Health literacy and cancer self-management behaviors: A scoping review

Cancer. 2018 Nov 1;124(21):4202-4210. doi: 10.1002/cncr.31733. Epub 2018 Sep 28.

Abstract

Background: Increasing demands on health care systems require patients to take on more active roles in their health. Effective self-management has been linked to improved health outcomes, and evidence shows that effective self-management is linked to health literacy (HL). HL is an important predictor of successful self-management in other chronic diseases but has had minimal testing in cancer.

Methods: A scoping review was conducted to examine and summarize what is known about the association between HL and self-management behaviors and health service utilization in the cancer setting. The methodological framework articulated by Arksey and O'Malley was used and was further refined with the Joanna Briggs Institute methodology. Inclusion criteria included the following: peer review; publication in English; and adult patients and caregivers of all races, ethnicities, and cultural groups. Use of a validated instrument to measure HL was required.

Results: The search yielded 2414 articles. After the removal of duplicates and the performance of title scans and abstract reviews, the number was reduced to 44. Of the 44 full-text articles reviewed, 17 met the inclusion criteria. A number of important self-management behaviors and related outcomes were found to be associated with HL. These included the uptake of cancer screening, the receipt of prescribed chemotherapy, and a greater risk of postoperative complications.

Conclusions: This literature review shows that HL is associated with important self-management behaviors in cancer. The implications of these associations for individuals with inadequate HL and for the health care system are significant. More research is needed to explore these associations.

Keywords: health literacy; health services; neoplasms; self-care; self-management.

Publication types

  • Systematic Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / therapy
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / psychology
  • Early Detection of Cancer / statistics & numerical data
  • Health Behavior*
  • Health Literacy / statistics & numerical data*
  • Humans
  • Neoplasms / epidemiology*
  • Neoplasms / therapy*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / therapy
  • Self Care / methods
  • Self Care / psychology
  • Self Care / standards
  • Self Care / statistics & numerical data
  • Self-Management* / psychology
  • Self-Management* / statistics & numerical data

Substances

  • Antineoplastic Agents