Association of health literacy with chronic pain and pain-related distress.

Abstract

Research suggests health literacy should be considered when treating chronic pain. The purpose of this secondary analysis was to examine the relationship of health literacy with pain and psychological functioning and to determine whether health literacy status was associated with outcomes after a brief psychological intervention for chronic pain. Participants with chronic musculoskeletal pain (N = 60) were randomized to a five-session psychological intervention or control group between September 2018 and February 2020. Participants completed a baseline and postassessment, which included measures of health literacy status (i.e., adequate vs. lower level), pain severity, pain interference, pain catastrophizing, depression, anxiety, and pain acceptance. Participants were mostly female (78.3%) and Black (88.3%) with a mean age of 62.2 years. At baseline, lower levels of health literacy were associated with greater pain severity ( p = .003), pain catastrophizing ( p = .03), and depressive symptoms ( p = .02). Among those randomized to the intervention group, health literacy status was not related to engagement in the intervention. However, those with adequate levels of health literacy were more likely to have lower depressive symptoms ( p = .045) and higher acceptance of pain ( p = .01) at postintervention compared to those with lower levels. Among individuals with chronic pain, those with lower levels of health literacy may have worse pain and psychological functioning. Those with lower levels may also not benefit as much from standardized psychological interventions for pain management. Clinicians delivering psychological interventions for chronic pain may want to consider screening for health literacy status and adapt the intervention to ensure understanding. Public Significance StatementThis study suggests that among individuals with chronic pain, those with lower levels of health literacy may have worse pain and psychological functioning and may not benefit as much from psychological interventions for pain management. Clinicians delivering psychological interventions for chronic pain may want to consider screening for health literacy status and adapt the intervention to ensure understanding.

Perceived Stress and Life Stressors in Adults with and without Fibromyalgia

“…One study suggests that factors such as childhood neglect, sexual assault, lower income and education levels, and increased body mass index may contribute to increased likelihood of FM [ 28 ]. Another study suggests that symptoms of chronic pain and depression may be exacerbated by lower levels of health literacy [ 53 ]. Finally, Quinn et al [ 4 ] propose that health-related outcomes may be related to affect balance (the difference between positive and negative affect) with this balance associated with the PASTOR theory of resilience [ 54 ].…”