Health Literacy and Adherence to Therapy in Type 2 Diabetes: A Cross-Sectional Study in Portugal.

Q2 Medicine Health literacy research and practice Pub Date : 2024-10-01 Epub Date: 2024-10-08 DOI:10.3928/24748307-20240625-01

Simone Rodrigues, Ana Isabel Patrício, Cátia Cristina, Flávia Fernandes, Gisela Marcelino Santos, Inês Antunes, Inês Pintalhão, Marília Ribeiro, Rita Lopes, Silvana Moreira, Sofia A Oliveira, Susana Pereira Costa, Susete Simões, Tatiana Carvalho Nunes, Luiz Miguel Santiago, Inês Rosendo

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Abstract

Background: Therapy adherence is a key factor in the control of type 2 diabetes mellitus (T2DM). Optimal self-care requires skills in health literacy (HL).

Objective: This study aims to analyze the relationship between HL and adherence to therapy and to understand the possible influence of other sociodemographic and disease variables.

Methods: A multicenter, cross-sectional study was conducted in Portuguese in 13 different primary health care units in both rural and urban environments. A sociodemographic questionnaire and two validated instruments, "Medical Term Recognition Test" and "Summary of Diabetes Self-Care Activities," were applied. The last value of hemoglobin A1c (HbA1c) and the number of chronic medications were collected from clinical records. Descriptive statistics and bivariate correlations were performed as well as multivariable linear regression to assess the association between HL and adherence to therapy.

Key results: Participants (n = 354) were on average age 63.67 ± 10.39 years, 57.1% male and 42.9% female, 68.4% with inadequate HL and an average HbA1c of 7 ± 1.18%. Better HL was correlated with higher adherence to the total of self-care activities, nonpharmacological therapy, and foot care. In multivariable linear regression analyses, better HL (β = 0.176, p = .003), less than minimum wage (β = -0.197, p = .001) and insulin therapy (β = 0.272, p = .001) were independently associated with increased adherence to overall self-care activities.

Conclusion: In a representative sample of people with T2DM in Portugal, HL was a key factor for greater adherence to demanding self-care activities. [HLRP: Health Literacy Research and Practice. 2024;8(4):e194-e203.].

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2 型糖尿病患者的健康素养与坚持治疗：葡萄牙横断面研究

背景：坚持治疗是控制 2 型糖尿病（T2DM）的关键因素。最佳的自我护理需要具备健康素养（HL）技能：本研究旨在分析健康素养与坚持治疗之间的关系，并了解其他社会人口和疾病变量可能产生的影响：在农村和城市环境中的 13 个不同的初级卫生保健单位用葡萄牙语开展了一项多中心横断面研究。研究采用了一份社会人口学调查问卷和两种经过验证的工具，即 "医学术语识别测试 "和 "糖尿病自我护理活动总结"。从临床记录中收集了血红蛋白 A1c（HbA1c）的最后数值和慢性药物的数量。通过描述性统计和双变量相关性以及多变量线性回归来评估 HL 与坚持治疗之间的关系：主要结果：参与者（n = 354）平均年龄为 63.67 ± 10.39 岁，57.1% 为男性，42.9% 为女性，68.4% HL 不足，平均 HbA1c 为 7 ± 1.18%。较好的 HL 与较高的自我护理活动、非药物疗法和足部护理的依从性相关。在多变量线性回归分析中，较好的HL（β = 0.176，p = .003）、低于最低工资标准（β = -0.197，p = .001）和胰岛素治疗（β = 0.272，p = .001）与总体自我护理活动的依从性增加独立相关：结论：在葡萄牙具有代表性的 T2DM 患者样本中，HL 是更多地坚持要求严格的自我保健活动的关键因素。[HLRP：健康素养研究与实践，2024；8（4）：e194-e203]。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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