title: Suboptimal health literacy in patients with lung cancer or head and neck cancer.
abstract: BACKGROUND
  Health literacy is the capacity to seek, understand and utilise health information to make informed health decisions. Suboptimal health literacy has been linked to poor health outcomes. This study assessed health literacy in patients treated for head and neck or lung cancer and associations between health literacy and demographic factors and distress levels.
  
  
  METHODS
  Consecutive English-speaking patients were approached at Peter MacCallum Cancer Centre. Face-to-face interviews were conducted. Health literacy was assessed using the Shortened Test of Functional Health Literacy in Adults (S-TOFHLA) and Health Literacy Management Scale (HeLMS). Distress was assessed by the Distress Thermometer.
  
  
  RESULTS
  Response rate was 73 % (n = 93). Using S-TOFHLA, prevalence of inadequate and marginal health literacy was 5.4 and 6.5 % respectively, and both groups were associated with older age (p = 0.043) and low education level (p = 0.009). Specific assessment of S-TOFHLA revealed that 70 % could not interpret prescription labels. HeLMS reported that 17 % had health literacy difficulties. Low scores on domains of HeLMS were associated with lower education level (p < 0.05) but younger age (p < 0.05). Distress was not associated with S-TOFHLA scores but related to low scores in two domains of HeLMS (p < 0.05).
  
  
  CONCLUSIONS
  Using two different measures, a substantial proportion of patients have poor health literacy abilities and may experience difficulties in accessing health services.
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, Victoria, 8006, Australia.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Koay
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.forename: Karla
authors.initials: K
authors.lastname: Gough
authors.forename: Rachelle
authors.initials: R
authors.lastname: Buchbinder
authors.forename: Danny
authors.initials: D
authors.lastname: Rischin
authors.forename: David
authors.initials: D
authors.lastname: Ball
authors.forename: June
authors.initials: J
authors.lastname: Corry
authors.forename: Richard H
authors.initials: RH
authors.lastname: Osborne
authors.forename: Michael
authors.initials: M
authors.lastname: Jefford
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D057220:Health Literacy; D006801:Humans; D007802:Language; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged