Health literacy, pain intensity and pain perception in patients with chronic pain.

BACKGROUND: Chronic pain poses a large burden for the healthcare system and the individuals concerned. The impact of health literacy (HL) on health status and health outcomes is receiving more and more attention. The aim of this study was to evaluate the association of HL with chronic pain intensity and pain perception.

METHODS: A total of 121 outpatients suffering from chronic pain (pain duration >3 months) were evaluated. The HL was measured using the health literacy screening questions. Pain intensity was measured with a Visual Analogue Scale (VAS) and pain perception with the short-form McGill Pain Questionnaire (SF-MPQ).

RESULTS: Individuals with low HL had significantly higher VAS values (Pearson correlation coefficient= -0.270, p = 0.003). Stepwise regression analysis showed that HL has a significant association with pain intensity (odds ratio [OR] = 2.31; 95% confidence interval [CI] 1.11-4.83), even after controlling for age and sex (OR = 2.27; 95% CI 1.07-4.82), but no longer after controlling for education (OR = 2.10; 95% CI 0.95-4.64).

CONCLUSION: Individuals with a higher HL showed less pain intensity, which seems to be caused by a better pain management; therefore, supporting the development of HL in patients with chronic pain could be seen as an important objective of integrated care.