Health Literacy, Self-Management and Patient-Reported Outcomes in Prostate Cancer Survivors: A Mixed Methods...

To systematically review the literature to identify the influence of health literacy on self-management behaviours and patient-reported outcomes of individuals with prostate cancer.

A mixed methods systematic was review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews. This review is reported according to PRISMA 2020 statement. Six electronic databases (Medline, CINAHL, PsycInfo, Web of Science, Embase, Scopus) were searched in December 2023 using the key terms "prostate cancer" and "health literacy."

Ten articles describing nine studies were included. The findings indicate that, among those living with a prostate cancer diagnosis, there is a significant association between low health literacy and poorer self-management behaviours and patient-reported outcomes, including poorer quality of life, greater fear of progression and treatment regret. Among the included studies, there was high variability in how low health literacy was measured, evaluated and reported, limiting the ability to draw robust comparisons between the levels of health literacy across the included studies.

This review establishes a relationship between low health literacy and a range of health outcomes for prostate cancer survivors. Further research is needed to consolidate this evidence using validated, comprehensive health literacy measures consistently across studies.

Cancer nurses have a critical role in supporting access, interpretation and utilisation of health information in the self-management of cancer-related effects. Cancer nurses should use universal precautions when communicating with those living with prostate cancer, assuming that anyone may have health literacy difficulties and adjust communication accordingly. Additionally, cancer nurses should also aim to embed information regarding self-management behaviours in routine care for this population.