title: What role does health literacy play in patients' involvement in medical decision-making?
abstract: Patients vary in their preferences towards involvement in medical decision-making. Previous research, however, gives no clear explanation for this observed variation in their involvement. One possible explanation might be health literacy. Health literacy refers to personal characteristics and social resources needed for people to access, understand and use information to make decisions about their health. This study aimed to examine the relationship between health literacy and self-reported patient involvement. With respect to health literacy, we focused on those competences relevant for medical decision-making. We hypothesized that people with higher health literacy report that they are more involved in medical decision-making. A structured questionnaire was sent to members of the Dutch Health Care Consumer Panel in May 2015 (response 46%, N = 974). Health literacy was measured using five scales of the Health Literacy Questionnaire. A regression model was used to estimate the relationship between health literacy and self-reported involvement. In general, our results did not show a relationship between health literacy and self-reported involvement. We did find a positive significant association between the health literacy scale appraisal of health information and self-reported involvement. Our hypothesis was partly confirmed. The results from this study suggest that higher order competences, that is to say critical health literacy, in particular, are important in reporting involvement in medical decision-making. Future research is recommended to unravel further the relationship between health literacy and patient involvement in order to gain insight into whether health literacy might be an asset to enhance patient participation in medical decision-making.
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Anne E M
authors.initials: AE
authors.lastname: Brabers
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands.|Department of General Practice, CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Jany J D J M
authors.initials: JJ
authors.lastname: Rademakers
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands.|Department of Sociology, Department of Human Geography, Utrecht University, Utrecht, the Netherlands.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk
authors.affiliation: NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Judith D
authors.initials: JD
authors.lastname: de Jong
mesh_terms: D000368:Aged; D000066491:Clinical Decision-Making; D005260:Female; D057220:Health Literacy; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010361:Patients; D010820:Physicians; D011795:Surveys and Questionnaires