The Effect of Literacy Level on Health Related-Quality of Life, Self-Efficacy and Self-Management Behaviors in Diabetic Patients

  • Alireza Shahab Jahanlou Mail Health Education Unit, Cardiovascular Research Center, Hormozgan University of Medical Sciences, Hormozgan, Iran.
  • Nader Alishan Karami Department of Health Information Management, Hormozgan University of Medical Sciences, Hormozgan, Iran.
Keywords:
Diabetes mellitus, chronic obstructive, C-reactive protein type 2, Education, Hemoglobin A, glycosylated, Quality of Life, Self-Efficacy, World Health Organization

Abstract

Illiteracy in studies on quality of life (QOL) and self-efficacy (SE) of diabetic patients has been ignored. Illiteracy and diabetes have high rates in developing countries. The aim of this study was to identify the effect of literacy level on health outcomes. To achieve this, we studied health outcomes such as SE, self-management behaviors and Health-Related Quality of Life (HRQOL) in diabetic patients. A cross-sectional study was carried out in an Iranian urban federally-funded diabetes clinic (with 1400 diabetes patients) in Bandar Abbas, a city located in south of Iran. 256 Non Insulin Dependent Diabetic Mellitus patients were chosen during June, July and August 2007. Patients were grouped as illiterates, low-literates and literates. SE and QOL were measured by standard questionnaires. HbA1C was measured by calorimetric method. Data was collected with interview. Data analysis was carried out with one way ANOVA Post Hoc, and bivariate analysis method. Literacy level among the three groups from the view points of age, physical domain, psychological domain, environmental domain and SE were significant. There was no significant difference for the level of HbA1C among three groups. Literacy level does not have any effects on glycemic control. There is a strong relationship between self-efficacy and QOL domains.

References

Katz MG, Jacobson TA, Veledar E, Kripalani S. Patient]literacy and question-asking behavior during the medical encounter: a mixed-methods analysis. J Gen Intern Med 2007;22(6):782-6. Epub 2007 Apr 12.

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.

DeWalt DA, Boone RS, Pignone MP. Literacy and its relationship with self-efficacy, trust, and participation in medical decision making. Am J Health Behav 2007;31 Suppl 1:S27-35.

Davis TC, Arnold C, Berkel HJ, Nandy I, Jackson RH, Glass J. Knowledge and attitude on screening mammography among low-literate, low-income women. Cancer 1996;78(9):1912-20.

Lindau ST, Tomori C, Lyons T, Langseth L, Bennett CL, Garcia P. The association of health literacy with cervicalcancer prevention knowledge and health behaviors in a multiethnic cohort of women. Am J Obstet Gynecol 2002;186(5):938-43.

Miller LG, Liu H, Hays RD, Golin CE, Ye Z, Beck CK, Kaplan AH, Wenger NS. Knowledge of antiretroviral regimen dosing and adherence: a longitudinal study. Clin Infect Dis 2003;36(4):514-8. Epub 2003 Jan 30.

Spandorfer JM, Karras DJ, Hughes LA, Caputo C. Comprehension of discharge instructions by patients in an urban emergency department. Ann Emerg Med 1995;25(1):71-4.

Arnold CL, Davis TC, Berkel HJ, Jackson RH, Nandy I, London S. Smoking status, reading level, and knowledge of tobacco effects among low-income pregnant women. Prev Med 2001;32(4):313-20.

Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes. Arch Intern Med 1998;158(2):166-72.

Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. Inadequate literacy is a barrier to asthma knowledge and self-care. Chest 1998;114(4):1008-15.

Moon RY, Cheng TL, Patel KM, Baumhaft K, Scheidt PC. Parental literacy level and understanding of medical information. Pediatrics 1998;102(2):e25.

Wilson FL, McLemore R. Patient literacy levels: a consideration when designing patient education programs. Rehabil Nurs 1997;22(6):311-7.

Hahn EA, Cella D, Dobrez DG, Weiss BD, Du H, Lai JS, Victorson D, Garcia SF. The impact of literacy on healthrelated quality of life measurement and outcomes in cancer outpatients. Qual Life Res 2007;16(3):495-507. Epub 2006 Nov 8.

