DOI QR코드

DOI QR Code

The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes

  • Jeong, Jihye (Department of Nursing, College of Medicine, Inje University) ;
  • Park, Namhee (Department of Nursing, College of Medicine, Inje University) ;
  • Shin, So Young (Department of Nursing, College of Medicine, Inje University)
  • Received : 2014.06.05
  • Accepted : 2014.09.29
  • Published : 2014.09.30

Abstract

Purpose: This study aimed to assess the levels of and relationships among health literacy, knowledge about diabetes, and self-care activities in the Korean low-income elderly with diabetes and to identify factors influencing the self-care activities of this vulnerable population. Methods: This study surveyed a total of 151 low-income elderly patients with diabetes registered at 16 Visiting Health Care Services in B City, Korea. Health literacy was measured with the Newest Vital Sign. Diabetes knowledge was measured with the Diabetes Knowledge Test. The Summary of Diabetes Self-care Activities Questionnaire was used to assess diabetes self-care activities. A stepwise multiple regression analysis was conducted to identify significant factors influencing diabetes self-care activities in these patients. Results: In the regression model, diabetes knowledge (${\beta}=.322$, p<.001), exercise (${\beta}=.337$, p<.001), and experiences of diabetes education (${\beta}=.241$, p=.001) were significantly associated with increased diabetes self-care activities in low-income elderly patients with diabetes when gender, education, health literacy, and subjective health state were controlled. Conclusion: To improve diabetes self-care activities in the low-income elderly with diabetes, it is important to develop a customized program considering their knowledge, exercise, and diabetes education experience.

