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Is the health literacy of informal caregivers associated with the psychological outcomes of breast cancer survivors?

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Abstract

Purpose

To investigate whether health literacy (HL) among informal caregivers of breast cancer (BC) survivors is associated with patient psychological outcomes.

Methods

We used data (n = 340 pairs) from baseline questionnaires administered in the MyHealth trial investigating nurse-led BC follow-up. All BC survivors and their invited caregivers were included immediately after completion of primary treatment. We performed multivariate regression analyses to examine the association between caregiver HL (nine dimensions as measured by the Health Literacy Questionnaire) as exposure and patient depression, anxiety, and health-related quality of life (HQoL) as outcomes. We further examined whether any association differed according to type of caregiver, patient HL, and patient activation (skill in managing one’s health).

Results

Three dimensions, “ability to engage with providers” (β = − 0.2), “navigating the system” (β = − 0.2), and “understand health information” (β = − 0.2), were significantly associated with lower patient depression (p < 0.05), while four dimensions, “having sufficient information” (β = 0.3), “navigating the system” (β = 0.2), “find health information” (β = 0.2), and “understand health information” (β = 0.2), were significantly associated with better patient HQoL (p < 0.05). No significant associations were found for anxiety. Patient HL and activation did not significantly modify the associations, while certain associations for depression were stronger in patients with non-partner caregivers.

Conclusions

The HL of informal caregivers may play an important role in optimizing psychological outcomes in cancer survivors.

Implications for Cancer Survivors

Involving informal caregivers, who can provide support related to health information and services, may be beneficial for the psychological well-being of cancer survivors.

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Funding

The MyHealth trial was funded by the Danish Cancer Society, Region Zealand, Rigshospitalet (Copenhagen University Hospital) and the Capital Region of Denmark.

Author information

Authors and Affiliations

  1. Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Beverley Lim Høeg, Randi Valbjørn Karlsen, Christoffer Johansen & Pernille Envold Bidstrup

  2. Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark

    Marie Hoffmann Frederiksen & Elisabeth Anne Wreford Andersen

  3. Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark

    Lena Saltbæk, Anne Sofie Friberg, Susanne Oksbjerg Dalton & Trine Allerslev Horsbøl

  4. Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark

    Lena Saltbæk & Susanne Oksbjerg Dalton

  5. Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark

    Anne Sofie Friberg & Christoffer Johansen

  6. Department of Psychology, University of Copenhagen, Copenhagen, Denmark

    Pernille Envold Bidstrup

Authors
  1. Beverley Lim Høeg
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  2. Marie Hoffmann Frederiksen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by BLH, MHF, EAWA, LS, RVK, and PEB. The first draft of the manuscript was written by BLH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Beverley Lim Høeg.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Høeg, B.L., Frederiksen, M.H., Andersen, E.A.W. et al. Is the health literacy of informal caregivers associated with the psychological outcomes of breast cancer survivors?. J Cancer Surviv 15, 729–737 (2021). https://doi.org/10.1007/s11764-020-00964-x

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