Association between health literacy and satisfaction with health care among parents of long-term ill children: a cross-sectional study

Background: Inadequate health literacy has been shown to impact patient satisfaction with health care, a frequently used measure of health care quality. Low parental satisfaction with paediatric care can lead to lower compliance with prescribed medication and treatment and thus worsen the child's health outcomes. This study explored the relationship between the health literacy of parents of long-term ill children and parents’ satisfaction with the health care, and whether this relationship varied by the introduction of an eHealth device. Methods: : This cross-sectional study was based on the data collected in a larger clinical study from questionnaires filled out by 77 parents of chronically ill children admitted to neonatal and specialized surgery departments in southern Sweden between August 2019 and June 2020. Statistical analysis was performed using Mann Whitney and Kruskal-Wallis nonparametric tests, Spearman's rank correlation and multivariate logistic regression. Results: : A substantial and statistically significant correlation was observed between parental health literacy and almost all dimensions of parental satisfaction, with the highest correlation between health literacy and satisfaction with information (r=0.476, p<0.001). Health literacy was a significant independent predictor of high satisfaction with information and technical skills, and high overall satisfaction. An eHealth communication device moderated the relationship between health literacy and satisfaction with communication. Conclusion: The study indicates that health literacy is among important predictors of parents’ satisfaction with health care. Health services should be sensitive to variations in parental health literacy and should tailor information and communication to parental needs to secure the best health outcomes for chronically sick children. Further studies are needed to evaluate the clinical benefits of assessing parental health literacy for child health outcomes. Trial registration: ClinicalTrials.gov identifier: NCT04150120.