title: The impact of health literacy on health-related quality of life (HRQoL) and utility assessment among patients with rheumatic diseases.
abstract: OBJECTIVE
  The objective of this study was to investigate the impact of health literacy (HL) on health-related quality of life (HRQoL) and utility assessment among patients with rheumatic diseases.
  
  
  METHODS
  HL was measured by the rapid estimate of adult literacy in medicine (REALM) and was characterized as low or adequate. HRQoL and utility scores were assessed using the SF-36, SF-6D, and EQ-5D. Comparisons of sociodemographics and HRQoL in patients with low or adequate HL were made using t test, chi-square, or Mann-Whitney U tests. Spearman's correlation and partial correlations were used to study the relationship between HL, HRQoL, and utility scores, with significant correlations further explored using multiple linear regression models.
  
  
  RESULTS
  Data were analyzed from 199 subjects. Patients with adequate HL had significantly higher education levels, better dwelling status, lower disease activity, and better physical functioning (PF). There was a significant although weak correlation between HL level and PF. After adjustment, HL level was shown to independently explain 3.7% of the variance in the PF score. Nevertheless, there was no impact of HL on utility assessment or other HRQoL domains.
  
  
  CONCLUSIONS
  HL did not impact HRQoL in general, but was found to have a weak impact on the PF of patients with rheumatic diseases.
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore.
authors.forename: Xu-Hao
authors.initials: XH
authors.lastname: Zhang
authors.forename: Shu-Chuen
authors.initials: SC
authors.lastname: Li
authors.forename: Kok-Yong
authors.initials: KY
authors.lastname: Fong
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D057220:Health Literacy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012216:Rheumatic Diseases; D012846:Singapore