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World Journal of Surgery

, Volume 43, Issue 1, pp 96–106 | Cite as

Health Literacy Among Surgical Patients: A Systematic Review and Meta-analysis

  • Mélissa RoyEmail author
  • Joseph P. Corkum
  • David R. Urbach
  • Christine B. Novak
  • Herbert P. von Schroeder
  • Steven J. McCabe
  • Karen Okrainec
Scientific Review

Abstract

Health literacy is the extent to which patients are able to understand and act upon health information. This concept is important for surgeons as their patients have to comprehend the nature, risks and benefits of surgical procedures, adhere to perioperative instructions, and make complex care decisions about interventions. Our review aimed to determine the prevalence of limited health literacy of the surgical patient population. A search of MEDLINE and EMBASE was performed from inception until January 14th 2017 for experimental and observational studies reporting surgical patients’ health literacy measurement. Overall pooled proportion of surgical patients with limited health literacy was calculated using a random-effects model and methodologic quality was assessed. A total of 40 studies representing 18,895 surgical patients were included in our quantitative synthesis. Pooled estimate of limited health literacy was 31.7% (95%CI 24.7–39.2%, I2 99.0%). There was low risk of bias among the majority of the 51 studies included in the qualitative synthesis. Statistical heterogeneity could not be fully accounted for by methodologic quality or patient and surgical characteristics. However, some of the heterogeneity was accounted by measurement tool [combined proportions with the REALM and NVS of 35.6 (95%CI 31.5–39.9, I2 73.0%)]. A number of different health literacy measurement tools were used (19 overall). Our review demonstrates a high prevalence of limited health literacy among surgical patients with considerable heterogeneity. Our findings suggest the importance of recognizing and addressing surgical patients with limited health literacy and the need for standardization in measurement tools.

Notes

Funding

The contents of this article were developed under a grant from the Canadian Institute of Health Research (CIHR), the Frederick Banting and Charles Best Canada Graduate Scholarship, awarded to support Mélissa Roy’s graduate degree.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Supplementary material

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  1. 1.Division of Plastic and Reconstructive Surgery, Department of SurgeryUniversity of TorontoTorontoCanada
  2. 2.Division of Plastic and Reconstructive Surgery, Department of SurgeryDalhousie UniversityHalifaxCanada
  3. 3.Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoCanada
  4. 4.Division of Internal Medicine, Department of MedicineUniversity of TorontoTorontoCanada

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