Abstract
References
- GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. doi:10.1016/S0140-6736(20)30925-9
- Deyo RA, Mirza SK. The case for restraint in spinal surgery: does quality management have a role to play? Eur Spine J. 2009;18(Suppl 3):S331-7. doi:10.1007/s00586-009-0908-x
- Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun. 2010;15(Suppl 2):9-19. doi:10.1080/10810730.2010. 499985
- Ferlengez AG, Demiröz D. Evaluation of anesthesia-related knowledge and concerns of patients according to their education levels: a survey study. Istanbul Med J. 2023;24(1):88-93. doi:10.4274/imj.galenos.2023. 75418
- De Oliveira GS Jr, McCarthy RJ, Wolf MS, Holl J. The impact of health literacy in the care of surgical patients: a qualitative systematic review. BMC Surg. 2015;15(1):86. doi:10.1186/s12893-015-0073-6
- Lans A, Bales JR, Fivecoat K, et al. Health literacy in orthopedic surgery: a systematic review. HSS J. 2023;19(1):120-127. doi:10.1177/ 15563316221108483
- Özdemir S, Algın A. Türkiye’de sağlık okuryazarlığı. SDÜ Tıp Fakültesi Dergisi. 2020;27(4):566-567. doi:10.17343/sdutfd.814154
- Chang ME, Baker SJ, Dos Santos Marques IC, et al. Health literacy in surgery. HLRP: Health Lit Res Pract. 2020;4(1):e45-65. doi:10.3928/ 24748307-20191121-01
- Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Serv Res. 2022;22(1):1148. doi:10.1186/s12913-022-08527-9
- Muscat DM, Smith J, Mac O, et al. Addressing health literacy in patient decision aids: an update from the International Patient Decision Aid Standards. Med Decis Mak. 2021;41(7):848-869. doi:10.1177/ 0272989X211011101
- Aleid AM, Alkhawajah AA, Alshammary AA, et al. Assessing health literacy and decision-making autonomy in neurosurgical patients: a multi-centre study in Saudi Arabia. J Adv Trends Med Res. 2024;1(1):27-31. doi:10.4103/ATMR.ATMR_124_24
- Gandhi SD, Khanna K, Harada G, et al. Factors affecting the decision to initiate anticoagulation after spine surgery: findings from the AOSpine Anticoagulation Global Initiative. Global Spine J. 2020;12(4):548-558. doi:10.1177/2192568219897598
- Liang Z, Xu M, Liu G, Zhou Y, Howard P. Patient-centred care and patient autonomy: doctors' views in Chinese hospitals. BMC Med Ethics. 2022;23(1):38. doi:10.1186/s12910-022-00777-w
- Seely KD, Higgs JA, Nigh A. Utilizing the "teach-back" method to improve surgical informed consent and shared decision-making: a review. Patient Saf Surg. 2022;16(1):12. doi:10.1186/s13037-022-00322-z
- Zhu L, Mou W, Chen R. Can the ChatGPT and other large language models with internet-connected database solve the questions and concerns of patient with prostate cancer and help democratize medical knowledge? J Transl Med. 2023;21(1):269. doi:10.1186/s12967-023-04123-5
- Baradaran K, Gracia C, Alimohammadi E. Exploring strategies to enhance patient safety in spine surgery: a review. Patient Saf Surg. 2025; 19(1):3. doi:10.1186/s13037-025-00426-2
- Berete F, Gisle L, Demarest S, et al. Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population? BMC Public Health. 2024;24(1):1182. doi:10.1186/s12889-024-18676-7
- Turhan Z, Yalnız Dilcen H, Dolu İ. The mediating role of health literacy on the relationship between health care system distrust and vaccine hesitancy during COVID-19 pandemic. Curr Psychol. 2022;41(11):8147-8156. doi:10.1007/s12144-021-02105-8
- Theiss LM, Wood T, McLeod MC, et al. The association of health literacy and postoperative complications after colorectal surgery: a cohort study. Am J Surg. 2022;223(6):1047-1052. doi:10.1016/j.amjsurg.2021.10.024
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.
