The Impact of Health Information Literacy on Decision-Making Conflict in Patients with Comorbid Diabetes and Cancer
DOI:
https://doi.org/10.65761/pjcr.2026.273Keywords:
Decision-making, health information literacy, decision-making conflict, diabetes, cancerAbstract
Background: Low health information literacy could heighten decisional uncertainty in various areas of health care decision making.
Objective: The purpose of this study was to explore how health information literacy affects decision-making conflict and its five subdimensions for patients with comorbid diabetes and cancer.
Methods: A quantitative, cross-sectional design was used with 220 patients. Data were analyzed using reliability analysis, descriptive statistics, normality testing, Pearson and Spearman correlations, multivariate general linear modelling, multivariable regression, confidence-interval checks, and regression-equivalent moderation analysis. The study was conducted in the oncology outpatient department, inpatient oncology unit, and associated diabetes/endocrinology clinic of Mayo Hospital, Lahore, Pakistan. Data collection was conducted between January 2025 and June 2025.
Results: Health information literacy showed higher reliability (α= .950), and the Decision Conflict Scale also demonstrated excellent reliability (α = .976). Total DCS scores were not normally distributed, W = .956, p < .001; therefore, non-parametric and confidence-interval checks were considered alongside parametric models. Health information literacy was negatively associated with total decision conflict, r = -.601, p < .001. The multivariate general linear model showed a significant effect of health information literacy group on the five DCS subscales, Wilks' Lambda = .682, F (10, 420) = 8.87, p < .001. Regression models confirmed that higher health information literacy predicted lower total decision conflict and lower conflict across all five DCS subscales. The regression-equivalent moderation model showed that family support significantly moderated the relationship between health information literacy and effective decision conflict, B = .260, p = .039.
Conclusion: The higher health information literacy level relates to decreased conflict in decision-making in several decisional domains among patients with comorbid diabetes and cancer.
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