinicians should be cognizant of patients' HL levels and incorporate HL best practices into consultations and interactions with patients with breast cancer to facilitate SDM.
OBJECTIVES: We explored the relationship between patient-perceived shared decision making (SDM) and three domains of health literacy (HL) in patients with breast cancer. METHODS: In this cross-sectional study, we prospectively recruited a convenience sample of 511 breast cancerpatients from 3 hospitals in Taiwan. Patients completed questionnaires about HL and perceived SDM in a recent consultation. Sequential regressions, controlling for International Classification of Functioning, Disability and Health (ICF)-related factors) were conducted. Interactions of each HL domain with age or education were also assessed for the relationship with perceived SDM. RESULTS: Higher scores in the HL domains of healthcare and disease prevention, but lower scores in the health promotion domain, were significantly associated with a higher perceived level of SDM after controlling for ICF-related factors (R2 = 33.44%). The association of SDM with two domains of HL varied with age, while the relationship between the 3 HL domains and SDM differed across education levels. CONCLUSION: Each HL domain was significantly associated with perceived SDM after controlling for the ICF-related factors and across different age- and education-stratifications. PRACTICE IMPLICATIONS: Clinicians should be cognizant of patients' HL levels and incorporate HL best practices into consultations and interactions with patients with breast cancer to facilitate SDM.
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