Quality of life and fear of disease progression are associated with aspects of health literacy in men with prostate cancer from Germany

Purpose: Our research aimed to identify whether specific aspects of health literacy (HL) are associated with quality of life (QOL) and fear of progression (FOP) in men with prostate cancer (PC).

Methods: We conducted a cross-sectional study. Regarding HL, we surveyed communication skills, guideline awareness, and knowledge in several domains: PC, health care system, own physical condition, dealing with health problems. Research questions were addressed using regression models for QOL and FOP including sociodemographic and disease-related variables as additional predictors.

Results: One thousand five hundred seventy-seven men completed the questionnaire. Better QOL was statistically significant associated with communication skills (OR 2.24; CI 1.57-3.21), knowledge of dealing with health problems (OR 2.54; CI 1.74-3.72), and knowledge of own physical condition (OR 0.63; CI 0.42-0.95). FOP decreased with increasing communication skills (β - 0.09; CI - 0.15 to - 0.04), knowledge of health care system (β - 0.07; CI - 0.12 to - 0.02), and knowledge of dealing with health problems (β - 0.21; CI - 0.27 to - 0.15). It increased with guideline awareness (β 0.07; CI 0.02-0.11), PC knowledge (β 0.11; CI 0.06-0.16), and knowledge about own physical condition (β 0.11; CI 0.05-0.17).

Conclusions: The findings lead to the hypothesis that some aspects of HL may have a positive and some a negative influence on men with PC. Men should not be overwhelmed by a recommendation for self-observation or by promotion of PC knowledge. Interventions are needed that provide knowledge for managing health problems. Communication in health care should be tailored to men's needs.