Factors Related to Health Literacy in Patients with Uncontrolled Type 2 Diabetes
Keywords:Health Literacy, Uncontrolled Type 2 Diabetes, perceived health status, Social support, Services of diabetes clinic
The purpose of this descriptive survey research was to investigate the health literacy level and factors related to health literacy among people with uncontrolled type 2 diabetes. The sample was made up of 370 people who were attributed with type 2 diabetes and had HbA1C level of > 7% in a diabetes clinic, of hospitals in Uttaradit province. They were randomized by multi-stage random sampling. The research instruments included 2 questionnaires. The first questionnaire was the health literacy questionnaire. The reliability of the first questionnaire was 0.70. The second questionnaire was composed of health status perception's questionnaire, family social support questionnaire, and services of diabetes clinic questionnaire. The reliability of the second questionnaire was 0.70, 0.90, and 0.76, respectively. The data were analyzed by frequency, percentage, mean, standard deviation, Pearson's product moment correlation coefficient and Eta coefficient. The findings revealed that 44.1% of patients with uncontrolled type 2 diabetes had a high health literacy level. Meanwhile, 55.9% had a low health literacy level. The mean value of their health literacy was ( = 168.30, S.D. = 28.57) The health literacy related factors that were found to have positive correlation were the education level (η = .446, p < .001), services of diabetes clinic (r = . 307, p < .001), health status perception (r = . 283, p < .001), and family social support (r = .137, p < .01). However, age was found to have a negative correlation (r = -.345, p < .001). These four associated factors should be promoted to enhance the health literacy of people with uncontrolled type 2 diabetes.
Aekplakorn, W. (Ed.). (2014). The fifth national health examination survey, 2014. Nonthaburi: Health System Research Institute. [In Thai].
Bains, S. & Egede, L. (2011). Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low-income population with type 2 diabetes. Diabetes Technology & Therapeutics, 13(3), 335-341. doi: 10.1089/dia.2010.0160.
Barr, V.J., Robinson, S., Marin-Link, B., Underhill, L., Ravensdale, D. & Sandy, S. (2003). The expanded chronic care model: An integration of concepts and strategies from population health promotion. Model Hospital Quarterly, 7(1), 73-82.
Best, J. W. (1977). Research in education. (3rd ed.). Englewood Cliffs, NJ: Prentice Hall.
Brook, R. H., Ware Jr, J. E., Davies-Avery, A., Stewart, A. L., Donald, C. A., Rogers, W.H., … Johnston, S.A. (1979). Overview of adult health status measures fielded in Rand’s health insurance study. Medical Care, 17(7), 1-131.
Cavanaugh, K.L. (2011). Health literacy in diabetes care: explanation, evidence and equipment. Diabetes management (London, England), 1(2): 191–199. doi: 10.2217/dmt.11.5.
Diabetes Association of Thailand (DAT), Endocrine Society of Thailand, & National Health Security Office. (2017). Clinical practice guidelines for management of diabetes 2017. Pathum Thani: Rom Yen Media. [In Thai].
Department of Disease Control, Division of non-communicable disease. (2018). Indicators of Diabetes and Hypertension report, B.E.2561. Retrieved 15 December 2018 from http://www.thaincd.com/2016/mission/documents- detail.php?id =12966&tid=32&gid=1-020. [In Thai].
Glass, C. J. (2013). Religion and ageing and the role of education. In Sherron, R. H., & Lumsden, D. B. (Eds), Introduction to educational gerontology: Series in death, dying, and bereavement. (3rd ed.), (pp. 108-133). New York: Taylor & Francis.
House, J. (1987). Social support and social structure. Sociological Forum, 2(1), 135-146.
International Diabetes Federation. (2017). IDF Diabetes Atlas. (8th ed). Retrieved 26 November 2018 from http://diabetesatlas.org/resources/2017-atlas.html.
Jordan, J.E., Buchbinder, R. & Osborne, R.H. (2010). Conceptualising health literacy from the patient perspective. Journal of Patient Education and Counseling, 79, 36-42.
Kaeodumkoeng, K & Treepeturai, N. (2011). Health literacy. Bangkok: Thammasat Printing house. [In Thai].
