The effect of health literacy on quality of life in individuals with chronic spinal cord injury.

Abstract

STUDY DESıGN: Cross-sectional survey. OBJECTıVES: This study aimed to investigate health literacy (HL) in individuals with spinal cord injury (SCI), focusing on its relationship with quality of life (QoL) and related factors. SETTıNG: Rehabilitation Service, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey. Between May 2025 and October 2025, 61 SCI participants aged 18-70 were enrolled in the Başakşehir Çam and Sakura City Hospital. HL and QoL surveys were administered to the participants. This cross-sectional study collected demographic and survey data from participant records. This study used the Ferrans & Powers Quality of Life Index Spinal Cord Injury Version (QLI) to measure QoL. The Turkey Health Literacy Scale (TSOY-32) was utilized to evaluate HL levels. QLI assesses QoL through four core subdomains: Health and Functioning, Family, Social/ Economic, and Psychological/Spiritual. Among the 61 individuals with SCI, 80.3% were male. Falls were the leading cause of injury, accounting for 44.3% of the cases, and 55.7% of the participants had complete SCI. It was determined that 26.2% of individuals had insufficient HL, 27.9% had problematic/limited HL, 32.8% had adequate HL, and 13.1% had excellent HL levels. A significant positive relationship was found between HL and QoL. Individuals with excellent HL had significantly higher scores on the social and economic subdomains of the QLI compared to those in the insufficient and problematic/limited categories. The multivariable regression model was statistically significant (F (12,48) = 2.649, p = 0.008), explaining 16.5% of the variance in overall QoL (adjusted R² = 0.165). HL levels are positively associated with QoL. For these reasons, conducting studies aimed at enhancing HL in individuals with SCI, particularly through communication and education strategies, would be beneficial.