The effect of health literacy on spinal surgery decision in neurosurgery patients

Abstract

Aims: The aim of the study was to determine how health literacy affects Turkish neurosurgery patients' spine surgery preferences and to identify barriers to obtaining informed consent and thus create better patient education methods. Methods: The research included 118 patients who visited the neurosurgery outpatient clinic for spinal complaints. The Turkish Health Literacy Scale (TSOY-32) was used to evaluate patients who received four different health literacy assessments: inadequate (23.7%), problematic (36.4%), sufficient (28.8%), and excellent (11.0%). Results: Patients who demonstrated better health literacy showed decreased acceptance of surgical procedures (82.1% inadequate vs. 46.2% excellent, p=0.023) and increased second opinion seeking (25.0% vs. 69.2%, p<0.001). The logistic regression analysis demonstrated that patients with sufficient and excellent health literacy showed 72% and 81% decreased odds of accepting surgery when compared to patients with inadequate literacy. The factors that influenced patient choices depended on their literacy level because physician recommendations proved more significant for patients with low literacy (92.9% vs. 53.8%, p=0.008) and personal research became more important for patients with high literacy (25.0% vs. 92.3%, p<0.001). The study found that education level strongly correlated with health literacy (r=0.72, p<0.001) and health literacy strongly correlated with decision satisfaction (r=0.59, p<0.001). Conclusion: The research demonstrates that health literacy assessment during surgical consultations combined with specific communication approaches helps patients make informed decisions in neurosurgical practice.

Keywords

• Health literacy
• neurosurgery
• patient decision-making
• spinal surgery

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