Health literacy and patient-reported outcomes in preoperative patients undergoing lumbar spine surgery: a cross-sectional study.

IF 4.9 1区医学 Q1 CLINICAL NEUROLOGY

Spine Journal Pub Date : 2025-04-05 DOI:10.1016/j.spinee.2025.04.010

Issei Higashino, Nobuhiro Takiguchi, Shohei Egi, Seiichi Odate, Kazuaki Morizane, Kazuki Uemura

{"title":"Health literacy and patient-reported outcomes in preoperative patients undergoing lumbar spine surgery: a cross-sectional study.","authors":"Issei Higashino, Nobuhiro Takiguchi, Shohei Egi, Seiichi Odate, Kazuaki Morizane, Kazuki Uemura","doi":"10.1016/j.spinee.2025.04.010","DOIUrl":null,"url":null,"abstract":"Background context: Health literacy (HL) plays an important role in health outcomes (e.g., Activities of Daily Living and Quality of Life) among patients with chronic diseases and elderly persons. The association between functional HL and health outcomes in patients with lumbar degenerative disease has also been revealed. Comprehensive HL includes three levels of functional, communicative, and critical HL that may affect the health outcomes of patients undergoing lumbar spine surgery. However, the association between comprehensive HL and health outcomes in patients undergoing lumbar spine surgery has not yet been investigated.Purpose: To examine the impact of comprehensive HL on patient-reported outcomes (PROs) of pain-related disabilities and health-related quality of life in patients undergoing lumbar spine surgery.Study design/setting: Cross-sectional study.Patient sample: Patients aged 18 years or older who presented to a general hospital-based spine center for the surgical treatment of lumbar degenerative disease.Outcome measures: Oswestry Disability Index 2.0 (ODI), EuroQol-5D-5L (EQ-5D-5L).Methods: Between June 2023 and May 2024, consecutive patients aged 18 years or older presenting to the spine center were approached for participation in this cross-sectional study. Patients completed a questionnaire concerning sociodemographic characteristics; Functional, Communicative, and Critical Health Literacy (FCCHL); and PROs, including ODI and EQ-5D-5L. A multivariable linear regression analysis with potential confounders was performed to examine the relationship between FCCHL and PROs.Results: Of 128 eligible patients, 124 (97%) were included in the statistical analysis. Higher total FCCHL score was significantly associated with better PROs (ODI (regression coefficient, -10.6; [95% confidence interval, -17.6, -3.6]), EQ-5D-5L (0.093 [0.022, 0.165])) in a linear dose-response manner. Functional HL was not associated with PROs; however, communicative and critical HL were both associated with PROs.Conclusions: Higher comprehensive HL, including functional, communicative, and critical HL, was associated with better PROs, characterized by lower ODI and higher EQ-5D-5L scores, in a linear dose-response manner in patients undergoing lumbar spine surgery. Our study suggests that comprehensive HL is important to prevent disabilities in daily life due to lumbar degenerative disease.","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.spinee.2025.04.010","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background context: Health literacy (HL) plays an important role in health outcomes (e.g., Activities of Daily Living and Quality of Life) among patients with chronic diseases and elderly persons. The association between functional HL and health outcomes in patients with lumbar degenerative disease has also been revealed. Comprehensive HL includes three levels of functional, communicative, and critical HL that may affect the health outcomes of patients undergoing lumbar spine surgery. However, the association between comprehensive HL and health outcomes in patients undergoing lumbar spine surgery has not yet been investigated.

Purpose: To examine the impact of comprehensive HL on patient-reported outcomes (PROs) of pain-related disabilities and health-related quality of life in patients undergoing lumbar spine surgery.

Study design/setting: Cross-sectional study.

Patient sample: Patients aged 18 years or older who presented to a general hospital-based spine center for the surgical treatment of lumbar degenerative disease.

Outcome measures: Oswestry Disability Index 2.0 (ODI), EuroQol-5D-5L (EQ-5D-5L).

Methods: Between June 2023 and May 2024, consecutive patients aged 18 years or older presenting to the spine center were approached for participation in this cross-sectional study. Patients completed a questionnaire concerning sociodemographic characteristics; Functional, Communicative, and Critical Health Literacy (FCCHL); and PROs, including ODI and EQ-5D-5L. A multivariable linear regression analysis with potential confounders was performed to examine the relationship between FCCHL and PROs.

Results: Of 128 eligible patients, 124 (97%) were included in the statistical analysis. Higher total FCCHL score was significantly associated with better PROs (ODI (regression coefficient, -10.6; [95% confidence interval, -17.6, -3.6]), EQ-5D-5L (0.093 [0.022, 0.165])) in a linear dose-response manner. Functional HL was not associated with PROs; however, communicative and critical HL were both associated with PROs.

Conclusions: Higher comprehensive HL, including functional, communicative, and critical HL, was associated with better PROs, characterized by lower ODI and higher EQ-5D-5L scores, in a linear dose-response manner in patients undergoing lumbar spine surgery. Our study suggests that comprehensive HL is important to prevent disabilities in daily life due to lumbar degenerative disease.

查看原文本刊更多论文

健康素养和术前腰椎手术患者报告的结果：一项横断面研究

背景背景：健康素养（HL）在慢性病患者和老年人的健康结果（如日常生活活动和生活质量）中起着重要作用。功能性HL与腰椎退行性疾病患者健康结局之间的关联也已被揭示。综合性HL包括可能影响腰椎手术患者健康结局的功能性、交流性和危重性HL三个级别。然而，腰椎手术患者的综合HL与健康结果之间的关系尚未被调查。目的：研究综合性HL对腰椎手术患者疼痛相关残疾和健康相关生活质量的影响。研究设计/设置：横断面研究。患者样本：年龄在18岁或以上的患者，在综合医院脊柱中心接受腰椎退行性疾病的手术治疗。结局指标：Oswestry残疾指数2.0 (ODI), EuroQol-5D-5L （EQ-5D-5L）。方法：在2023年6月至2024年5月期间，连续向脊柱中心就诊的18岁及以上患者进行了横断面研究。患者完成一份有关社会人口学特征的问卷；功能、交际和关键健康素养（FCCHL）和pro，包括ODI和EQ-5D-5L。采用含潜在混杂因素的多变量线性回归分析来检验FCCHL与PROs之间的关系。结果：128例符合条件的患者中，124例（97%）纳入统计分析。FCCHL总分越高，PROs （ODI）越好(回归系数为-10.6；[95%置信区间，-17.6,-3.6]),EQ-5D-5L(0.093[0.022, 0.165]))呈线性剂量-响应方式。功能性HL与PROs无关；然而，交际型和批判型HL均与pro相关。结论：在腰椎手术患者中，更高的综合性HL（包括功能性、交流性和危重性HL）与更好的PROs相关，其特征是更低的ODI和更高的EQ-5D-5L评分，呈线性剂量反应方式。我们的研究表明，综合HL对预防腰椎退行性疾病导致的日常生活残疾很重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.