Examining the moderating role of health literacy in the relationship between surgical fear and health perception in cataract surgery

Surgical fear in patients undergoing cataract surgery may negatively affect compliance and outcomes. However, its interaction with health perception and health literacy remains unclear. It is clinically significant to understand the impact of health literacy on the connection between health perception and fear of surgery. This study aimed to explore the association between surgical fear and health perception and to assess whether health literacy moderates this relationship among patients awaiting cataract surgery. A descriptive, correlational design was conducted with 225 patients at a university hospital’s eye clinic between April and August 2025. Data were collected prior to surgery through face-to-face interviews using the Sections “Personal information form,” “Surgical fear scale,” “Health perception scale,” and “Health literacy scale.” The mean scores were: surgical fear 6.38 ± 10.98, health perception 51.35 ± 4.98, and health literacy 95.44 ± 19.08. No significant correlation was observed between surgical fear and either health perception or health literacy. However, a strong positive correlation was found between health perception and health literacy. Moderation analysis indicated that health literacy significantly moderated the relationship between health perception and surgical fear. Simple slope analysis showed that, among patients with low health literacy, lower health perception was associated with higher surgical fear, whereas no significant association was observed among those with high health literacy. Among patients awaiting cataract surgery, health literacy moderated the relationship between health perception and surgical fear. Lower health perception was associated with greater surgical fear among individuals with low health literacy, whereas this association was not significant among those with high health literacy. These findings suggest that considering patients’ health literacy levels may help inform the development of tailored preoperative communication and counselling strategies for cataract surgery. Not applicable.