Health literacy in hand surgery patients: a cross-sectional survey.
OBJECTIVE
To determine the prevalence of and factors associated with limited health literacy among outpatients presenting to an urban academic hospital-based hand surgeon.


METHODS
A cohort of 200 English- and Spanish-speaking patients completed the Newest Vital Sign (NVS) health literacy assessment tool, a sociodemographic survey, and 2 Patient-Reported Outcomes Measurement Information System-based computerized adaptive testing questionnaires: Patient-Reported Outcomes Measurement Information System Pain Interference and Upper-Extremity Function. The NVS scores were divided into limited (0-3) and adequate (4-6) health literacy. Multivariable regression modeling was used to identify independent predictors of limited health literacy.


RESULTS
A total of 86 patients (43%) had limited health literacy (English-speaking: 33%; Spanish-speaking: 100%). Factors associated with limited health literacy were advanced age, lower income, and being publicly insured or uninsured. Increasing years of education was a protective factor. Primary language was not included in the logistic regression model because all Spanish-speaking patients had limited health literacy. When evaluating health literacy on a continuum, primary language was the factor that most influenced the NVS scores, accounting for 14% of the variability.


CONCLUSIONS
Limited health literacy was commonplace among patients seeing a hand surgeon, more so in elderly and disadvantaged individuals. We hope our study raises awareness of this issue among hand surgeons and encourages providers to simplify messages and improve communication strategies.


METHODS
Prognostic II.
Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, MA.
Mariano E
ME
Menendez
Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, MA.
Chaitanya S
CS
Mudgal
Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, MA.
Jesse B
JB
Jupiter
Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, MA. Electronic address: dring@partners.org.
David
D
Ring
D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D006225:Hand / Q000601:surgery*; D057220:Health Literacy / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011634:Public Health
Health literacy; communication; hand surgery; public health