Khumthong, T., Potisiri, W. & Kaeodumkoeng, K. (2016). Factors Influencing health literacy for people at risk of diabetes mellitus and hypertension of Uthai Thani and Ang Thong. Veridian E-Journal, Science and Technology Silpakorn University, 3(6), 67-85. [In Thai].
Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21th century. Health Promotion International, 15(3), 259-267. doi: 10.1093/heapro/15.3.259.
Rasu, R.S., Bawa,W.A., Hu,A., Sharma, R., Stahnke, A.M. & Burros, S. (2018). Evaluation of health literacy in veteran Affairs outpatient population: A focus on patient self-perceived health status. Journal of Community Medicine & Health Education, 8(3). doi: 10.4172/2161-0711.1000613
Rattanawarang, W. & Chantha, W. (2018). Health literacy of self-care behaviors for blood glucose control in patients with type 2 diabetes, Chainat province. The Journal of Baromarajonani Collage of Nursing, 24(2), 34-51. [In Thai].
Reading, S.R., Go, A.S., Fang, M.C., Singer, D.E., Liu, I.A., Black, M.H., … Reynolds, K. (2017). Health literacy and awareness of atrial fibrillation. Journal of the American Heart Association, 6(4), 1-9. doi: 10.1161/JAHA.116.005128
Romero, S.S., Scortegagna, H.M. & Doring, M. (2018). Functional health literacy level and behavior in the health of the elderly. Texto Contexto Enferm, 27(4), 1-12.
Rothman, R.L., Malone, R., Bryant, B., Shintani, A.K., Crigler, B., DeWalt, D.A., … Pignone, M.P. (2004). Influence of patient literacy on the effectiveness of a primary care-based diabetes disease management program. The Journal of the American Medical Association, 14, 1711-1716. doi: 10.1001/jama.292.14.1711
Saeed, H., Saleem, Z., Naeem, R., Shahzadi, I. & Islam, M. (2018). Impact of health literacy on diabetes outcomes: A cross-sectional study from Lahore, Pakistan. Public Health, 156, 8-14. doi: 10.1016/j.puhe.2017.12.005
Saeko, K. (2009). Health literacy among eye surgery patients. Bangkok: Mahidol University. [In Thai].
Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., … Bindman, A.B. (2002). Association of health literacy with diabetes outcomes. Journal of the American Medical Association, 288, 475–482.
Singh, S.G. & Aiken, J. (2017). The effect of health literacy level on health outcomes in patients with diabetes at a type 5 health centre in Western Jamaica. International Journal of Nursing Sciences, 4, 266-270.doi: 10.1016/j.ijnss.2017.06.004.
Stolar, M. (2010). Glycemic control and complications in type 2 diabetes mellitus. American Journal of Medicine, 23(3 Supplement), S3-11.
Sukprasan, T., Rattanawarang, W. & Jaruchawalit, P. (2018). The relationship between functional health literacy and blood sugar level control in patients with type 2 diabetes in Buddhachinaraj Hospital, Phitsanulok. Journal of Health Education, 41(2), 157-167. [In Thai].
Srisatidnarakul, B. (2010). The methodology in nursing research (5th ed.). Bangkok: you & I intermedia. [In Thai].
Thanasukan, C. & Neelapaichit, N. (2016). The survey of health literacy in diabetes and hypertension patients in Thailand. Nontaburi: Health Education Division, Department of Health Service Support, Ministry of Public Health. [In Thai].
Thummaphol, P., Piaseu, N. & Jarupat Maruo, S. (2016). Health literacy and clinical outcomes in people with hypertension, dyslipidemia and type 2 diabetes mellitus. Journal of Nursing and Health Care. 34(3), 176-182. [In Thai].
Toci, E., Burazeri, G., Jerliu, N., Sørensen, K., Ramadani, N., … Brand, H. (2014). Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo. Health Promotion International, 30(3), 667-673. doi:10.1093/heapro/dau009
Uttaradit Provincial Public Health Office. (2018). Documents for government inspections and supervision, Ministry of Public Health in 2018 at Uttaradit province. Uttaradit: Uttaradit provincial public health office. [In Thai].
Wongnisanatakul, K. (2018). Health literacy among diabetic patients at the family practice center of Phra Nakhon Si Ayutthaya Hospital. Journal of Preventive Medicine Association of Thailand, 8(1), 49-61.