Researchers determine that patients undergoing same-day surgery, low functional health literacy is associated with poorer postoperative recovery and lower health-related quality of life. Patients in today's health care system are expected to take part and to be engaged in their own care. Consequently, they have to be able to read and understand health instructions on how to manage their own recovery at home.

Functional health literacy (FHL) is defined as "an individual's capacity to gain access to and to understand and use, information in ways to promote and maintain good health. The team analyzed data from 704 patients (mean age, about 48; 59% women), of whom 60.7% reported sufficient FHL, 31.7% problematic FHL, and 7.7% inadequate FHL.

Recovery Levels

Global scores on the Swedish web version of Quality of Recovery (SwQoR) indicated poor recovery (higher scores) in both inadequate (37.4) and problematic (22.9) FHL groups, with a statistically significant difference between sufficient (17.7) and inadequate FHL.

Problems included trouble breathing, sleeping difficulties, not having a general feeling of well-being and having difficulty feeling relaxed. Patients with inadequate FHL also had lower mean scores on the EuroQol-Visual Analog Scale than those with sufficient FHL (73 vs.78), and significantly lower mean scores on physical function (72 vs. 81), bodily pain (51 vs. 61), general health (68 vs.75), vitality (50 vs. 62), mental health (65 vs.77), and the physical component summary (41 vs. 45).

Patients in the problematic FHL group scored significantly lower than the sufficient group on physical function (75 vs. 81), vitality (56 vs. 62), social functioning (81 vs. 84), mental health (73 vs. 77), and the mental component summary (47 vs. 49). Mental health was the only subscore in which patients with inadequate FHL group scored significantly lower than those with problematic FHL (65 vs. 72).

It is important to routinely screen all patients who are planned for day surgery regarding FHL in order to identify those in need of individually designed information and support to optimize their ability to have a good postoperative recovery.

Postoperative Recovery

"It is also important to systematically measure both health literacy and postoperative recovery in day surgery patients and thereby identify both patients with low FHL and patients with poorer quality of recovery, preferably by using digitalized solutions to continuously monitor patients' recovery over time.

Before they can universally implement interventions for patients, who may be most vulnerable (to) adverse outcomes (due to) their health literacy, they have to better define the prevalence of poor health literacy in (the U.S.).

They routinely capture a health literacy 'score' via a nurse-administered questionnaire in both the inpatient and outpatient environments. They are excited to see health literacy continuing to be studied in different venues and hope that as new data reinforces the importance of outcomes-based research, we will see other health systems begin to capture the metric.

At most institutions, including ours, both the patient and their family members are educated about postoperative care and recovery verbally, along with written instructions. However, that usually happens on the day of discharge.

For those with low health literacy, he added, "it would be beneficial for (this information) to be given in an iterative fashion leading up to their discharge, so the information is reinforced, rather than given at one-time point only."