Janet Papadakos1,2,3,4,5,6, Jan Barnsley7,8,9,10,11,12, Whitney Berta7,8,9,10,11,12, Gillian Rowlands7,8,9,10,11,12, Diana Samoil7,8,9,10,11,12, Doris Howell7,8,9,10,11,12. 1. Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Hospital Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada. Janet.papadakos@uhnresearch.ca. 2. Patient Education, Cancer Care Ontario, Toronto, Canada. Janet.papadakos@uhnresearch.ca. 3. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. Janet.papadakos@uhnresearch.ca. 4. Institute of Public Health, Aarhus University, Aarhus, Denmark. Janet.papadakos@uhnresearch.ca. 5. Institute for Health Society, Newcastle University, Baddiley-Clark Bldg, Newcastle Upon Tyne, UK. Janet.papadakos@uhnresearch.ca. 6. Department of Psychosocial Oncology and Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada. Janet.papadakos@uhnresearch.ca. 7. Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Hospital Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada. 8. Patient Education, Cancer Care Ontario, Toronto, Canada. 9. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. 10. Institute of Public Health, Aarhus University, Aarhus, Denmark. 11. Institute for Health Society, Newcastle University, Baddiley-Clark Bldg, Newcastle Upon Tyne, UK. 12. Department of Psychosocial Oncology and Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Abstract
BACKGROUND: Increasing demands on Canada's healthcare system require patients to take on more active roles in their health. Effective self-management has been linked to improved health outcomes; and there is evidence that effective behaviors, and subsequent healthcare utilization, are linked to self-efficacy and health literacy; however, this link has had minimal testing in the cancer context. Our aim is to examine the association between self-efficacy, health literacy, chemotherapy self-management behaviors, and health service utilization. DESIGN AND METHODS: A cross-sectional survey that included validated measures of self-efficacy, health literacy, chemotherapy self-management, and health service utilization was completed by participants (N = 213). Multivariable modeling using hierarchical linear regression was used to examine the association between variables. RESULTS: Self-efficacy contributed significantly to explaining variation in chemotherapy self-management score. Health literacy was not significantly associated with any of the dependent variables. CONCLUSION: Participants with higher self-efficacy had higher chemotherapy self-management scores compared to participants with low self-efficacy. Contrary to evidence in the chronic disease self-management literature, this study demonstrated that health literacy was not associated with chemotherapy self-management behavior nor was it associated with self-efficacy. Building patient self-efficacy in the context of chemotherapy self-management could be particularly helpful both in the cancer center and in the domain of oral chemotherapy management at home where patients are required to take on significant responsibility for self-management.
BACKGROUND: Increasing demands on Canada's healthcare system require patients to take on more active roles in their health. Effective self-management has been linked to improved health outcomes; and there is evidence that effective behaviors, and subsequent healthcare utilization, are linked to self-efficacy and health literacy; however, this link has had minimal testing in the cancer context. Our aim is to examine the association between self-efficacy, health literacy, chemotherapy self-management behaviors, and health service utilization. DESIGN AND METHODS: A cross-sectional survey that included validated measures of self-efficacy, health literacy, chemotherapy self-management, and health service utilization was completed by participants (N = 213). Multivariable modeling using hierarchical linear regression was used to examine the association between variables. RESULTS: Self-efficacy contributed significantly to explaining variation in chemotherapy self-management score. Health literacy was not significantly associated with any of the dependent variables. CONCLUSION: Participants with higher self-efficacy had higher chemotherapy self-management scores compared to participants with low self-efficacy. Contrary to evidence in the chronic disease self-management literature, this study demonstrated that health literacy was not associated with chemotherapy self-management behavior nor was it associated with self-efficacy. Building patient self-efficacy in the context of chemotherapy self-management could be particularly helpful both in the cancer center and in the domain of oral chemotherapy management at home where patients are required to take on significant responsibility for self-management.
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