Health literacy and attitudes toward complementary and alternative medicine (CAM) among patients with urolithiasis

Abstract

Background: The use of complementary and alternative medicine (CAM) is common among patients with chronic and recurrent conditions, including urinary system stones. Understanding the relationship between patients’ attitudes toward CAM and their level of health literacy is essential for promoting informed and safe use of complementary therapies. Methods: This descriptive study was conducted at the Urology Clinic of Balıkesir University Hospital and included 202 patients who underwent surgery for urolithiasis. Data were collected using a structured questionnaire, the Holistic Complementary and Alternative Medicine Attitude Scale (HCAMAS), and the Health Literacy Scale (HLS). Descriptive statistics, Pearson correlation analysis, and Classification and Regression Tree (CART) analysis were performed. Results: The mean age of the participants was 49.48 ± 13.37 years, and 64.3% reported using CAM, with medicinal waters being the most frequently preferred method (70.63%). Participants demonstrated moderate levels of both CAM attitudes (HCAMAS: 32.69 ± 5.29) and health literacy (HLS: 32.60 ± 8.68). Correlation analyses indicated very weak but statistically significant inverse associations between CAM attitudes and the critical and interactive dimensions of health literacy, as well as between the CAM subdimension and critical health literacy. CART analysis identified educational level as the strongest determinant of both health literacy and CAM attitudes. Conclusion: Although no overall association was observed between CAM attitudes and health literacy, the high prevalence of CAM use underscores the need for targeted patient education regarding complementary therapies. Strengthening health literacy through tailored educational interventions may promote informed decision-making and support the safe integration of CAM with conventional medical care.