Fayers PM, Machin D. Quality of life: Assessment, Analysis and Interpretation. New York: John Wiley and Sons Ltd.; 2000. p. 25-30.

Hänninen J, Takala J, Keinänen-Kiukaanniemi S. Good continuity of care may improve quality of life in Type 2 diabetes. Diabetes Res Clin Pract 2001;51(1):21-7.

Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Diabetes Care 2006;29(4):823-9.

Gerber BS, Brodsky IG, Lawless KA, Smolin LI,Arozullah AM, Smith EV, Berbaum ML, Heckerling PS,Eiser AR. Implementation and evaluation of a low-literacy diabetes education computer multimedia application. Diabetes Care 2005;28(7):1574-80.

Inoue K, Matsumoto M, Kobayashi Y. The combination of fasting plasma glucose and glycosylated hemoglobin predicts type 2 diabetes in Japanese workers. Diabetes Res Clin Pract 2007;77(3):451-8. Epub 2007 Mar 7.

Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB. Association of health literacy with diabetes outcomes. JAMA 2002;288(4):475-82.

Rothman RL, Malone R, Bryant B, Shintani AK, Crigler B, Dewalt DA, Dittus RS, Weinberger M, Pignone MP. A randomized trial of a primary care-based diseasemanagement program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes. Am J Med 2005;118(3):276-84.

Aghamollaei T, Eftekhar H, Shojaeizadeh D, Mohammad K, Nakhjavani M, Ghofranipour F. Behavior, metabolic control and health-related quality of life in diabetic patients at bandar abbas diabetic clinic. Iranian J Publ Health 2003;32(3):54-9.

World Health Organization (WHO). WHO country cooperation strategy at a glance [Online]. 2006 [cited 2011 Apr 1]. Available from: URL:http://www.who.int/countryfocus/cooperation_strategy/ccs_irn_en.pdf

Aghamolaei T, Eftekhar H, Mohammad K, Nakhjavani M, Shojaeizadeh D, Ghofranipour F, Safa O. Effects of a health education program on behavior, hbA1c and healthrelated quality of life in diabetic patients. Acta Med Iran 2005;43(2):89-94.

The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28(3):551-8.

World Health Organization (WHO). Introduction, administration, scoring and generic version of the assessment [Online]. 2006 Dec [cited 2011 Apr 1]; Available from:URL:http://www.who.int/mental_health/media/en/76.pdf

Glasgow RE, Toobert DJ, Riddle M. Diabetes-specific social learning variables and self-care behaviors among persons with type II diabetes. Health Psychol 1989; 8:285-303.

Qari FA. Glycemic and good target control among diabetics at a university and Erfan private hospital. Turkish J Endocrinol Metab 2005;2:49-54.

Fisher E. Low literacy levels in adults: implications for patient education. J Contin Educ Nurs 1999;30(2):56-61.

Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev 1999;15(3):205-18.

Hoey H, Aanstoot HJ, Chiarelli F, Daneman D, Danne T, Dorchy H, Fitzgerald M, Garandeau P, Greene S, Holl R, et al. Good metabolic control is associated with better quality of life in 2,101 adolescents with type 1 diabetes. Diabetes Care 2001;24(11):1923-8.

Trief PM, Wade MJ, Britton KD, Weinstock RS. A prospective analysis of marital relationship factors and quality of life in diabetes. Diabetes Care 2002;25(7):1154-8.

Pala T, Eser E, Ozmen B, Aydemir O, Boyvoda S. The determinants of quality of life including treatment satisfaction in patients with type two diabetes mellitus: are different generic Qol instruments sensitive to the same determinants? Turkish J Endocrinol Metab 2004;8(3):91-9.

How to Cite
1.
Shahab Jahanlou A, Alishan Karami N. The Effect of Literacy Level on Health Related-Quality of Life, Self-Efficacy and Self-Management Behaviors in Diabetic Patients. Acta Med Iran. 49(2):153-158.
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