Health literacy in gastrointestinal diseases: a comparative analysis between patients with liver cirrhosis, inflammatory bowel disease and gastrointestinal cancer

Abstract

Currently, there are only few data on health literacy in patients with chronic gastrointestinal diseases such as gastrointestinal cancer, inflammatory bowel disease (IBD) and, in particular, liver cirrhosis available. Moreover, head-to-head comparisons between patients with these different diseases are lacking. In this study, 379 patients were enrolled. Of these, 102 patients had gastrointestinal cancer, 86 had IBD, and 191 had cirrhosis. Health literacy was quantified using the Health Literacy Questionnaire (HLQ) developed by Osborne et al. (Swinburne University, Australia) and was compared between these three groups. Patients with cancer had the best health literacy across all nine subscales of the HLQ, while patients with cirrhosis had the poorest. In detail, patients with cirrhosis had significantly poorer health literacy than patients with cancer or IBD in subscales such as “feeling understood and supported by healthcare providers”, “having sufficient information to manage my health”, “appraisal of health information”, “ability to actively engage with healthcare providers” or “understanding health information well enough to know what to do” (p < 0.05 for cirrhosis versus IBD or cancer, respectively). In conclusion, health literacy differs remarkably between patients with chronic gastrointestinal diseases such as cirrhosis, IBD or gastrointestinal cancers.

Serious Illness Communication in Cirrhosis Care: Tools to Improve Illness Understanding, Prognostic Understanding, and Care Planning

“…In one study, when compared to patients with gastrointestinal malignancies and inflammatory bowel disease, patients with cirrhosis were found to have the poorest understanding of their illness. 17 In this study of 379 patients, those with advanced liver disease were found to have poorer illness understanding than those who were more compensated. Another study conducted in 150 outpatients with cirrhosis highlighted deficits in disease self-management.…”

Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

“…It is important to educate the young patients with IBD during family planning counseling. [ 194 – 200 ] Low health literacy is present in IBD populations and more common among older AAs [ 201 – 203 ] Opportunities exist for providing more health literacy-sensitive care in IBD to address disparities and to benefit those with low health literacy. [ 203 ] Unfortunately, to date, racial disparities and racism severely impacts AAW during pregnancies in health and diseases while attending care coordination services.…”

“…[ 194 – 200 ] Low health literacy is present in IBD populations and more common among older AAs [ 201 – 203 ] Opportunities exist for providing more health literacy-sensitive care in IBD to address disparities and to benefit those with low health literacy. [ 203 ] Unfortunately, to date, racial disparities and racism severely impacts AAW during pregnancies in health and diseases while attending care coordination services. [ 125 , 204 , 205 ] Fulminant colitis disease during conception and pregnancy in women with IBD increases the risk of pregnancy complications and adverse neonatal outcomes .…”

GITalk: Communication Skills Training for Gastroenterology Fellows Improves Self-Assessed Preparedness for Serious Illness Conversations

“…Unfortunately, patients and families often lack a thorough understanding of their illness trajectory and infrequently participate in conversations related to advance care planning (ACP). [6,7] Communication around treatment decisions are often delayed and tend to take place in the inpatient setting, where mortality is high, especially in conditions such as decompensated cirrhosis. [8][9][10][11] One reason for such delayed and limited communication in this high-risk population may be gaps in training for general and subspecialty gastroenterology (GI) fellows.…”