Oral Health Literacy and Mental Health Among Oral Cancer Patients: A Cross-sectional Study in Ahvaz

Abstract

Background: Oral cancer poses a substantial public health challenge in Southwest Iran, with profound implications for patients' physical and psychological well-being. Objectives: This study aimed to examine the association between oral health literacy and mental health status, including depression, anxiety, and stress, among patients with oral cancer in Ahvaz, Iran. Methods: This cross-sectional study was conducted in 2024 among 74 patients with oral cancer registered in the Khuzestan Cancer Registry. Participants completed two validated questionnaires: the Adult Oral Health Literacy Questionnaire and the Depression, Anxiety, and Stress Scale-21. Data were entered and analyzed using SPSS version 26 for descriptive and inferential statistics. The significance level was set at P < 0.05. Results: The mean oral health literacy score was 6.81 ± 2.72, indicating an inadequate level. Numeracy was the highest competency, whereas listening skills were the poorest. The mental health assessment revealed severe anxiety (16.62 ± 6.43) and moderate levels of depression (15.10 ± 5.63) and stress (19.56 ± 5.85). Age was significantly associated with anxiety (P = 0.04), with older patients reporting higher levels. Education level showed a positive trend, with higher oral health literacy scores (P = 0.005). No significant correlation was found between the oral health literacy score and the Depression, Anxiety, and Stress Scale-21 subscales; however, minor positive correlations were observed between the decision-making/numeracy domains and stress and anxiety. Conclusions: Oral cancer patients in Ahvaz experience a high burden of psychological distress coupled with inadequate oral health literacy. These findings underscore the need for integrated care models that combine targeted oral health literacy interventions with robust psychological support to improve self-management, treatment adherence, and overall quality of life.