TY - JOUR T1 - Effect of Communicative and Critical Health Literacy on Trust in Physicians Among Patients With Systemic Lupus Erythematosus (SLE): The TRUMP2-SLE Project JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.220678 SP - jrheum.220678 AU - Nao Oguro AU - Nobuyuki Yajima AU - Yoshia Miyawaki AU - Ryusuke Yoshimi AU - Yasuhiro Shimojima AU - Ken-ei Sada AU - Keigo Hayashi AU - Kenta Shidahara AU - Natsuki Sakurai AU - Chiharu Hidekawa AU - Dai Kishida AU - Takanori Ichikawa AU - Yuichi Ishikawa AU - Noriaki Kurita Y1 - 2022/11/15 UR - http://www.jrheum.org/content/early/2023/01/10/jrheum.220678.abstract N2 - Objective Patients who trust their physicians have been shown to demonstrate good medication adherence, self-management, and favorable disease outcomes. This study examines how trust in physicians is affected by functional health literacy (HL) and by broader concepts of HL, including communicative HL and critical HL, among patients with systemic lupus erythematosus (SLE). Methods This was a cross-sectional study using baseline data from the Trust Measurement for Physicians and Patients with SLE (TRUMP2-SLE) study, an ongoing multicenter cohort study conducted at 5 academic centers. The 14-item Functional, Communicative, and Critical Health Literacy Scale assessed the 3 dimensions of HL; each item of the scale was scored on a 4-point Likert scale, ranging from 1 to 4. Outcomes were trust in one's physician and trust in physicians in general using the 5-item Wake Forest Physician Trust Scale, which ranged from 0 to 100 points. General linear models were fit. Results A total of 362 patients with SLE were included. Trust in one's physician increased with higher functional and communicative HL (per 1-point increase: mean difference 3.39, 95% CI 0.39-6.39, and mean difference 5.88, 95% CI 2.04-9.71, respectively). Trust in physicians in general increased with higher communicative HL and decreased with higher critical HL (per 1-point increase: mean difference 7.09, 95% CI 2.34-11.83, and mean difference –6.88, 95% CI –11.72 to –2.04, respectively). Longer internet use was associated with both higher communicative and critical HL. Conclusion The findings suggest that rheumatologists need to improve their communication to match each patient's HL, which may foster trust and lead to improved self-management and outcomes in SLE. They also suggest that the formation of the rheumatologist-patient relationship may negate the effect of high critical HL in building trust. ER -