Prevalence of patients with limited health literacy in rotator cuff tears and their experiences with care: a mixed-methods study

Background: Limited health literacy (LHL) can affect the ability to understand and apply health information. For patients with rotator cuff tears, following post-treatment guidelines is crucial for recovery. However, existing resources often don't meet the needs of those with LHL, potentially delaying recovery. This study investigates the prevalence of LHL in patients with rotator cuff tears, the challenges in managing health information, and possible strategies to improve care. Methods: The prevalence of LHL in patients with rotator cuff tears was assessed using the Single-Item Literacy Screener. To explore the challenges in managing health information and possible solutions, semistructured interviews based on the Health Literacy Questionnaire were conducted with twelve patients. Data were collected through audio recordings and field notes, which were transcribed and analyzed using thematic analysis. Results: The prevalence of LHL in patients contacted by phone was 9.3% and 40.7% when contacted at the outpatient clinic. Patients experienced significant language barriers in health care communication, challenges in finding and evaluating relevant health information. These patients reported diverse and specific needs for tailored health information. They suggested using formats that cater to their preferences and sought support from their social networks to better manage their condition and treatment journey. Conclusions: This study adds to the evidence that LHL is common and associated with multiple challenges in health care engagement. Addressing these challenges through personalized, accessible communication strategies, in combination with support from their social environment, should be a priority for health care systems aiming to reduce inequalities and improve patient outcomes in patients with rotator cuff tears.