The relationship between stress, anxiety, and health literacy in parents of children with chronic gastroenterological diseases: a multi-center cross-sectional study.

backgroundParents caring for a child with a chronic illness experience a significant psychological burden, which can manifest as increased stress and anxiety. Furthermore, they must tackle the challenge of understanding the complexities of the healthcare system. In such circumstances, adequate health literacy is necessary to communicate efficiently with healthcare professionals and make informed decisions about a child's care. It also seems that higher health literacy may alleviate the emotional strain faced by such parents. In light of its apparent significance, this study sought to assess the relationship between health literacy and both perceived stress and anxiety for parents of children with chronic gastrointestinal diseases.

methodA survey was administered using paper-and-pencil interviews at five pediatric centers across major Polish cities from May to December 2023, including a convenience sample of 562 parents of children with chronic gastrointestinal conditions. A self-administered questionnaire comprising 84 items was utilized. The instrument integrated validated measures for assessing health and e-health literacy, perceived stress, and anxiety. The hierarchical linear regression models were developed for scores reflecting the intensity of perceived stress and anxiety. The independent variables included in the models were health and e-health literacy scores, sociodemographics, Internet and social media use, as well as the child's age, disease duration, number of hospitalizations, and the use of emergency services in the preceding year.

resultsThe analysis results confirmed that parents with problematic, inadequate, or undetermined health literacy experienced higher stress than those with sufficient health literacy (B, 95%CI: 3.29, 0.94 - 5.64; 2.30, 0.88 - 3.73, and 1.74, 0.14 - 3.34, respectively). Furthermore, lower health literacy was also a significant predictor of higher anxiety (B, 95%CI: 3.37, 1.28 - 5.45, 1.75, 0.49 - 3.01, and 2.14, 0.72 - 3.56, respectively).

conclusionsOur study confirmed that health literacy is an important factor related to the level of perceived stress and anxiety experienced by parents of children with chronic gastrointestinal diseases. Interventions to develop health literacy in this group can result in improved well-being.