References
- GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. doi:10.1016/S0140-6736(20)30925-9
- Deyo RA, Mirza SK. The case for restraint in spinal surgery: does quality management have a role to play? Eur Spine J. 2009;18(Suppl 3):S331-7. doi:10.1007/s00586-009-0908-x
- Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun. 2010;15(Suppl 2):9-19. doi:10.1080/10810730.2010. 499985
- Ferlengez AG, Demiröz D. Evaluation of anesthesia-related knowledge and concerns of patients according to their education levels: a survey study. Istanbul Med J. 2023;24(1):88-93. doi:10.4274/imj.galenos.2023. 75418
- De Oliveira GS Jr, McCarthy RJ, Wolf MS, Holl J. The impact of health literacy in the care of surgical patients: a qualitative systematic review. BMC Surg. 2015;15(1):86. doi:10.1186/s12893-015-0073-6
- Lans A, Bales JR, Fivecoat K, et al. Health literacy in orthopedic surgery: a systematic review. HSS J. 2023;19(1):120-127. doi:10.1177/ 15563316221108483
- Özdemir S, Algın A. Türkiye’de sağlık okuryazarlığı. SDÜ Tıp Fakültesi Dergisi. 2020;27(4):566-567. doi:10.17343/sdutfd.814154
- Chang ME, Baker SJ, Dos Santos Marques IC, et al. Health literacy in surgery. HLRP: Health Lit Res Pract. 2020;4(1):e45-65. doi:10.3928/ 24748307-20191121-01
- Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Serv Res. 2022;22(1):1148. doi:10.1186/s12913-022-08527-9
- Muscat DM, Smith J, Mac O, et al. Addressing health literacy in patient decision aids: an update from the International Patient Decision Aid Standards. Med Decis Mak. 2021;41(7):848-869. doi:10.1177/ 0272989X211011101
- Aleid AM, Alkhawajah AA, Alshammary AA, et al. Assessing health literacy and decision-making autonomy in neurosurgical patients: a multi-centre study in Saudi Arabia. J Adv Trends Med Res. 2024;1(1):27-31. doi:10.4103/ATMR.ATMR_124_24
- Gandhi SD, Khanna K, Harada G, et al. Factors affecting the decision to initiate anticoagulation after spine surgery: findings from the AOSpine Anticoagulation Global Initiative. Global Spine J. 2020;12(4):548-558. doi:10.1177/2192568219897598
- Liang Z, Xu M, Liu G, Zhou Y, Howard P. Patient-centred care and patient autonomy: doctors' views in Chinese hospitals. BMC Med Ethics. 2022;23(1):38. doi:10.1186/s12910-022-00777-w
- Seely KD, Higgs JA, Nigh A. Utilizing the "teach-back" method to improve surgical informed consent and shared decision-making: a review. Patient Saf Surg. 2022;16(1):12. doi:10.1186/s13037-022-00322-z
- Zhu L, Mou W, Chen R. Can the ChatGPT and other large language models with internet-connected database solve the questions and concerns of patient with prostate cancer and help democratize medical knowledge? J Transl Med. 2023;21(1):269. doi:10.1186/s12967-023-04123-5
- Baradaran K, Gracia C, Alimohammadi E. Exploring strategies to enhance patient safety in spine surgery: a review. Patient Saf Surg. 2025; 19(1):3. doi:10.1186/s13037-025-00426-2
- Berete F, Gisle L, Demarest S, et al. Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population? BMC Public Health. 2024;24(1):1182. doi:10.1186/s12889-024-18676-7
- Turhan Z, Yalnız Dilcen H, Dolu İ. The mediating role of health literacy on the relationship between health care system distrust and vaccine hesitancy during COVID-19 pandemic. Curr Psychol. 2022;41(11):8147-8156. doi:10.1007/s12144-021-02105-8
- Theiss LM, Wood T, McLeod MC, et al. The association of health literacy and postoperative complications after colorectal surgery: a cohort study. Am J Surg. 2022;223(6):1047-1052. doi:10.1016/j.amjsurg.2021.10.024
Details
| Primary Language | English |
|---|---|
| Subjects | Brain and Nerve Surgery (Neurosurgery) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | May 30, 2025 |
| Submission Date | April 26, 2025 |
| Acceptance Date | May 5, 2025 |
| Published in Issue | Year 2025 Volume: 7 Issue: 3 |
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