Health literacy and recovery following a non-catastrophic road traffic injury

Bamini Gopinath; Jagnoor Jagnoor; Annette Kifley; Ilaria Pozzato; Ashley Craig; Ian D Cameron

doi:10.1186/s12889-022-13707-7

Health literacy and recovery following a non-catastrophic road traffic injury

BMC Public Health. 2022 Jul 19;22(1):1380. doi: 10.1186/s12889-022-13707-7.

Authors

Bamini Gopinath^{1

2}, Jagnoor Jagnoor^{3

4}, Annette Kifley³, Ilaria Pozzato³, Ashley Craig³, Ian D Cameron³

Affiliations

¹ John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia. bamini.gopinath@mq.edu.au.
² Macquarie University Hearing, Department of Linguistics, Faculty of Medicine, Health and Human Sciences, The Australian Hearing Hub, 16 University Avenue, Macquarie University, Sydney, NSW, 2109, Australia. bamini.gopinath@mq.edu.au.
³ John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.
⁴ The George Institute for Global Health, University of New South Wales, Sydney, Australia.

Abstract

Background: Health literacy (HL) is rarely addressed in rehabilitation research and practice but can play a substantial role in the recovery process after an injury. We aimed to identify factors associated with low HL and its relationship with 6-month health outcomes in individuals recovering from a non-catastrophic road traffic injury.

Methods: Four hundred ninety-three participants aged ≥17 years who had sustained a non-catastrophic injury in a land-transport crash, underwent a telephone-administered questionnaire. Information was obtained on socio-economic, pre-injury health and crash-related characteristics, and health outcomes (quality of life, pain related measures and psychological indices). Low HL was defined as scoring < 4 on either of the two scales of the Health Literacy Questionnaire that covered: ability to actively engage with healthcare providers ('Engagement' scale); and/or understanding health information well enough to know what to do ('Understanding' scale).

Results: Of the 493, 16.9 and 18.7% scored < 4 on the 'Understanding' and 'Engagement' scale (i.e. had low HL), respectively. Factors that were associated with low HL as assessed by both scales were: having pre-injury disability and psychological conditions; lodging a third-party insurance claim; experiencing overwhelming/great perceived sense of danger/death during the crash; type of road user; low levels of social satisfaction; higher pain severity; pain catastrophizing; and psychological- and trauma-related distress. Low HL (assessed by both scales) was associated with poorer recovery outcomes over 6 months. In these longitudinal analyses, the strongest association was with disability (p < 0.0001), and other significant associations were higher levels of catastrophizing (p = 0.01), pain severity (p = 0.04), psychological- (p ≤ 0.02) and trauma-related distress (p = 0.003), lower quality of life (p ≤ 0.03) and physical functioning (p ≤ 0.01).

Conclusions: A wide spectrum of factors including claim status, pre-injury and psychological measures were associated with low HL in injured individuals. Our findings suggest that targeting low HL could help improve recovery outcomes after non-catastrophic injury.

Keywords: Health literacy; Non-catastrophic injury; Recovery; Road traffic crash.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Accidents, Traffic*
Health Literacy*
Humans
Pain Measurement
Quality of Life / psychology
Surveys and Questionnaires