Health Literacy Assessment Tools in Spine Surgery.

Area of Science:

• Spine Surgery
• Health Literacy Assessment
• Patient Outcomes

Background:

• Health literacy (HL) significantly impacts patient-reported outcomes (PROs) in spine surgery.
• Current HL assessment tools often lack specificity for spinal conditions and fail to capture multidimensional HL aspects (e.g., numeracy, visual comprehension).

Purpose of the Study:

• To systematically review and synthesize existing health literacy (HL) assessment tools utilized in spine surgery.
• To identify the strengths, weaknesses, and research gaps in measuring spine-specific HL.

Main Methods:

• A scoping review was conducted using PubMed, Embase, and Cochrane Library databases (2014-2024).
• Included studies assessed HL in patients with spinal conditions, extracting data on study design, HL tools, HL dimensions, and sociodemographic factors.
• Descriptive analysis was employed to synthesize the findings.

Main Results:

• Nine studies involving 2958 patients identified eight HL tools (3 objective, 5 subjective).
• Assessed HL dimensions included print, numeracy, oral, and visual comprehension, with no tools specifically addressing spine-related literacy.
• Limited HL (9%-50%) was linked to older age, lower education, non-native English speakers, and socioeconomic disparities.

Conclusions:

• Current HL assessment tools in spine surgery are predominantly general and lack essential spine-specific content.
• A comprehensive, multidimensional HL tool tailored for spine surgery is necessary to enhance patient comprehension and facilitate shared decision-making.