Access to health information, health literacy and health-related quality of life among women living with breast cancer: Depression and anxiety as mediators

Objective: This study examined the direct and indirect influences of health literacy and access to health information on the quality of life among 205 women living with breast cancer in Ghana. Methods: A cross-sectional survey design was employed. The interviewer-administered instrument included the health literacy scale, questions on access and satisfaction with healthcare information, depression and anxiety scale, and the Functional Assessment of Cancer Therapy-Breast Cancer. Results: Access to health information and health literacy had significant indirect effects on quality of life through depression and anxiety. Whereas health literacy had direct influence on quality of life after controlling for other factors, access to information had no direct influence on quality of life. Conclusion: Health literacy and access to health information improve quality of life in women living with breast cancer by reducing the levels of depression and anxiety. Depression and anxiety serve as possible mechanisms for the positive impacts of access to health information and health literacy on improved quality of life among breast cancer patients. Practice implications: Health care providers need to ensure that the information needs of patients are met in oncology practice to reduce their negative emotional states which would lead to improved health and wellbeing. (C) 2019 Elsevier B.V. All rights reserved.