Abstract
Introduction and hypothesis
Our objectives were to describe the health literacy (HL) of urogynecology patients, characterize women with and without adequate HL, and compare errors made on the PFDI-20 and PFIQ-7.
Methods
English-speaking women presenting to an academic urogynecology clinic in June–July 2018 were invited to complete questionnaires including the Newest Vital Sign™ (NVS), the Pelvic Floor Distress Inventory—Short Form 20 (PFDI-20), and the Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7). An NVS score > 4 indicated adequate HL. Descriptive analyses compared women with and without adequate HL and the rates and types of errors made on the PFDI-20 and PFIQ-7.
Results
The mean age of participants (N = 115) was 65 + 15 years; 87% were white/Caucasian; 62% were college-educated. NVS scores indicated likely adequate HL in 61%. Participants at risk for limited HL (39%) were older, less educated, more likely to live alone, and more likely to require assistance to manage their healthcare (all p < 0.05). Those requesting help to complete the questionnaires (29%) had lower HL. Errors occurred more often on the PFDI-20 (44%) than PFIQ-7 (5%) regardless of HL status. Those who received help were less likely to make errors on the PFDI-20 (p < 0.05).
Conclusions
Overall 39% of patients were at risk for limited HL. Older age, living alone, less education, and requiring assistance to manage healthcare increased risk of limited HL. Errors were more common on the PFDI-20 than PFIQ-7 regardless of HL status and occurred even when participants received help completing the questionnaires, though less frequently.
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References
Health Resources & Services Administration. Health literacy. 2019. Available from: https://www.hrsa.gov/about/organization/bureaus/ohe/health-literacy/index.html. Accessed 12th August 2018.
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15(3):259–67. https://doi.org/10.1093/heapro/15.3.259.
Berkman N, Sheridan S, Donahue K, Halpern D, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97–107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005.
Hälleberg NM, Nilsson U, Dahlberg K, Jaensson M. Association between functional health literacy and postoperative recovery, health care contacts, and health-related quality of life among patients undergoing day surgery: secondary analysis of a randomized clinical trial. JAMA Surg. 2018;153(8):738–45. https://doi.org/10.1001/jamasurg.2018.0672.
Kutner M, Greenberg E, Jin Y, Paulsen C. The health literacy of America’s adults: results from the 2003 national assessment of adult literacy. US Department of Education NCES. 2006. Available from: https://nces.ed.gov/pubs2006/2006483.pdf. Accessed 12th August 2018.
Ad Hoc Committee on Health Literacy. Health literacy: report of the Council on Acientific Affairs. JAMA. 1999;281(6):552–7.
Nielsen-Bohlman L, Panzer AM, Kindig DA. Health literacy: a prescription to end confusion. National Academies Press (US). 2004. https://doi.org/10.17226/10883.
Pfizer. The newest vital sign. 2010. Available from: https://www.pfizer.com/health/literacy/public-policy-researchers/nvs-toolkit. Accessed 12th August 2018.
Weiss BD, Mays MZ, Martz W, et al. Quick assessment of literacy in primary care: the newest vital sign [published correction appears in Ann Fam Med. 2006;4(1):83]. Ann Fam Med. 2005;3(6):514-522. https://doi.org/10.1370/afm.405.
Barber MD, Kuchibhatla MN, Pieper DF, Bump RC. Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol. 2001;185(6):1388–95. https://doi.org/10.1067/mob.2001.118659.
Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13. https://doi.org/10.1016/j.ajog.2004.12.025.
National Institutes of Health. How to write easy-to-read health materials: medlineplus. 2017. Available from: https://medlineplus.gov/etr.html. Accessed 23rd March 2018.
Spencer BS, Hadden PD, Brown MD, Oliphant MD. Considering low health literacy how do the pelvic floor distress inventory—short form 20 and pelvic floor impact questionnaire—short form 7 measure up? Female Pelvic Med Reconstr Surg. 2019;25(2):145–8. https://doi.org/10.1097/SPV.0000000000000672.
Anger JT, Lee U, Mittal BM, Pollard M, Tarnay C, Maliski S, et al. Health literacy and disease understanding among aging women with pelvic floor disorders. Female Pelvic Med Reconstr Surg. 2012;18(6):340–3. https://doi.org/10.1097/SPV.0b013e31826fb8d3.
Sripad AA, Rupp BM, Gage JL, Feliciano KM, Willis-Gray M, Wu JM. Health literacy in women presenting to a urogynecology practice. Female Pelvic Med Reconstr Surg. 2018;24(6):435–9. https://doi.org/10.1097/SPV.0000000000000494.
Davidson ERW, Myers EM, De La Cruz JF, Connolly A. Baseline understanding of urinary incontinence and prolapse in new urogynecology patients. Female Pelvic Med Reconstr Surg. 2019;25(1):67–71. https://doi.org/10.1097/SPV.0000000000000499.
Good MM, Korbly N, Kassis NC, et al. Prolapse-related knowledge and attitudes toward the uterus in women with pelvic organ prolapse symptoms. Am J Obstet Gynecol. 2013;209(5):481.e1-6. https://doi.org/10.1016/j.ajog.2013.06.001.
Senekjian L, Heintz K, Egger MJ, et al. Do women understand urogynecologic terminology? Female Pelvic Med Reconstr Surg. 2011;17(5):215–7. https://doi.org/10.1097/SPV.0b013e31822dcffe.
Reagan KML, O’Sullivan DM, Harvey DP, Lasala CA. Readability of patient information pamphlets in urogynecology. Female Pelvic Med Reconstr Surg. 2015;21(2):63–5. https://doi.org/10.1097/SPV.0000000000000152.
Haller J, Keller Z, Barr S, Hadden K, Oliphant SS. Assessing readability: are urogynecologic patient education materials at an appropriate reading level? Female Pelvic Med Reconstr Surg. 2019;25(2):139–44. https://doi.org/10.1097/SPV.0000000000000653.
Acknowledgments
We would like to acknowledge the Center for Health Literacy at the University of Arkansas for Medical Sciences for their partnership on this project and specifically Dr. Kristie Hadden for her insight and guidance.
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Presentation: American Urogynecologic Society/International Urogynecological Association Joint Scientific Meeting, Nashville, TN, September 24–28, 2019.
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Spencer, J.E., Brown, H.W. & Oliphant, S.S. Health literacy and PFDI-20 and PFIQ-7 completion in urogynecology patients. Int Urogynecol J 32, 3209–3215 (2021). https://doi.org/10.1007/s00192-020-04643-4
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DOI: https://doi.org/10.1007/s00192-020-04643-4