Glycemic control in type 2 diabetes: role of health literacy and shared decision-making

Figures & data

Table 1 Patient characteristics, HbA1C, and preference for SDM

	N	%		N	%
Sex			Family history of diabetes
Male	145	39.0	Yes	224	64.7
Female	227	61.0	No	122	35.3
Age (years)			Duration of diabetes
≤54	54	14.5	≤4	80	26.0
55–64	91	24.5	5–9	66	21.4
65–74	116	31.2	10–14	55	17.9
≥75	111	29.8	≥15	107	34.7
Educational level			Treatment pattern
Elementary school	157	43.9	Oral medication	266	77.8
Middle school	60	16.8	Insulin use	35	10.2
High school	82	22.9	Both of above	41	12.0
College or above	59	16.5	History of chronic disease
HbA1C	298		No	76	21
Mean (SD): 7.22 (1.50)			Yes	286	79
<7	148	49.7	Preference of SDM
7–8	85	28.5	Patient decision	38	10.3
≥8	65	21.8	SDM	145	39.3
			Physician decision	186	50.4

Abbreviation: SDM, shared decision-making.

Table 2 Factors influencing patients’ involvement in the process of shared decision-making

Factors	Mean (SD)	Positive %^a	Negative %^b
1. Information on related treatment options	3.22 (1.04)	46.4	26.5
2. Encouragement from healthcare provider	3.39 (1.06)	55.1	23.5
3. Relevant health knowledge was delivered via interesting ways (such as brochures, videos, DVDs, and websites)	3.21 (1.02)	45.1	24.5
4. Enough time to discuss with the physician	3.44 (1.06)	56.2	20.0
5. Physician explained illness in colloquial language	3.53 (1.13)	61.1	21.3
6. Influenced from non-medical pathways (eg, media, news, etc)	3.10 (1.13)	40.9	28.4
7. Opinions of the main caregiver (family)	3.22 (1.16)	47.6	27.6

Notes: ^aPositive % = number of patients that answered “frequently influenced” or “always influenced”/total number of patients. ^bNegative % = number of patients that answered “not influenced at all ” or “a little influenced”/total number of patients.

Table 3 Multiple regression analysis for the relationships among participant characteristics, HL, and patients’ perceived involvement in SDM

	Dependent variables				Perceived involvement
Independent variables	FHL	IHL	CHL	Total HL	Model 1	Model 2	Model 3
Sex	0.018	−0.004	0.005	0.009	−0.014	−0.014	−0.016
Age	−0.083	−0.059	−0.040	−0.081	−0.065	−0.048	−0.052
Education
Elementary school	−0.216**	−0.219**	−0.194**	−0.276***	−0.066	−0.008	−0.011
Middle school	−0.209**	−0.051	−0.106	−0.165**	−0.031	−0.013	0.002
High school	0	0	0	0	0	0	0
College or above	0.133*	0.140*	0.103	0.166**	0.019	−0.018	−0.010
Perceived health status	0.161**	0.147**	0.197***	0.219***	0.213***	0.174**	0.159**
HL
FHL					−0.028
IHL						0.236***
CHL							0.251***
F	11.99***	8.94***	7.94***	18.17***	3.03**	5.69***	6.12***

Notes: *p<0.05; **p<0.01; ***p<0.001.

Abbreviations: CHL, critical HL; FHL, functional HL; HL, health literacy; IHL, interactive HL; SDM, shared decision-making.

Table 4 Multinomial logistic regression for the relationships among HbA1C values, patients’ perceived involvement in SDM, HL, and patients’ preferences in decision-making

	Patient decision-making vs SDM			Physician decision-making vs SDM
	B	Exp. (B)	95% CI	B	Exp. (B)	95% CI
HbA1C	0.338*	1.402	1.078–1.822	0.213*	1.237	1.018–1.503
Perceived involvement	−1.083*	0.338	0.148–0.774	0.312	1.366	0.813–2.297
HL
FHL	0.382	1.465	0.761–2.821	−0.222	0.801	0.558–1.150
IHL	0.851	2.343	0.773–7.103	0.258	1.295	0.703–2.385
CHL	−1.205*	0.300	0.091–0.987	−0.651	0.522	0.270–1.009

Note: *p<0.05; ***p<0.001. F=31.70***; Cox-Snell R²=0.104.

Abbreviations: CHL, critical HL; FHL, functional HL; HL, health literacy; IHL, interactive HL; SDM, shared decision-making.