{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T08:49:25Z","timestamp":1774687765524,"version":"3.50.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Orthop Relat Res"],"published-print":{"date-parts":[[2018,4]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Health literacy is the ability to obtain, process, and understand health information needed to make appropriate health decisions. The proper comprehension by patients regarding a given disease, its treatment, and the physician\u2019s instructions plays an important role in shared decision-making. Studies have disagreed over the degree to which differences in health literacy affect patients\u2019 preferences for shared decision-making; we therefore sought to evaluate this in the context of shared decision-making about carpal tunnel release.<\/jats:p>\n <\/jats:sec>\n \n Questions\/purposes<\/jats:title>\n (1) Do patients with limited health literacy have different preferences of shared decision-making for carpal tunnel release than those with greater levels of health literacy? (2) How do patients with limited health literacy retrospectively perceive their role in shared decision-making after carpal tunnel release?<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Over a 32-month period, one surgeon surgically treated 149 patients for carpal tunnel syndrome. Patients were eligible if they had cognitive and language function to provide informed consent and complete a self-reported questionnaire and were not eligible if they had nerve entrapment other than carpal tunnel release or had workers compensation issues; based on those, 140 (94%) were approached for study. Of those, seven (5%) were lost to followup before 6 months, leaving 133 for analysis here. Their mean age was 55 years (range, 31\u201376 years), and 83% (111 of 133) were women. Thirty-three percent (44 of 133) of patients had less than a high school education. Health literacy was measured according to the Newest Vital Sign during the initial visit, and a score of \u2264 3 was considered limited health literacy. Forty-four percent of patients had limited health literacy. The Control Preferences Scale was used for patients to indicate their preferred role in surgical decision-making preoperatively and to assess their perceived level of involvement postoperatively. Bivariate and multivariable analyses were performed to determine whether patients\u2019 clinical, demographic, and health literacy factors accounted for the preoperative preferences and postoperative assessments of their role in shared decision-making. A total of 133 patients would provide 94% power for a medium effect size for linear regression with five main predictors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We found no differences between patients with lower levels of health literacy and those with greater health literacy in terms of preferences of shared decision-making for carpal tunnel release (3.0 \u00b1 1.6 versus 2.7 \u00b1 1.4; mean difference, 0.3; 95% confidence interval, -0.2 to 0.8; p = 0.25). A history of surgical procedures (coefficient = -0.32, p < 0.01) and a lower Disabilities of the Arm, Shoulder and Hand score (coefficient = 0.17, p = 0.02) were independently associated with a preference for an active role in shared decision-making. However, patients with limited health literacy (coefficient = -0.31, p = 0.01) and an absence of a caregiver (coefficient = -0.28, p = 0.03) perceived a more passive role in actual decision-making.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Physicians should be aware of the discrepancy between preferences and perceptions of shared decision-making among patients with limited health literacy, and physicians should consider providing a decision aid tailored to basic levels of health literacy to help patients achieve their preferred role in decision-making.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n Level II, prognostic study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s11999.0000000000000075","type":"journal-article","created":{"date-parts":[[2018,4,27]],"date-time":"2018-04-27T16:07:25Z","timestamp":1524845245000},"page":"846-851","source":"Crossref","is-referenced-by-count":21,"title":["Patients With Limited Health Literacy Have Similar Preferences but Different Perceptions in Surgical Decision-making for Carpal Tunnel Release"],"prefix":"10.1097","volume":"476","author":[{"given":"Young Hak","family":"Roh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Do","family":"Koh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Oh","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Ho","family":"Noh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Sik","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goo Hyun","family":"Baek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2018,2,22]]},"reference":[{"key":"R1-20230814","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1007\/s11606-013-2466-5","article-title":"The impact of health literacy on desire for participation in healthcare, medical visit communication, and patient reported outcomes among patients with hypertension","volume":"28","author":"Aboumatar","year":"2013","journal-title":"J Gen Intern Med"},{"key":"R2-20230814","first-page":"369","article-title":"Health literacy, communication, and treatment decision-making in older cancer patients","volume":"23","author":"Amalraj","year":"2009","journal-title":"Oncology (Williston Park)."},{"key":"R3-20230814","first-page":"1038","article-title":"Development of the QuickDASH: comparison of three item-reduction approaches","volume":"87","author":"Beaton","year":"2005","journal-title":"J Bone Joint Surg Am."},{"key":"R4-20230814","doi-asserted-by":"crossref","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: an updated systematic review","volume":"155","author":"Berkman","year":"2011","journal-title":"Ann Intern Med"},{"key":"R5-20230814","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.pec.2011.02.004","article-title":"Patient preferences for shared decisions: a systematic review","volume":"86","author":"Chewning","year":"2012","journal-title":"Patient Educ Couns"},{"key":"R6-20230814","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.2106\/00004623-200407000-00003","article-title":"The moving target: a qualitative study of elderly patients' decision-making regarding total joint replacement surgery","volume":"86","author":"Clark","year":"2004","journal-title":"J Bone Joint Surg Am."