Main Article Content
Health literacy, Patient participation, Breast cancer
Background: Patient participation in medical decisions is essential and requires sufficient knowledge and awareness. Thus, the aim of this study was to investigate the relationship between health literacy and the participation of breast cancer patients in their medical decisions in Shiraz, Iran.
Methods: This was a descriptive-analytical study conducted on 196 women with breast cancer in 2016-2017. Data were collected using the standardized Health Literacy for Iranian Adults (HELIA) and the Decisional Conflict Scale. The data were analyzed using descriptive statistics and inferential methods (t test, Pearson correlation, ANOVA, and Kruskal-Wallis) on SPSS 21.
Results: The mean age of participants was 46.7 years. Their health literacy was inadequate (18.7) and their decisional conflict was average (51.79). There was also an inverse and significant relationship between health literacy and decisional conflict (P < 0.001, r = -0.81)
Conclusion: Increasing health literacy could reduce decisional conflict. It requires training individuals be able to access credible and reliable sources of information. This training can be provided through doctors, treatment staff, and public and social media.
2. Rafii F, M. Soleimani, N. Seyed-Fatemi. Concept Analysis of Participation of Patient with Chronic Disease: Use of Hybrid Model. Iran Journal of Nursing. 2010;23(67):35-48.
3. Gionfriddo MR, Leppin AL, Brito JP, LeBlanc A, Boehmer KR, et al. A systematic review of shared decision making interventions in chronic conditions: a review protocol. Systematic reviews. 2014;3(1):38.
4. Vahdat S, Hamzehgardeshi L, Hessam S, Hamzehgardeshi Z. Patient involvement in health care decision making: A review. Iranian Red Crescent Medical Journal. 2014;16(1).
5. Smith SK, Nutbeam D, McCaffery KJ. Insights into the concept and measurement of health literacy from a study of shared decision-making in a low literacy population. Journal of health psychology. 2013:1359105312468192.
6. Tariman JD, Doorenbos A, Schepp KG, Singhal S, Berry DL. Older adults newly diagnosed with symptomatic myeloma and treatment decision making. Oncol Nurs Forum. 2014;41(4):411-9.
7. De las Cuevas C, Peñate W. To what extent psychiatric patients feel involved in decision making about their mental health care? Relationships with socio-demographic, clinical, and psychological variables. Acta neuropsychiatrica. 2014;26(06):372-81.
8. AsadiJanati N, Vahdat S, Yazdan Panah A. Studying patient participation in controlling postoperative infection in orthognathic surgery in BouAli Hospital, Tehran in 2012-2013. MEDICAL SCIENCES JOURNAL. 2014;24(3):189-93.
9. Ghiyasvandian S, Mousavizadeh Sn, Dehghan Nayeri N, Haghani H. The Effect of Decision Aid's Pakage in Selected Treatment by Patients with Early Stage Breast Cancer and Decision making Outcomes. Journal of Fasa University of Medical Sciences. 2013;3(3):271-9.
10. Khosravi A, Ahmadzadeh Kh, Arastoopoor Sh, R. T. Health Literacy Levels ofDiabetic Patients Referred to Shiraz Health Centers and Its Effective Factors. Health Inf Manage. 2015;12(2):194-205.
11. Malloy-Weir LJ, Charles C, Gafni A, Entwistle VA. Empirical relationships between health literacy and treatment decision making: A scoping review of the literature. Patient education and counseling. 2015;98(3):296-309.
12. Reisi M, Mostafavi F, Hasanzade A, Sharifirad GR. The Relationship between Health Literacy, Health Status and Healthy Behaviors among Elderly in Isfahan, Iran. Health System Research. 2011;7(4):469-80.
13. Tavousi M, Ebadi M, Azin A, Shakerinejad G, Hashemi A, et al. Definitions of health literacy: a review of the literature. Journal of the Iranian Institute for Health Sciences. 2014;13(1):119-24.
14. Torres RY, Marks R. Relationships among health literacy, knowledge about hormone therapy, self-efficacy, and decision-making among postmenopausal health. Journal of health communication. 2009;14(1):43-55.
15. Yee LM, Simon MA. The role of health literacy and numeracy in contraceptive decision-making for urban Chicago women. Journal of community health. 2014;39(2):394-9.
16. TAVOUSI M, HAERI MA, RAFIEFAR S, SOLIMANIAN A, SARBANDI F, et al. Health literacy in Iran: findings from a National study. Journal of the Iranian Institute for Health Sciences Research. 2016;15(1):95-102.
