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Results from a comprehensive literature review reveal that women with breast cancer in racial minority groups experience reduced quality of life related to low levels of health literacy, are less likely to report knowing or correctly answer questions regarding different tumor characteristics, and are at higher risk of insufficient health literacy due to socioeconomic inequities. These results were published in the Clinical Journal of Oncology Nursing.
Health literacy needs for patients with cancer can impact health outcomes. Notably, Black women with breast cancer more frequently have high-grade breast tumors at diagnosis and experience increased mortality rates. This literature review, which identified and reviewed 12 studies published in the United States between 2014 and 2023, assessed the role of health literacy and health behaviors in Black women with breast cancer.
Of the 12 studies, 10 used a descriptive, cross-sectional design, with 4 of those studies being secondary analyses of other studies. A total of 5 studies directly evaluated the relationships between health literacy and health outcomes, which included patient engagement, hospitalization rate, and management of chronic issues. One study did not directly evaluate health literacy but rather assessed clinicians’ perspectives on social determinants of health, which included the effects of health literacy on outcomes.
Insufficient health literacy associated with reduced self-efficacy and higher cancer-related needs, especially in women with breast cancer, in a study in which 57% of the patients with inadequate health literacy were Black women. Low health literacy was also associated with poor adherence to medication and reduced self-efficacy in Black women with breast cancer.
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Furthermore, low health literacy associated with more frequent hospitalizations and longer hospital stays. Non-Hispanic patients in racial minority groups experienced more hospital admissions compared with their non-Hispanic White counterparts. These findings emphasize the critical importance of addressing health literacy disparities in the context of cancer care to improve patient outcomes.
This proactive assessment and evaluation of health literacy can contribute to improved communication and relationships between patients and healthcare providers by identifying opportunities for education and resource collaboration, ultimately fostering positive health behaviors, noted the researchers. Additional research could assess the frequency and key points for implementing cancer health literacy assessments to determine the optimal time during treatment to educate patients effectively about cancer health maintenance, which could support improved health outcomes.
“The understanding of the importance of health literacy levels from patients and providers, particularly nurses, can help expand the quality of care patients with cancer receive and mitigate adverse events during and after cancer treatment. Additional introspection into factors that motivate positive health behaviors and adequate health literacy levels in this population is needed to understand more about the role that health literacy plays in cancer health across the continuum,” concluded the authors.
Reference
Moore L, Hayes AE. Cancer health literacy in Black women with breast cancer: a comprehensive literature review. Clin J Oncol Nurs. 2023;27(5):507-513. doi:10.1188/23.CJON.507-513
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