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Cognition, educational attainment and diabetes distress predict poor health literacy in diabetes: A cross-sectional analysis of the SHELLED study

Citation

Chen, P and Callisaya, M and Wills, K and Greenaway, T and Winzenberg, T, Cognition, educational attainment and diabetes distress predict poor health literacy in diabetes: A cross-sectional analysis of the SHELLED study, PLoS ONE, 17, (4) pp. e0267265. ISSN 1932-6203 (2022) [Refereed Article]


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DOI: doi:10.1371/journal.pone.0267265

Abstract

Objectives

To identify factors that predict poor health literacy amongst people with diabetes.

Design

Cross-sectional analysis of baseline data from a prospective study of diabetic foot disease.

Setting

Patients attending a tertiary hospital diabetes outpatient clinic in Tasmania, Australia.

Participants

222 people with diabetes mellitus, aged >40 years, with no history of foot ulceration, psychotic disorders or dementia.

Outcome measures

Health literacy was measured using the short form Test of Functional Health Literacy in Adults (functional health literacy), and the Health Literacy Questionnaire (HLQ), which measures nine domains of health literacy. Predictors included demographic characteristics, cognition, diabetes distress, depression, and educational attainment.

Results

In multivariable analysis, greater educational attainment (OR 0.88, 95% CI 0.76, 0.99) and poorer cognition (OR 0.71, 95% CI 0.63, 0.79) were associated with poorer functional health literacy. Age was negatively associated with domains of appraisal of health information and ability to find good health information (both beta = -0.01). Educational attainment was positively associated with four domains, namely having sufficient information to manage my health, actively managing my health, appraisal of and ability to find good health information (beta ranging from +0.03 to 0.04). Diabetes distress was negatively associated with five domains: having sufficient information to manage my health, social support for health, ability to actively engage with healthcare providers, navigating the healthcare system and ability to find good health information (beta ranging from -0.14 to -0.18).

Conclusion

Poorer cognition and poorer educational attainment may be detrimental for an individualís functional health literacy, and education, diabetes distress and older age detrimental across multiple health literacy domains. Clinicians and policy makers should be attuned to these factors when communicating with people with diabetes and in designing healthcare systems to be more health-literacy friendly in order to improve diabetes outcomes.

Item Details

Item Type:Refereed Article
Keywords:cognition, diabetes, health, literacy
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Geriatrics and gerontology
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Primary care
UTAS Author:Chen, P (Miss Pamela Chen)
UTAS Author:Callisaya, M (Dr Michele Callisaya)
UTAS Author:Wills, K (Dr Karen Wills)
UTAS Author:Greenaway, T (Dr Tim Greenaway)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
ID Code:150252
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-06-05
Last Modified:2022-06-06
Downloads:0

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