Abstract
ABSTRACTObjective:To investigate the association between inadequate functional health literacy, considering the Short Assessment of Health Literacy for Portuguese-speaking Adults, and glycemic control in elderly patients with type 2 diabetes, and to examine this association in low social support settings, according to Medical Outcomes Study .Methods:Cross-sectional study conducted at the diabetes referral center of a university hospital. Participants were recruited among type 2 diabetes patients aged 60 years or older, between May 2013 and November 2014. The primary outcome was the most recent glycated hemoglobin value measured within the last 6 months.Results:A total of 398 elderly patients with type 2 diabetes were evaluated. Of these, 232 were not eligible to participate. The final sample comprised 166 participants. Hierarchical multiple linear regression was performed. The following variables were entered in three blocks: sociodemographic characteristics, clinical variables and health literacy scores. Regression analysis of the interaction between health literacy and social support as a determinant of glycemic control was also performed. Mean age of subjects was 68.0 years (standard deviation of 5.9). Mean glycated hemoglobin value was 8.5% (standard deviation of 1.4). Short assessment of health literacy for Portuguese speaking adults score was independently associated with glycated hemoglobin (B=-0.059; p=0.043). The interaction between social support and health literacy score (p=0.003) was a determinant of glycemic control.Conclusion:Health literacy is associated with glycemic control. Social support may modify the relation between health literacy and glycemic control.
Highlights
Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services required to make appropriate health decisions
Associations between inadequate health literacy and conditions, such as poor ability to understand and follow medical instructions,(5) higher risk of hospital admission[6] and higher mortality rates[7] have been demonstrated. These findings make investigation of associations between health literacy and chronic disease control an important field of research.[8]. Type 2 diabetes mellitus (DM2) is thought to be a good model for study of such relations, since it is a complex disease that requires selfcare and proper understanding of pharmacological and non-pharmacological treatments, among individuals with longstanding disease
We propose an evaluation of the relationships between social support, functional health literacy, and glycemic control in elderly diabetics
Summary
To investigate the association between inadequate functional health literacy, considering the Short Assessment of Health Literacy for Portuguese-speaking Adults, and glycemic control in elderly patients with type 2 diabetes, and to examine this association in low social support settings, according to Medical Outcomes Study. Short assessment of health literacy for Portuguese speaking adults score was independently associated with glycated hemoglobin (B=-0.059; p=0.043). Objetivo: Verificar a associação entre alfabetismo em saúde inadequado, segundo o Short Assessment of Health Literacy for Portuguese-speaking Adults, e controle glicêmico, em pacientes idosos com diabetes tipo 2, bem como avaliar tal associação no contexto de baixo suporte social, segundo o Medical Outcomes Study. A interação entre suporte social e escore de alfabetismo em saúde (p=0,003) foi determinante para o controle glicêmico. Descritores: Alfabetismo em saúde; Diabetes mellitus tipo 2; Glicemia; Idoso; Saúde do idoso
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