ASCRS Conference Coverage

Education, Surgical Planning Boost Patient Understanding and Trust in Colorectal Surgery

Kate Young

Key Highlights

  • Education beyond high school significantly increases the likelihood of adequate health literacy and trust in colorectal surgeons.
  • Patients with cancer or diverticular disease were less likely to have adequate health literacy or full understanding of their care.

In a cross-sectional study of 200 patients undergoing colorectal surgery, researchers found that educational attainment, disease type, and the presence of a planned surgical procedure were significantly associated with patients’ levels of health literacy, understanding, and trust in their surgeons. Patients with some college education or higher were nearly twice as likely to possess adequate health literacy, and those with scheduled operations demonstrated more than twice the trust in their surgeons compared with those without scheduled procedures. Researchers presented their study results at the American Society of Colon & Rectal Surgery Scientific Meeting in San Diego, CA.

Health literacy is a crucial determinant of patient comprehension and trust, both of which influence outcomes such as adherence to treatment and post-operative recovery. In the complex realm of colorectal surgery, understanding treatment plans can be particularly challenging for patients, making it essential to evaluate how literacy and trust factor into surgical preparedness and satisfaction.

quote from study

This study, conducted at an academic health system’s colon and rectal surgery department, involved patients who had preoperative consultations but no prior surgeries with the attending surgeon. Following their clinic visit, patients completed three assessments: the BRIEF Health Literacy Screening Tool, a self-reported understanding survey, and the Wake Forest Trust Scale. The BRIEF tool categorized literacy as limited (4–12), marginal (13–16), or adequate (17–20). Linked demographic and clinical data were analyzed using logistic mixed models and linear regressions to evaluate associations.

The mean patient age was 54.4 years, with the majority identifying as female (55.5%) and non-Hispanic White (74.5%). Most participants (62%) had a college degree or higher. Education emerged as a strong predictor of adequate health literacy (odds ratio [OR] = 1.92; P < .001). Patients with cancer diagnoses were significantly less likely to have adequate literacy (OR = 0.34), and those with diverticular disease had reduced understanding of surgical care (OR = 0.41; P < .001). Adequate literacy correlated with better understanding, and greater understanding correlated with increased trust (P = .05). Trust levels were notably higher in patients with scheduled inpatient (P = .01) or outpatient (P = .0035) surgeries.

“Routine health literacy screening in surgery clinics can identify patients at risk for lower understanding of complex surgical care,” the study authors concluded. “Multimodal communication tools and pre-operative follow-up visits may assist surgeons in delivering understandable surgical information to their patients and developing more trusting relationships.”

Reference:
Nehemiah A, Appel S, Roberson JL, Goldberg DW, Chu DI, Krouse RS. Health literacy, patient understanding, and trust in colorectal surgery. Presented at: American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting; May 10, 2025; San Diego, CA. https://ascrs25.eventscribe.net/agenda.asp?pfp=ePosters