References

  1. Korea Centers for Disease Control & Prevention. Korea health statistics 2011: The 5th Korea national health and nutrition examination survey. Policy Report. Seoul: Korea Centers for Disease Control & Prevention; 2012 December. Report No.: 11-1351159-000027-10.
  2. Ministry of Health and Welfare. The 3rd national health promotion strategy 2011-2020 (HP2020). Policy Report. Seoul: Ministry of Health and Welfare; 2011 June. Report No.:11-1352000-000285-13.
  3. Kim HY, Yun WJ, Shin MH, Kweon SS, Ahn HR, Choi SW, et al. Management of diabetic mellitus in low-income rural patients. Korean Journal of Preventive Medicine and Public Health. 2009;42(2):315-322. http://dx.doi.org/10.3961/jpmph.2009.42.5.315 https://doi.org/10.3961/jpmph.2009.42.5.315
  4. American Diabetes Association. Statistics about diabetes [Internet]. Alexandria VA: American Diabetes Association. 2011 [cited 2012 February 18]. Available from: http://www.diabetes.org/diabetes-basics/diabetes-statistics/?loc=DropDownDB-stats.
  5. American Diabetes Association. Standards of medical care in diabetes-2009. Diabetes Care. 2009;32(1):13-61. http://dx.doi.org/10.2337/dc09-S013
  6. Fitzgerald JT, Anderson RM, Funnell MM, Hiss RG, Hess GE, Barr PA, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706-710. http://dx.doi.org/10.2337/diacare.21.5.706 https://doi.org/10.2337/diacare.21.5.706
  7. Lee HJ, Park KY, Park HS, Kim IJ. The effect of problem solving nursing counseling and intensified walking exercise on diabetes self-care, coping strategies, and glycemic control among clients with DM type 2. Journal of Korean Academic Nursing. 2005;35(7):1314-1324. https://doi.org/10.4040/jkan.2005.35.7.1314
  8. Fenwick EK, Xie J, Ress G, Finger RP, Lamoureux EL. Factors associated with knowledge of diabetes in patients with type 2 diabetes using the diabetes knowledge test validated with rasch analysis. Public Library of Science. 2013;8(12):1-12. http://dx.doi.org/10.1371/journal.pone.0080593
  9. Bains SS, Eqede LE. Associations between health literacy, diabetes knowledge, self-care behaviors and glycemic control in a low income population with type 2 diabetes. Diabetes Technology & Therapeutics. 2001;13(3):335-341. http://dx.doi.org/10.1089/dia.2010.0160
  10. Chi-Lum B. Friend or Foe? Consumers using the internet for medical information. The Journal of Medical Practice Management. 1999;14(4):196-198.
  11. Benzel Lindley JA. Exploration of factors impacting the self-care of elders with diabetes. [dissertation]. [Arizona]: Arizona University; 2005. 237 p.
  12. Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. Journal of the American Medical Association. 2002;288(4):475-482. http://dx.doi.org/10.1001/jama.288.4.475 https://doi.org/10.1001/jama.288.4.475
  13. Kim SH, Lee EJ. The influence of functional literacy on perceived health status in Korean older adults. Journal of Korean Academic Nursing. 2008;38(2):195-203. http://dx.doi.org/10.4040/jkan.2008.38.2.195 https://doi.org/10.4040/jkan.2008.38.2.195
  14. Kim JE. Measuring the level of health literacy and influence factors: Targeting the visitors of a university hospital's outpatient clinic. Journal of Korean Clinical Nursing Research. 2011;17(1):27-34.
  15. Lee TW, Kang SJ. Health literacy in the Korean elderly and influencing factors. Journal of the Korean Gerontological Society. 2008;28(4):847-863.
  16. Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: The Newest Vital sign. Annals of Family Medicine. 2005;3(6):514-522. http://dx.doi.org/10.1370/afm.405 https://doi.org/10.1370/afm.405
  17. Choi EJ. Factors related to glycemic control in patients with type 2 diabetes mellitus. [Dissertation]. [Seoul]: Yonsei University; 2007. 131 p.
  18. Toobert DJ, Glasgow RE. Assessing diabetes self-management: The summary of diabetes self-care activities questionnaire. In: Bradley C, editor. Handbook of psychology and diabetes. Switzerland: Harwood Academic; 1994. p. 351-375.
  19. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care. 2000;23(7):943-950. http://dx.doi.org/10.2337/diacare.23.7.943 https://doi.org/10.2337/diacare.23.7.943
  20. Chang SJ, Song MS. The validity and reliability of a Korean version of the summary of diabetes self-care activities questionnaire for older patients with type 2 diabetes. Journal of Korean Adult Nursing. 2009;21(2):235-244.
  21. Park JY, Lee TY, Jang KS, Oh HY. A study on blood glucose level and self management among community dwelling type II diabetes patients. Journal of Korean Adult Nursing. 2010;22(3):271-280.
  22. Park MY, Kim KH. The study related to perceived stress, stress coping method, self-care behavior and hemoglobin A1c of elderly diabetic mellitus patients. Journal of Korean Academy Fundamental Nursing. 2008;15(2):186-194.
  23. Park JY. A study on self management, hemoglobin A1c (HbA1c), and perceived health status for the type II diabetes patients. Journal of Korean Biological Nursing Science. 2010;12(2):106-113.
  24. McCleary JV. Health literacy and its association with diabetes knowledge, self-efficacy and disease self-management among African Americans with diabetes mellitus. Association of Black Nursing Faculty Journal. 2011;22(2):25-32.
  25. Yang NY. Knowledge, self efficacy and self care behavior regarding foot care among elderly diabetes mellitus patients. Journal of Korean Adult Nursing. 2009;21(4):413-422.
  26. Zhang HL, Kim HL. Compliance and barriers to self-care behaviors in patients with type 2 diabetes. Journal of Korean Clinical Nursing Research. 2010;16(1):155-166.
  27. Mun YH. The effects of an exercise program on the physical, physiological and emotional status of the aged. Journal of Korean Academy of Community Health Nursing. 2006;17(4):451-460.
  28. Yoo JH. A study on the relationship of self-care behavioral compliance and perceived self-efficacy in type II diabetic patient. Journal of Korean Academy Fundamental Nursing. 2000;7(3):453-465.
  29. Karter AJ, Subramanian U, Saha C, Crosson JC, Parker MM, Swain BE, et al. Barriers to insulin initiation: The translating research into action for diabetes insulin starts project. Diabetes Care. 2010;33(4):733-735. http://dx.doi.org/10.2337/dc09-1184 https://doi.org/10.2337/dc09-1184
  30. Mbaezue N, Mayberry R, Gazmararian J, Quarshie A, Ivonye C, Heisler M. The impact of health literacy on self-monitoring of blood glucose in patients with diabetes receiving care in an inner-city hospital. Journal of the National Medical Association. 2010;102(1):5-9. https://doi.org/10.1016/S0027-9684(15)30469-7