17. Busch EL, Martin C, DeWalt DA, Sandler RS. Functional health literacy, chemotherapy decisions, and outcomes among a colorectal cancer cohort. Cancer control: journal of the Moffitt Cancer Center. 2015;22(1):95-101.
18. Khdemi N, Khassi K. the study of cancer incidence and cancer registration in kermanshah province between 2009-2010 in women. 2. 2014;6(24):32-9.
19. Hatam N, Keshtkar V, Salehi A, Rafei H. The financial cost of preventive and curative programs for breast cancer: a case study of women in Shiraz-Iran. International journal of health policy and management. 2014;2(4):187.
20. Salesi M, Khoshneshin Ghashghaee Z, Daryanoosh F, Tahmasebi S, Taleie A. The effect of eight weeks aerobic exercise on cardiovascular and hormonal risk factors in breast cancer patients. Razi Journal of Medical Sciences. 2015;22(131):35-43.
21. Gohari MR, Fard Z, Abolghasemi J, Mohammadi M, Mokhtari P. Prognostic factors of metastases in breast cancer patients using the recurrent Andersen-Gill model. Koomesh. 2013;14(4):Pe483-Pe9, En63.
22. Sharifian A, Pourhoseingholi MA, Emadedin M, Rostami Nejad M, Ashtari S, et al. Burden of Breast Cancer in Iranian Women is Increasing. Asian Pacific journal of cancer prevention : APJCP. 2015;16(12):5049-52.
23. MONTAZERI A, Tavousi M, RAKHSHANI F, Azin SA, Jahangiri K, et al. Health Literacy for Iranian Adults (HELIA): development and psychometric properties. 2014.
24. Izadirad H, Zareban I. The Relationship of Health Literacy with Health status, Preventive Behaviors and Health services Utilization in Baluchistan, Iran. J Educ Community Health. 2015;2(3):43-50.
25. O'Connor AM. Validation of a decisional conflict scale. Medical decision making. 1995;15(1):25-30.
26. Tagai EK. The relationship between health literacy and indicators of decision making for colorectal cancer screening among African Americans: University of Maryland, College Park; 2016.
27. Sahrayi M, Panahi R, Kazemi S-s, GoliRostami Z, Rezaie H, et al. The study of Health Literacy of adults in Karaj. Journal of Health Literacy. 2017;1(4):230-8.
28. Haghighi ST, Lamyian M, Granpaye L. Assessment of the level of health literacy among fertile Iranian women with breast cancer. Electronic physician. 2015;7(6):1359.
29. Hur I, Lee R, Schmidt J. How Healthcare Technology Shapes Health Literacy? A Systematic Review. 2015.
30. Wigfall LT, Tanner AH. Health Literacy and Health-Care Engagement as Predictors of Shared Decision-Making Among Adult Information Seekers in the USA: a Secondary Data Analysis of the Health Information National Trends Survey. Journal of cancer education : the official journal of the American Association for Cancer Education. 2016.
31. Essink-Bot M, Dekker E, Timmermans D, Uiters E, Fransen M. Knowledge and informed decision-making about population-based colorectal cancer screening participation in groups with low and adequate health literacy. Gastroenterology research and practice. 2016;2016.
32. Jukkala A, Walker DK, Krontiras H, Azuero A, Meneses K. Readiness to engage in treatment decision-making during initial surgical oncology consultation for early stage breast cancer. Clinical Nursing Studies. 2013;1(2):69.
33. Doyle KL, Woods SP, Morgan EE, Iudicello JE, Cameron MV, et al. Health-related decision-making in HIV disease. Journal of clinical psychology in medical settings. 2016;23(2):135-46.
34. Bergeron CD, Friedman DB, Spencer SM, Miller SC, Hilfinger Messias DK, et al. An Exploratory Survey of Older Women’s Post-Fall Decisions. Journal of applied gerontology. 2016:0733464816653361.
35. LeBlanc A, Kenny DA, O'Connor AM, Légaré F. Decisional conflict in patients and their physicians: a dyadic approach to shared decision making. Medical decision making. 2009;29(1):61-8.
36. Brabers AE, Rademakers JJ, Groenewegen PP, van Dijk L, de Jong JD. What role does health literacy play in patients' involvement in medical decision-making? PloS one. 2017;12(3):e0173316.