[Association of health literacy with health management among diabetics].
OBJECTIVE
To understand status of health literacy among diabetics and their health management behaviors, and analyze the relationship of health literacy and health management.


METHODS
A two-staged cluster randomized sampling method was used to investigate 1 130 diabetics in Beijing, Ningbo and Xiamen from October to November in 2012. All participants should be diagnosed by primary hospital and above and have lived in the community over six months. Diabetic patients who indicated that they had severely impaired vision or cognitive disorder, or had severe physical deterioration, or did not live in the address provided were excluded. A total of 1 130 questionnaires were sent out and 1 083 eligible questionnaires were taken back, accounting for 96.87%. Multivariate logistic regression was adopted to analyze the association between health literacy and health management behaviors and blood glucose level.


RESULTS
Among those participants, 47.7% (517) were men, 52.3% (566) were women, the age was (67.0 ± 9.5). According to diabetes health literacy scores, 73.7% (798/1 083) of them were classified as poor health literacy and 26.1% (283/1 083) as essential health literacy. Health literacy was associated with health management behaviors independently, demonstrating that the probability of utilizing health education, free physical examination, lifestyle guidance, monitoring blood glucose on their own, measuring blood glucose more than once a week and taking hypoglycemic agent regularly among diabetics with essential health literacy were 1.40 (95%CI:1.03-1.91), 1.65 (95%CI: 1.19-2.28), 2.70 (95%CI:1.98-3.69), 2.05 (95%CI:1.34-3.15), 2.56 (95%CI:1.85-3.56) , 1.48 (95%CI:1.07-2.06) times of those in diabetics with poor health literacy (P < 0.05).


CONCLUSIONS
Health literacy may affect health management behaviors among diabetics. More activities targeted on diabetics with low health literacy were suggested to improve their' health literacy and their skills about diabetes mellitus management.
Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Centre, Beijing 100191, China.
Qingqi
Q
Zeng
Ying
Y
Jiang
Yanfei
Y
Yuan
Xiuqin
X
Wen
Yahui
Y
Sun
Ding
D
Tian
Xiaohuai
X
Wang
Email: changchun@bjmu.edu.cn.
Chun
C
Chang
D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016903:Drug Monitoring