title: 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).
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.
authors.affiliation: School of Nursing, University of North Carolina, Chapel Hill, NC 27599, USA. lsong@unc.edu
authors.forename: Lixin
authors.initials: L
authors.lastname: Song
authors.forename: Merle
authors.initials: M
authors.lastname: Mishel
authors.forename: Jeannette T
authors.initials: JT
authors.lastname: Bensen
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Chen
authors.forename: George J
authors.initials: GJ
authors.lastname: Knafl
authors.forename: Bonny
authors.initials: B
authors.lastname: Blackard
authors.forename: Laura
authors.initials: L
authors.lastname: Farnan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fontham
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Su
authors.forename: Christine S
authors.initials: CS
authors.lastname: Brennan
authors.forename: James L
authors.initials: JL
authors.lastname: Mohler
authors.forename: Paul A
authors.initials: PA
authors.lastname: Godley
mesh_terms: D000368:Aged; D057220:Health Literacy; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010809:Physical Fitness; D011159:Population Surveillance; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology*; D011788:Quality of Life