The Relationship Between Health Literacy and Visit Adherence Among Oncology Patients

Abstract

Cancer is a chronic disease that requires long-term treatment and high levels of discipline. However, non-adherence to scheduled visits remains a major barrier to the success of oncological therapy. This study aims to analyze the relationship between health literacy and visit adherence among oncology patients. This was a quantitative observational study using a cross-sectional approach involving 217 oncology patients at the NTB Provincial General Hospital (RSUD Provinsi NTB). The independent variable was health literacy, while the dependent variable was visit adherence. Confounding variables included age, educational level, socioeconomic status, cancer stage, duration of treatment, and type of therapy modality. Data were collected using validated questionnaires and analyzed using the Chi-square test for bivariate analysis and logistic regression for multivariate analysis.The results showed that the majority of respondents were aged ≥40 years (57.1%), highly educated (82.9%), and had high socioeconomic status (54.8%). Clinically, 62.5% of patients were in advanced stages (III/IV) with a treatment duration of < 6 months (60.4%). Most patients (85.3%) exclusively followed hospital medical protocols. The majority of patients' health literacy levels were categorized as good (78.8%), with a visit adherence rate of 71%. Bivariate analysis showed a significant relationship between health literacy and visit adherence (p < 0.001). Patients with low health literacy were 4.7 times more likely to be non-adherent compared to patients with high literacy (OR=4.708; 95% CI: 2.368-9.361). Multivariate analysis confirmed that health literacy is a significant independent predictor of adherence (p = 0.024) after controlling for education, treatment duration, and therapy modality. Simultaneously, these variables contributed 35.1% to patient visit adherence. NTB Provincial General Hospital is advised to optimize patient adherence through transformative education based on participatory approaches, such as the teach-back method, the use of local languages, and the establishment of a patient navigator system to provide ongoing personal and psychosocial support.