Importance Day surgery puts demands on the patients to manage their own recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes.

Objective To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of recovery (SwQoR), and health-related quality of life.

Design, Setting, and Participants This observational study was part of a secondary analysis of a randomized clinical trial of patients undergoing day surgery and was performed in multiple centers from October 2015 to July 2016 and included 704 patients.

Main Outcomes and Measures The primary end point was SwQoR in the FHL groups 14 days after surgery. Secondary end points were health care contacts, EuroQol-visual analog scales, and the Short Form (36) Health Survey in the FHL groups.

Results Of 704 patients (418 [59.4%] women; mean [SD] age with inadequate or problematic FHL levels, 47 [16] years and 49 [15.1], respectively), 427 (60.7%) reported sufficient FHL, 223 (31.7%) problematic FHL, and 54 (7.7%) inadequate FHL. The global score of SwQoR indicated poor recovery in both inadequate (37.4) and problematic (22.9) FHL. There was a statistically significant difference in the global score of SwQoR (SD) between inadequate (37.4 [34.7]) and sufficient FHL (17.7 [21.0]) (P < .001). The patients with inadequate or problematic FHL had a lower health-related quality of life than the patients with sufficient FHL in terms of EuroQol-visual analog scale scores (mean [SD], 73 [19.1], 73 [19.1], and 78 [17.4], respectively; P = .008), physical function (mean [SD], 72 [22.7], 75 [23.8], and 81 [21.9], respectively; P < .001), bodily pain (mean [SD], 51 [28.7], 53 [27.4], and 61 [27.0], respectively; P = .001), vitality (mean [SD], 50 [26.7], 56 [23.5], and 62 [25.4], respectively; P < .001), social functioning (mean [SD], 73 [28.2], 81 [21.8], and 84 [23.3], respectively; P = .004), mental health (mean [SD], 65 [25.4], 73 [21.2], and 77 [21.2], respectively; P < .001), and physical component summary (mean [SD], 41 [11.2], 42 [11.3], and 45 [10.1], respectively; P = .004). There were no differences between the FHL groups regarding health care contacts.

Conclusions and Relevance Inadequate FHL in patients undergoing day surgery was associated with poorer postoperative recovery and a lower health-related quality of life. Health literacy is a relevant factor to consider for optimizing the postoperative recovery in patients undergoing day surgery.

Trial Registration ClinicalTrials.gov Identifier: NCT02492191

重要 日手术要求患者根据给定的指示在家中管理自己的康复。健康素养水平低被证明与健康状况较差有关。

目的 描述瑞典接受日间手术的患者的功能健康素养水平，并描述功能健康素养（FHL）与健康护理接触者，恢复质量（SwQoR）和与健康相关的生活质量之间的关联。

设计，设置和参与者 这项观察性研究是对接受日间手术的患者进行的随机临床试验的次要分析的一部分，该研究于2015年10月至2016年7月在多个中心进行，纳入704位患者。

主要结果和措施 术后14天，FHL组的主要终点是SwQoR。次要终点是卫生保健联络人，EuroQol视觉模拟量表以及FHL组的简短表格（36）健康调查。

结果 704名患者（418名[59.4％]妇女；平均[SD]年龄中FHL水平不足或有问题）分别为47 [16]岁和49 [15.1]岁，其中427名（60.7％）报告了足够的FHL，223名（31.7） ％）有问题的FHL，以及54（7.7％）个不足的FHL。SwQoR的整体评分表明，在FHL不足（37.4）和有问题（22.9）的FHL中，恢复均较差。SwQoR（SD）的整体评分在不充分（37.4 [34.7]）和足够的FHL（17.7 [21.0]）之间有统计学上的显着差异（P  <.001）。FHL不足或有问题的患者的健康相关生活质量要比EuroQol视觉模拟量表评分低的FHL有较低的健康相关生活质量（平均值[SD]，73 [19.1]，73 [19.1]和78 [ 17.4]，分别; P = .008），身体机能（平均[SD]，72 [22.7]，75 [23.8]和81 [21.9]；P  <.001），身体疼痛（平均[SD]，51 [28.7]， 活力（分别为53 [27.4]和61 [27.0]；P = .001），活力（平均[SD]，50 [26.7]，56 [23.5]和62 [25.4]；P  <.001），社会功能（平均[SD]，73 [28.2]，81 [21.8]和84 [23.3]；P  = .004），心理健康（平均[SD]，65 [25.4]，73 [21.2]，分别为77和[21.2]；P  <.001）和物理组件摘要（分别为[SD]，41 [11.2]，42 [11.3]和45 [10.1]；P  = .004）。FHL组之间在医疗保健联系方面没有差异。

结论和相关性 日间手术患者的FHL不足与术后恢复较差和与健康相关的生活质量较低有关。健康素养是在进行日间手术的患者中优化术后恢复的考虑因素。

试验注册 ClinicalTrials.gov标识符：NCT02492191