Patient perception of understanding health education and instructions has moderating effect on glycemic control

BMC Public Health

Research Article

Yi-Sun Yang¹  Chien-Ning Huang¹  Chin-Yin Lew-Ting²  Gin-Den Chen³ 

[1] Department of Metabolism, Chung Shan Medical University Hospital, No. 110, Chien-Kuo N Road, Section1, 402, Taichung, Taiwan;Department of Public Health and Institute of Health Policy and Management, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, 100, Taipei, Taiwan;Department of Public Health and Institute of Health Policy and Management, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, 100, Taipei, Taiwan;Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Chien-Kuo N Road, Section1, 402, Taichung, Taiwan;School of Medicine, Chung Shan Medical University, No. 110, Chien-Kuo N Road, Section1, 402, Taichung, Taiwan;

关键词: Health literacy;    Glycosylated hemoglobin;    HbA1c;    Type 2 diabetes mellitus;    DM;    Glycemic control;   

DOI  :  10.1186/1471-2458-14-683

 received in 2014-06-02, accepted in 2014-06-30,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWhether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial. We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control.MethodsFive hundred and one consecutive patients with type 2 diabetes mellitus (DM) in the outpatient clinic of the metabolism department were recruited into this pilot study. The demographic data were collected from patients’ self-reports. The clinical background information was collected through electronic medical records. A questionnaire derived from part of the Mandarin Health Literacy Scale was used to measure numeracy and functional health literacy of people with diabetes. Health literacy levels were categorized into inadequate, marginal and adequate. Patient self-ratings of their perceived understanding of the health education information and instructions provided by their case manager in the past were categorized into two subgroups: better and poor. Patients with an HbA1c level equal to or below 7% were considered to have good glycemic control. Multivariate logistic regression was used to find associated factors of health literacy and understanding of health education and instructions. GENMOD procedures were used to analyze repeated outcome measurements of glycemic control.ResultsHigher educational attainment and higher household income (odds ratios were 2.23 and 2.22, respectively) were significantly associated with patients who had adequate health literacy. Higher educational attainment and patients with a family history of DM (odds ratios were 4.99 and 1.85, respectively) were significantly associated with better understanding of health education and instructions. Adequate health literacy is not the only factor associated with good glycemic control. The effect of adequate health literacy in achieving good glycemic control might be masked by patients with better understanding of health education and instructions.ConclusionsOur results revealed that not only were patients with adequate health literacy associated with good glycemic control but patients with marginal health literacy were also able to achieve good glycemic control. Adequate health literacy and better understanding of health education is highly correlated. The role of adequate health literacy on glycemic control could be suppressed if variables are over-controlled during analysis.

【 授权许可】

Unknown   
© Chen et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.