Effects of health literacy improvement program on self-care behaviors and health outcomes in older adults with type 2 diabetes and hypertension comorbidities 10.55131/jphd/2022/200203
Article Sidebar
Main Article Content
Abstract
Health literacy is a necessary factor affecting self-care behaviors. This randomized control trial research aimed to study the effects of a health literacy improvement program on self-care behaviors and health outcomes in older adult patients with diabetes and hypertension comorbidities. Older adults at a private primary care unit, Bangkok, Thailand; aged 60-69 years, who had been diagnosed with diabetes and hypertension, were selected by simple random sampling into experimental and control groups, of 30 people each. The experimental group received eight weeks of a health literacy improvement program. Group activities were held in three sessions at 4-week intervals. The control group received standard care only. Data were collected by using interview questionnaires at baseline, post-intervention, and follow-up. Research instrumentation included collected data on general characteristics and illness history. Health literacy, self-care behavior, healthy eating, physical activity, stress management, and medication adherence scales were also included. In addition, blood pressure and HbA1C were examined at baseline and follow-up. Descriptive statistics, independent t-test, chi-square, Repeated Measures ANOVA, and Bonferroni post hoc test were used for data analysis. After the intervention and follow-up, the experimental group had the following mean scores: health literacy (ME.118.33±7.79, 123±4.90; MC 94.53±7.51; 94.17±5.86, p< .001), self-care behaviors in healthy eating (ME 49.10±3.14, 52.13±3.19; MC 43.70±2.83, 43.66±3.25, p< .001), physical activities (ME36.90±2.26, 38.53±2.56; MC 26.90±2.67,26.83±2.67, p<.001), stress management (ME26.83±1.89, 28.30±1.89; MC 21.33±2.00,21.60±2.09, p<.001), and medication adherence (ME34.60±2.47, 36.07±1.87; MC 27.40±2.64, 28.30±3.18, p< .001), all of which were significantly higher than the control group. Furthermore, HbA1C (Diff_ME -0.46±0.50; Diff_MC.0.06±0.45, p< .05) and systolic blood pressure (Diff_ME -9.70±9.29; Diff_MC. -1.26± 12.89, p< .05) were significantly lower than the control group.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Foundation of Thai Gerontology Research and Development Institute. Situation of the elderly in Thailand. [Cited 2020 Aug 16]. Available from: https://thaitgri.org/
Jiamjarasrangsri W. Type 2 diabetes epidemiology, prevention and support self-management. 1st ed. Bangkok: Text and Journal Publication; 2017.
Petrie JR, Guzik TJ, Touyz RM. Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Can J Cardiol. 2018;34(5):575-84.doi: 10.1016/j.cjca.2017.12.005.
Wang Z, Yang T, Fu H. Prevalence of diabetes and hypertension and their interaction effects on cardio-cerebrovascular diseases: a cross-sectional study. BMC Public Health. 2021;21(1):1224. doi: https://doi.org/10.1186/s12889-021-11122-y
Thai Hypertension Society. 2019 Thai Guidelines on the Treatment of Hypertension [Internet]. 2019. Chaingmai: Trickthink; 2019 [Cited 2020 Aug 16]. Available from: http://www.thaihypertension.org/guideline.html
Abdullah A, Liew SM, Salim H, Ng CJ, Chinna K. Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review. PLOS ONE. 2019;14(5):e0216402. doi: 10.1371/journal.pone.0216402
Bailey SC, Brega AG, Crutchfield TM, Elasy T, Herr H, Kaphingst K, et al. Update on health literacy and diabetes. Diabetes Educ. 2014;40(5):581-604. doi: 10.1177/0145721714540220
Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med. 2004;19(12):1228-39. doi: 10.1111/j.1525-1497.2004.40153.x.
