Date of Award
Doctor of Philosophy in Nursing (PhD)
Geri Wood, PhD - Chair
Terri Armstrong, PhD
Nikhil Padhye, PhD
Matthew Katz, MD
Background: Despite a shared link to cognitive processing of health information suggested by their definitions, information on the association between uncertainty and health literacy is scarce. Their relationship has not been studied in pancreatic cancer patients.
Aims: To evaluate uncertainty and health literacy in pancreatic cancer patients, examine their bivariate correlation, and determine significant predictors.
Methods: This descriptive, cross-sectional study was conducted in a comprehensive cancer center. Uncertainty was measured using the Mishel Uncertainty in Illness Scale -Community and health literacy was measured using the Cancer Health Literacy Test 30. Spearman’s rho tested correlation and linear regression models were used to test for predictors. Bias corrected, accelerated bootstrap was used when regression residuals violated normality.
Results: The sample (N=82) was predominantly male (55%), White/Caucasian (79%), married 74%), and receiving neo-adjuvant treatment in anticipation of potential surgical resection (49%). Mean age was 64.59 years ranging from 30 to 80. A significant but weak correlation was noted between uncertainty and health literacy (rs = -.25, p = .031). Health literacy was not a significant predictor of uncertainty after adjusting for age, gender, education, race/ethnicity, and phase of care. Education was a significant predictor of uncertainty (p < .001; ηp 2 = .276) and health literacy (p =.001; ηp 2 = .220). Race was also a significant predictor of uncertainty (p = .022, ηp 2 = .129) and health literacy (p < .00, ηp 2 = .319) and phase of care was a significant predictor of uncertainty (p = .007; ηp 2 = .162)
Conclusion: Health literacy and uncertainty had a significant albeit weak correlation. Health literacy is multifaceted and some of its features were accounted for by other socioeconomic and clinical variables. Education was a significant predictor of uncertainty and health literacy. Significant differences in the ability to interpret health events were found through the different phases of the pancreatic cancer experience. Although race/ethnicity was a significant predictor of uncertainty and health literacy in this study, inferences and generalizability are restricted by sample homogeneity.
Reynolds, Rae, "Uncertainty in Illness and Health Literacy in Pancreatic Cancer Patients" (2018). Dissertations (Open Access). 29.
uncertainty, health literacy, pancreatic cancer, education, race, treatment phase