Communicative and critical health literacy, and self-management behaviors in end-stage renal disease patients with diabetes on hemodialysis

• Published in: Patient education and counseling 2013-05, Vol.91 (2), p.221-227
• Main Authors: Lai, Alden Yuanhong, Ishikawa, Hirono, Kiuchi, Takahiro, Mooppil, Nandakumar, Griva, Konstadina
• Format: Article
• Language: English
• Subjects: Communication; Diabetes; Diabetes Mellitus, Type 2 - therapy; Diabetics; ESRD; Female; Health Behavior; Health communication; Health education; Health Knowledge, Attitudes, Practice; Health Literacy; Humans; Internal Medicine; Kidney diseases; Kidney Failure, Chronic - therapy; Male; Middle Aged; Nursing; Patient Education as Topic; Physician-Patient Relations; Renal Dialysis; Self Care; Self-management; Selfmanagement; Selfreport
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2012.12.018

Abstract Objective Health Literacy (HL) has been linked to disease self-management and various health outcomes, and can be separated into components of functional, communicative and critical skills. The high comorbidity between diabetes and end-stage renal disease (ESRD) poses concerns for compromised disease self-management. This study aimed to identify the relationships between HL and self-management behaviors in end-stage renal disease patients with diabetes. Methods Self-report questionnaires measuring HL and self-management with the Functional, Communicative and Critical HL scale and Summary of Diabetes Self-Care Activities, respectively, were implemented with a sample of 63 patients. Socio-demographic and clinical characteristics were obtained from medical records. Results Self-management in diabetes was associated with communicative and critical HL, but not functional HL. Educational attainment was associated only with functional HL. No relationship between HL and glycated hemoglobin (HbA1c ) was identified. Conclusion Communicative and critical HL skills are associated with self-management in ESRD patients with diabetes. Education levels are not related to self-management. Practice implications Healthcare professionals and health information aiming to improve self-management in ESRD patients with diabetes should consider their capacities of communicative and critical HL instead of solely assessing functional HL.