DOI QR코드

DOI QR Code

Influence of Health Literacy and Health Empowerment on Health Behavior Practice in Elderly Outpatients with Coronary Artery Disease

외래 통원 관상동맥질환 노인환자의 건강정보이해능력, 건강임파워먼트가 건강행위이행에 미치는 영향

  • Received : 2018.09.19
  • Accepted : 2018.10.18
  • Published : 2018.12.31

Abstract

Purpose: The purpose of this descriptive study was to identify the influence of health literacy and health empowerment on health behavior practice in elderly patients with coronary artery disease. Methods: 239 elderly outpatients older than 65 years of age were included. The data were analyzed with descriptive statistics including independent t-test, ANOVA, and hierarchical regression. Results: Major factors having a significant impact on health behavior practice were health literacy (${\beta}=.26$, p<.001) and health empowerment (${\beta}=.32$, p<.001). Health literacy was increased by 4.7% after controlling for general and health-related characteristics. Health empowerment increased by 5.9% after controlling for general and health-related characteristics, and health literacy. The two variables explained 35% of the variance in health behavior practice (F=7.74, p<.001). Conclusion: The main findings of this study can be utilized as the foundation for developing programs to promote health empowerment and health behavior practice of the elderly population. Furthermore, the results of the study can also be used to establish health-related strategies.

Keywords

Table 1. Characteristics of the Subjects

BGHSBR_2018_v24n3_293_t0001.png 이미지

Table 2. Level of Health Literacy, Health Empowerment and Health Behavior Practice

BGHSBR_2018_v24n3_293_t0002.png 이미지

Table 3. Differences in Health Behavior Practice according to Characteristics

BGHSBR_2018_v24n3_293_t0003.png 이미지

Table 4. Correlation among Health Literacy, Health Empowerment and Health Behavior

