Health literacy, complication awareness, and diabetic control in patients with type 2 diabetes mellitus.
OBJECTIVE
This paper is a report of a study to examine the relationship between health literacy, complication awareness and diabetic control among patients with type 2 diabetes mellitus, and to validate a Chinese version of the Short-form Test of Functional Health Literacy in Adults.


BACKGROUND
There is a rapidly increasing trend in the prevalence of diabetes mellitus in Asian countries. Alongside the considerable progress in recent decades of health education in the field of diabetes care, the effects of health literacy and complication awareness have received increasing attention over the past 10 years.


METHODS
This study was conducted from September 2005 to February 2006 with 149 Chinese patients (mean = 59.8 years, range: 27-90 years) who were undergoing/had undergone diabetic complication assessment. Survey data were collected using a structured questionnaire incorporating demographics; assessment of complication awareness in two sections: a self-developed 10-item patient awareness score and a modified Chinese version of the Summary of Diabetes Self-Care Activities measure; and health literacy as measured by the Chinese version of the Short Test of Functional Health Literacy in Adults. Diabetic control was assessed by the most recent HbA1c level.


RESULTS
Health literacy (P < 0.001) and patient awareness scores were negatively correlated to diabetic control (P = 0.035), but management of treatment in the Summary of Diabetes Self-Care Activities measure (P = 0.030), gender (P = 0.023) and duration of diabetes (P < 0.001) were positively correlated to HbA1c.


CONCLUSIONS
To develop effective patient education and improve patients' diabetic control and own complications, educational strategies need to consider patients' health literacy levels and self-care skills.
Tang
Ying Ho
YH
Medical and Geriatric Department, Our Lady of Maryknoll Hospital, Hong Kong SAR, China. tangyh2@ha.org.hk
Pang
Samantha M C
SM
Chan
Moon Fai
MF
Yeung
Grace S P
GS
Yeung
Vincent T F
VT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000592:standards; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D012648:Self Care / Q000592:standards*