Fransen MP, von Wagner C, Essink-Bot ML. Diabetes self-management in patients with low health literacy: ordering findings from literature in a health literacy framework. Patient Educ Couns. 2012;88(1):44-53. doi: 10.1016/j.pec.2011.11.015
Diabetes Association of Thailand under the Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn. Practice Guideline for Diabetes 2017 [Internet]. 2017 [Cited 2020 Aug 16]. Available from: https://www.dmthai.org/index.php/knowledge/healthcare-providers/cpg/443-guideline-diabetes-care-2017
Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67(12):2072-8. doi: 10.1016/j.socscimed.2008.09.050
Aaby A, Friis K, Christensen B, Rowlands G, Maindal HT. Health literacy is associated with health behaviour and self-reported health: A large population-based study in individuals with cardiovascular disease. Eur J Prev Cardiol. 2017;24(17):1880-8. doi: 10.1177/2047487317729538
Reisi M, Fazeli H, Mahmoodi M, Javadzade H. Application of the social cognitive theory to predict self-care behavior among type 2 diabetes patients with limited health literacy. Journal of Health Literacy. 2021;6(2):21-32.
Norasing M, Thanomphan S. Health literacy and health behavior in patients with uncontrolled blood sugar level or blood pressure: a case study of Nakornping Hospital, Chiang Mai. J Nakornping Hosp. 2019;10(1):36-50
Mitty E, Flores S. Assisted living nursing practice: health literacy and chronic illness management. Geriatr Nurs. 2008;29(4):230-5. doi: 10.1016/j.gerinurse.2008.06.007.
Cavanaugh KL. Health literacy in diabetes care: explanation, evidence and equipment. Diabetes Manag (Lond). 2011;1(2):191-9. doi: 10.2217/dmt.11.5.
McDonald M, Shenkman LJ. Health Literacy and Health Outcomes of Adults in the United States: Implications for Providers. IJAHSP. 2018;16(4). doi: 10.46743/1540-580X/2018.1689
Souza JG, Apolinario D, Magaldi RM, Busse AL, Campora F, Jacob-Filho W. Functional health literacy and glycaemic control in older adults with type 2 diabetes: a cross-sectional study. BMJ Open. 2014;4(2):e004180. doi: 10.1136/bmjopen-2013-004180.
Caruso R, Magon A, Baroni I, Dellafiore F, Arrigoni C, Pittella F, et al. Health literacy in type 2 diabetes patients: a systematic review of systematic reviews. Acta Diabetol. 2018;55(1):1-12. doi: 10.1007/s00592-017-1071-1
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: L. Erlbaum Associates; 1988. p. 567
Chiangkhong A, Intarakamhang U, Duangchan P, Macaskill A. Effectiveness of Health Literacy through Transformative Learning on Glycemic control Behavior in Adult Diabetes Patients: A Mixed Methods Approach. TJBS. 2019;14(3):49-61.
Intarakamhang U, Macaskill A. Effectiveness of a health literacy intervention based on transformative learning and incorporating positive psychology on health behavior and well-being of Thai families with NCDs risk. J Public Health Res. 2021;11(2). doi: 10.4081/jphr.2021.1935
Saentecha P, Lamluk P. The Effectiveness of a Program for Health Literacy Development in the Patients with Type 2 Diabetes. TH J of Health Edu. 2020;43(2):150-64.
Pannak P, Moolsart S, Kaewprom C. The Effectiveness of a Program for Health Literacy Development of the Patients with Uncontrolled Type 2 Diabetes at. Nursing Journal of The Ministry of Public Health. 2018;27(3):91-106.
Rattanapongsai P, Lagampan S, Pitchayapinyo P. Impact of a Medication Literacy Programme on Uncontrolled Type 2 Diabetic Patients’ Health Literacy on Medication and Medication Adherence. Thai Journal of Nursing Council. 2016;31(4) 50-62.
Thepin K, Moolsat S, Jantacumma N. Effectiveness of a Health Literacy Developmental Program in Patients with Uncontrolled Hypertension. Boromarajonani College of Nursing, Uttaradit Journal. 2018;11(1):197-212.
Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi: 10.1186/1471-2458-12-80