Introduction: There is a wide variation in patient’s involvement in their medical decision-making. Health literacy has been shown to be one of the main factors behind this observed variation. Previous studies have demonstrated a linear relationship between health literacy and self-reported involvement as well as postoperative clinical outcomes. This relationship however has not yet been examined in patients undergoing cardiac surgery, which has a higher rate of complications and mortality and is typically associated with a significant level of stress and anxiety.

Methods: This pilot study aimed to examine the relationship between the degree of health literacy, and self-reported patient involvement and clinical outcomes in 33 patients undergoing cardiac surgery. Additional objectives included the identification of factors influencing the degree of health literacy as well as the assessment of the preoperative and postoperative anxiety level in these patients. Several methodological tools were used in this descriptive and exploratory research opting for a mixed method analysis that include a preoperative and postoperative structured questionnaires, phone or in-person follow-up before the surgery and analysis of the standard documents given to the patients before their surgery. Descriptive and inferential statistical analysis were performed.

Results: Results revealed that patients reporting lower levels of health literacy reported being significantly more anxious. Similarly, results revealed a significant positive correlation between reported health literacy and reported degree of calmness. Furthermore, the higher the reported literacy comprehension, the more reassured patients felt. Patients who reported reading the informative documents reported higher literacy comprehension. Interestingly, these results were not explained by the patients’ level of education or confidence in their surgeon. In fact, while patients’ level of education varied (elementary to doctorate level), all reported high levels of confidence in their surgeon.

Conclusion: The degree of health literacy can play an important role in patient’s involvement in their own decision making when undergoing cardiac surgery. These results provide insight into the factors that could help improve patient’s health literacy proficiency and better assess their level of anxiety preoperatively. Future research is needed to unravel further this relationship and assess whether it has an impact on clinical outcomes.