Relationship Among Patients' Perceived Capacity for Communication, Health Literacy, and Diabetes Self-Care

Abstract

The mechanisms underlying the relations among health literacy, perceived capacity for communication, diabetes knowledge, and diabetes self-care are unclear. This study tested this relation using structural equation modeling with a sample of 137 Chinese patients 65 years of age or older with type 2 diabetes. The model showed that health literacy, knowledge, communication capacity, and diabetes self-care formed complex relations. After adjusting for age, education, and Chinese cultural influence, health literacy affected diabetes self-care indirectly through perceived capacity for communication (standardized estimate coefficient = .641, p < .001) but not diabetes knowledge. To enhance self-care, interventions should be tailored to increase patient health literacy and perceived capacity for communication with health care providers. Training should be provided to patients to enhance their communication abilities.

Acknowledgments

A. Y. M. Leung contributed to the study design, application of ethical approval, data analysis, interpretation of the findings, and revision of the manuscript. M. K. T. Cheung contributed to data collection, data analysis, and drafting of the manuscript. I. Chi contributed to study design, interpretation of the findings, and revision of the article. The authors acknowledge the invaluable contribution of the study participants. Special thanks go to Terry Wong and W. C. Shum for their kind support and assistance during data collection, and the anonymous reviewers for their thoughtful review and guidance. The authors also thank St. James' Settlement, Aberdeen Kai-Fong Welfare Association Social Service Centre, Hong Kong Society for Rehabilitation, and Hong Kong Sheng Kung Hui Council Welfare for their kind support during data collection. Ethical approval was obtained from the Ethical Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster.