☆ 4.3 Article

A Structural Equation Model Linking Health Literacy to Self-efficacy, Self-care Activities, and Health-related Quality of Life in Patients with Type 2 Diabetes

ASIAN NURSING RESEARCH (2016)

Journal

ASIAN NURSING RESEARCH

Volume 10, Issue 1, Pages 82-87

Publisher

ELSEVIER SCIENCE INC

DOI: 10.1016/j.anr.2016.01.005

Keywords

diabetes mellitus, type 2; health literacy; quality of life; self care; self efficacy

Funding

Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education, Science and Technology [2012R1A1B5000978]
National Research Foundation of Korea [2012R1A1B5000978] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)

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Abstract

Purpose: Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. Methods: A cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. Results: The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R-2 values, the final model accounted for 20.0% of the variance in self-efficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. Conclusions: This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients. Copyright (C) 2016, Korean Society of Nursing Science. Published by Elsevier. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Relationships Between Mobile eHealth Literacy, Diabetes Self-care, and Glycemic Outcomes in Taiwanese Patients With Type 2 Diabetes: Cross-sectional Study

Sophie Huey-Ming Guo, Hung-Chun Hsing, Jiun-Lu Lin, Chun-Chuan Lee

Summary: This study aimed to understand how people with diabetes seek online health information and use health applications, and to investigate the relationship between mobile eHealth literacy (mobile eHL) and diabetes outcomes in Taiwanese patients with type 2 diabetes. The study found that although patients with diabetes who rated their health conditions as moderate were confident in using mobile eHealth and technology, few adopted these tools in their daily lives. Mobile eHL had a direct effect on self-care behavior as well as knowledge and skills of computers, the internet, and mobile technology, and had an indirect effect on health outcomes.

JMIR MHEALTH AND UHEALTH (2021)