Health literacy, the ability to seek, understand and utilise health information, is important for health and health-related decisions. Suboptimal health literacy is associated with poorer health outcomes in many chronic conditions although this has not been studied in chronic low back pain (CLBP). This study explored health literacy in a community cohort with and without CLBP. 117 adults, comprising 61 with no history of CLBP and 56 with CLBP (28 with low and high disability, respectively, determined by a median split in Oswestry scores) participated. Using a mixed methods approach, data were collected on pain severity, LBP-related disability, fear avoidance, LBP beliefs, pain catastrophizing and health literacy was measured using the Short-form Test of Functional Health Literacy in Adults (S-TOFHLA). In-depth interviews were undertaken with 36 CLBP participants to explore beliefs about LBP and experiences in seeking, understanding and using LBP information. LBP-related beliefs and behaviours, rather than pain intensity and health literacy skills, were associated with disability related to LBP. Individuals with CLBP-high disability had poorer back pain beliefs and increased fear avoidance behaviours relating to physical activity. Although S-TOFHLA scores suggested adequate health literacy across all participants and these were not related to LBP beliefs and attitudes, interviews revealed that individuals with CLBP-high disability adopted a more passive coping style and had a patho-anatomical view of their disorder compared to individuals with CLBP-low disability.Purpose
Methods and results
