The influence of health literacy on pain self-efficacy in patients with chronic pain.

Abstract

Background Inadequate Health Literacy (HL) can be a serious problem in patients with chronic pain (CP). Difficulties in adequate handling information about health, illness and care can be an obstacle in multidisciplinary pain rehabilitation (MPR). Self-efficacy is an important predictor of health outcome in pain rehabilitation. Within the different pathways of the HL model, self-efficacy is a recurring patient factor. However, it is unknown how HL and self-efficacy relate to each other. To be able to improve health outcomes of people with CP without adequate HL a better understanding in how HL influences self-efficacy in people with chronic pain is required. Aim To investigate the influence of HL on pain self-efficacy (PSE) in people with CP. Methods Data of the “Pain rehabilitation for patients with inadequate health literacy” (PREPGO) study was used which concerned people with chronic pain who were eligible for MPR. To determine the influence of HL on pain self-efficacy hierarchical multiple regression was performed controlled for age, pain duration and employment status. Results The study included 56 participants. The mean age of the study population was 49 years and three-fourths of the participants were woman. Over two-third of the participants had no adequate HL. HL had no significant influence on PSE (p = .836), corrected for age, pain duration and employment status. The adequate HL group had a lower PSE score at the start of the MPR (p=.122) and makes almost double progress (10.8 vs. 5.8, p = .097) during the MPR versus the group without adequate HL. Conclusion It is still unclear how HL influences PSE, given the results of this study. Clinical Relevance Given the complexity of the pathways of HL in health outcomes. More research is needed whereby more insight of the constructs can be given in the associations of all factors in the HL model.