Associations between quality of life and health literacy in a Norwegian urban cancer population—a cross-sectional study

Background Cancer presents challenges for patients due to its complexity and treatment demands, resulting in a low quality of life. Patients must manage amounts of information, and make care decisions. Health Literacy (HL) may be key to managing these challenges. Existing research suggests an association between health-related quality of life (HRQOL) and HL in cancer patients. However, there remains a limited understanding of how dimensions of HRQOL associate with aspects of HL.Aims Investigate associations between domains of HRQOL and multidimensional HL in cancer patients while controlling for demographic and clinical variables.Methods A cross‑sectional study was conducted at a hospital in Oslo, Norway (2020 to 2022). Patient‑reported measures included HLQ (HL), FACT‑G (HRQOL), EORTC‑OH15 (oral QOL), and sociodemographic data. Clinical data were obtained from questionnaires and medical records. Multivariable linear regression analyses were performedResults We included 54 men and 63 women with cancer at a hospital outpatient clinic (mean age 61 years). Multivariable analysis on the association between HRQOL and HL, controlling for demographic and clinical variables, was performed. Significant associations were found between multiple HL domains, younger age, and fewer comorbidities (St. β ranged −0.20 to −0.39, p ranged .04 to <.001), explaining 6–20% of the variance. No associations with gender, living arrangements, education level, or treatment setting. Associations were observed between higher social well‑being scores and higher HL scores across most HLQ domains; higher emotional, physical, and functional well‑being scores were also associated with higher scores in several HLQ domains. All HLQ domains except appraisal of health information (HLQ5) were associated with HRQOL, HLQ7 (navigation) showed most associations (St. β ranged 0.19–0.53, p ranged 0.04 to <.001, explaining 11–46% of the variance). No associations between oral HRQOL and HL.Discussion This study reveals insights into how aspects of HRQOL associate with different HL dimensions in cancer patients. Higher scores on multidimensional HL—especially social support, patient–provider communication, information access, and navigation—relates to better social, emotional, physical, and functional QOL. The article highlights the need for clinician engagement, information appraisal, and navigation support to improve outcomes and guide HL interventions, and underscores the need to measure both concepts multidimensionally.