},{"key":"R7-20230814","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1177\/1753193415622341","article-title":"Interpretation of the QuickDASH score after open carpal tunnel decompression: threshold values associated with patient satisfaction","volume":"41","author":"Clement","year":"2016","journal-title":"J Hand Surg Eur Vol"},{"key":"R8-20230814","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S0738-3991(98)00123-2","article-title":"Information and patient participation in screening for prostate cancer","volume":"37","author":"Davison","year":"1999","journal-title":"Patient Educ Couns"},{"key":"R9-20230814","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.1369-7625.2007.00441.x","article-title":"Do people want to be autonomous patients? Preferred roles in treatment decision-making in several patient populations","volume":"10","author":"Deber","year":"2007","journal-title":"Health Expect"},{"key":"R10-20230814","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1001\/jama.1997.03540420081039","article-title":"Information needs and decisional preferences in women with breast cancer","volume":"277","author":"Degner","year":"1997","journal-title":"JAMA"},{"key":"R11-20230814","first-page":"21","article-title":"The Control Preferences Scale","volume":"29","author":"Degner","year":"1997","journal-title":"Can J Nurs Res."},{"issue":"Suppl 2","key":"R12-20230814","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/10810730.2014.938841","article-title":"Health literacy, numeracy, and other characteristics associated with hospitalized patients' preferences for involvement in decision making","volume":"19","author":"Goggins","year":"2014","journal-title":"J Health Commun"},{"key":"R13-20230814","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.2106\/JBJS.J.00951","article-title":"Patients' preferred and retrospectively perceived levels of involvement during decision-making regarding carpal tunnel release","volume":"93","author":"Gong","year":"2011","journal-title":"J Bone Joint Surg Am."},{"key":"R14-20230814","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1007\/BF02595921","article-title":"Patients' participation in medical care: effects on blood sugar control and quality of life in diabetes","volume":"3","author":"Greenfield","year":"1988","journal-title":"J Gen Intern Med"},{"key":"R15-20230814","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1471-2474-7-44","article-title":"The shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH","volume":"7","author":"Gummesson","year":"2006","journal-title":"BMC Musculoskelet Disord"},{"key":"R16-20230814","doi-asserted-by":"crossref","first-page":"3542","DOI":"10.1007\/s11999-015-4375-x","article-title":"Do upper extremity trauma patients have different preferences for shared decision-making than patients with nontraumatic conditions?","volume":"473","author":"Hageman","year":"2015","journal-title":"Clin Orthop Relat Res."},{"key":"R17-20230814","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1159\/000126073","article-title":"Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status","volume":"77","author":"Joosten","year":"2008","journal-title":"Psychother Psychosom"},{"key":"R18-20230814","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/BOT.0b013e3182793338","article-title":"Health literacy in an orthopedic trauma patient population: a cross-sectional survey of patient comprehension","volume":"27","author":"Kadakia","year":"2013","journal-title":"J Orthop Trauma"},{"key":"R19-20230814","doi-asserted-by":"crossref","first-page":"2701","DOI":"10.1001\/jama.288.21.2701","article-title":"Effects of decision aids for menorrhagia on treatment choices, health outcomes, and costs: a randomized controlled trial","volume":"288","author":"Kennedy","year":"2002","journal-title":"JAMA"},{"key":"R20-20230814","first-page":"27","article-title":"Measuring the level of health literacy and influence factors: targeting the visitors of a university hospital's outpatient clinic","volume":"17","author":"Kim","year":"2011","journal-title":"J Korean Clin Nurs Res."},{"key":"R21-20230814","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1177\/0272989X07306782","article-title":"\u2018It's my body\u2019: does patient involvement in decision making reduce decisional conflict?","volume":"27","author":"Kremer","year":"2007","journal-title":"Med Decis Making."},{"key":"R22-20230814","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/0272989X09342279","article-title":"The challenge of shared decision making among patients with lower literacy: a framework for research and development","volume":"30","author":"McCaffery","year":"2010","journal-title":"Med Decis Making"},{"key":"R23-20230814","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1136\/bmj.323.7311.493","article-title":"Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care","volume":"323","author":"Murray","year":"2001","journal-title":"BMJ"},{"key":"R24-20230814","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jhsa.2013.12.025","article-title":"The effect of patient involvement in surgical decision making for carpal tunnel release on patient-reported outcome","volume":"39","author":"Nam","year":"2014","journal-title":"J Hand Surg Am."},{"key":"R25-20230814","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/BF02640361","article-title":"The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills","volume":"10","author":"Parker","year":"1995","journal-title":"J Gen Intern Med."},{"key":"R26-20230814","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.amepre.2006.07.025","article-title":"Patient understanding of food labels: the role of literacy and numeracy","volume":"31","author":"Rothman","year":"2006","journal-title":"Am J Prev Med."},{"key":"R27-20230814","first-page":"CD003905","article-title":"Surgical treatment options for carpal tunnel syndrome","volume":"4","author":"Scholten","year":"2007","journal-title":"Cochrane Database Syst Rev."},{"key":"R28-20230814","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1136\/bmj.322.7284.444","article-title":"Towards a global definition of patient centred care","volume":"322","author":"Stewart","year":"2001","journal-title":"BMJ"},{"key":"R29-20230814","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1370\/afm.405","article-title":"Quick assessment of literacy in primary care: the newest vital sign","volume":"3","author":"Weiss","year":"2005","journal-title":"Ann Fam Med"},{"key":"R30-20230814","doi-asserted-by":"crossref","first-page":"227","DOI":"10.5993\/AJHB.32.3.1","article-title":"Relationship of preventive health practices and health literacy: a national study","volume":"32","author":"White","year":"2008","journal-title":"Am J Health Behav"}],"updated-by":[{"DOI":"10.1097\/corr.0000000000001501","type":"retraction","label":"Retraction","source":"retraction-watch","updated":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T00:00:00Z","timestamp":1602201600000},"record-id":"24396"}],"container-title":["Clinical Orthopaedics & Related Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00003086-201804000-00036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T05:39:16Z","timestamp":1691991556000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00003086-201804000-00036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,22]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1007\/s11999.0000000000000075","relation":{},"ISSN":["0009-921X"],"issn-type":[{"value":"0009-921X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,22]]}}}