Health Literacy, Perceived Stigma, Self-Efficacy, and HRQOL in Sickle Cell Disease.
Julia A O'Brien, Ronald L Hickman, Christopher Burant and 2 others
PMID 36377080WHAT IT FOUND
In adults with sickle cell disease, perceived stigma linked to worse physical health and pain.
Self-efficacy partially explained this link for physical health only. Health literacy showed no relationship with any outcome in this highly educated sample.
Key findings
01Health literacy did not correlate with perceived stigma, self-efficacy, health-related quality of life, or pain interference.
02Self-efficacy partially mediated the relationship between perceived stigma and physical health-related quality of life.
03Self-efficacy did not mediate the relationship between perceived stigma and mental health-related quality of life or pain interference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small (60 participants) and underpowered to fully test the mediation hypotheses. The participants were highly educated and recruited primarily through advocacy organizations, which may limit generalizability to the broader sickle cell disease population. The study used a cross-sectional design, so it cannot determine causality. Health literacy scores were high overall, which may have restricted the range needed to detect relationships. Data were collected entirely online during the COVID-19 pandemic, which may have influenced responses to stigma and depression measures.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that health literacy is irrelevant to sickle cell disease outcomes. The lack of association in this study is likely due to the small, highly educated sample that already had high health literacy, leaving little variation to detect a relationship.