BGHSBR_2018_v24n3_293_t0004.png 이미지

Table 5. Factors Affecting Health Behavior Practice

BGHSBR_2018_v24n3_293_t0005.png 이미지

References

  1. Statistics Korea. 2016 cause of death statistics [Internet]. Daejeon: Statistics Korea. 2016 [cited 2017 November 10]. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&bSeq=&aSeq=363268&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&s.
  2. Choi MJ, Jeong MH, Hwang SY. Restenosis and compliance with self-care among acute coronary syndrome patients undergoing follow-up angiograms. Korean Journal of Health Promotion. 2011;11(1):34-41.
  3. Lee HO, Jang SJ, Kim IS, Han JB, Park SH, Kim JH, et al. Longterm clinical outcomes after primary percutaneous coronary intervention in patients with acute myocardial infarction-on the basis of 65 years. The Journal of the Korea Contents Association. 2014:14(5):251-261. https://doi.org/10.5392/JKCA.2014.14.05.251
  4. Park HJ, Hwang SK. Linguistic and functional health literacy among community- dwelling old adults. Global Health & Nursing. 2014;4(2):49-58.
  5. Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, et al. Limited literacy in older people and disparities in health and healthcare access. Journal of the American Geriatrics Society. 2006;54(5):770-776. https://doi.org/10.1111/j.1532-5415.2006.00691.x
  6. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: An updated systematic review. Annals of internal medicine. 2011;155(2):97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005
  7. Kim J. Meta analysis of the correlation between health literacy and health related variables. Korean Society for Health Education and Promotion. 2018;35(1):101-113. https://doi.org/10.14367/kjhep.2018.35.1.101
  8. Park C, Song M, Cho B, Lim J, Song W, Chang HK, et al. Effects of a multi-disciplinary approached, empowerment theory based self-management intervention in older adults with chronic illness. Journal of Korean Academy of Nursing. 2015;45(2):192-201. https://doi.org/10.4040/jkan.2015.45.2.192
  9. Funnell MM, Anderson RM. Patient empowerment: A look back, a look ahead. The Diabetes Educator. 2003;29(3):454-464. https://doi.org/10.1177/014572170302900310
  10. Shearer NB, Fleury JD, Belyea M. Randomized control trial of the health empowerment intervention: Feasibility and impact. Nursing Research. 2010;59(3):203-211. https://doi.org/10.1097/NNR.0b013e3181dbbd4a
  11. Thakur RD. Feasibility study of the health empowerment intervention to evaluate the effect on self-management, functional health, and well-being in older adults with heart failure [dissertation]. Tempe: Arizona State University; 2017. p. 1-241.
  12. Londono AM, Schulz PJ. Influences of health literacy, judgment skills, and empowerment on asthma self-management practices. Patient Education and Counseling. 2015;98(7):908-917. https://doi.org/10.1016/j.pec.2015.03.003
  13. Nafradi L, Nakamoto K, Csabai M, Papp-Zipernovszky O, Schulz PJ. An empirical test of the Health Empowerment Model: Does patient empowerment moderate the effect of health literacy on health status? Patient Education and Counseling. 2018;101(3):511-517. https://doi.org/10.1016/j.pec.2017.09.004
  14. Park JA. The comparative study on stress and the compliance of sick role behavior according to the restenosis of coronary artery intervention patient [master's thesis]. Seoul: Kyung Hee University; 2003. p. 1-55.
  15. Jeong JH, Kim JS. Health literacy, health risk perception and health behavior of elders. Journal of Korean Academy of Community Health Nursing. 2014;25(1):65-73. https://doi.org/10.12799/jkachn.2014.25.1.65
  16. Jung EY, Hwang SK. Health literacy and health behavior compliance in patients with coronary artery disease. Korean Journal of Adult Nursing. 2015;27(3):251-261. https://doi.org/10.7475/kjan.2015.27.3.251
  17. Son HJ. Health empowerment of old adults with high risk diseases of cardio-cerebrovascular system [master's thesis]. Seoul: Yonsei University. 2016. p 1-90.
  18. Lee TW, Kang SJ. Development of the short form of the Korean health literacy scale for the elderly. Research in Nursing & Health. 2013;36(5):524-534. https://doi.org/10.1002/nur.21556
  19. Anderson RM, Fitzgerald JT, Gruppen LD, Funnell MM, Oh MS. The diabetes empowerment scale-short form (DES-SF). Diabetes Care. 2003;26(5):1641-1642. https://doi.org/10.2337/diacare.26.5.1641-a
  20. Park C, Park YH. Validity and reliability of Korean version of health empowerment scale (K-HES) for older adults. Asian Nursing Research. 2013;7(3):142-148. https://doi.org/10.1016/j.anr.2013.07.004
  21. Son YJ. The development and effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention. Journal of Korean Academy of Nursing. 2008;38(2):217-228. https://doi.org/10.4040/jkan.2008.38.2.217
  22. Lee MS. Health literacy and health behaviors among older adults with cardio-cerebrovascular disease residing in rural areas. Korean Journal of Adult Nursing. 2017;29(3):256-265. https://doi.org/10.7475/kjan.2017.29.3.256
  23. Yang JR. The effect of health literacy and self-efficacy on medication adherence among the elderly patients with chronic diseases. Health and Nursing. 2014;26(1):29-38.
  24. Wang RH, Hsu HC, Lee YJ, Shin SJ, Lin KD, An LW. Patient empowerment interacts with health literacy to associate with subsequent self-management behaviors in patients with type 2 diabetes: A prospective study in Taiwan. Patient Education and Counseling. 2016;99(10):1626-1631. https://doi.org/10.1016/j.pec.2016.04.001
  25. Lee YJ, Shin SJ, Wang RH, Lin KD, Lee YL, Wang YH. Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus. Patient Education and Counseling. 2016;99(2):287-294. https://doi.org/10.1016/j.pec.2015.08.021
  26. Camerini L, Schulz PJ, Nakamoto K. Differential effects of health knowledge and health empowerment over patients' self-management and health outcomes: A cross-sectional evaluation. Patient Education and Counseling. 2012;89(2):337-344. https://doi.org/10.1016/j.pec.2012.08.005
  27. van Schaik TM, Jorstad HT, Twickler TB, Peters RJ, Tijssen JP, Essink-Bot ML, et al. Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy. Netherlands Heart Journal. 2017;25(7-8):446-454. https://doi.org/10.1007/s12471-017-0963-6
  28. Suka M, Odajima T, Okamoto M, Sumitani M, Igarashi A, Ishikawa H, et al. Relationship between health literacy, health information access, health behavior, and health status in Japanese people. Patient Education and Counseling. 2015;98(5):660-668. https://doi.org/10.1016/j.pec.2015.02.013
  29. Eyuboglu E, Schulz PJ. Do health literacy and patient empowerment affect self-care behaviour? A survey study among Turkish patients with diabetes. BMJ Open. 2016;6(3):e010186. https://doi.org/10.1136/bmjopen-2015-010186
  30. Kim J. Measuring the level of health literacy and influence factors: Targeting the visitors of a university hospital's outpatient clinic. Journal of Korean Clinical Nursing Research. 2011;17(1):27-34.