Abstract
OBJECTIVES:The prevalence of diabetes mellitus has recently increased in Taiwan, and depression is common among these patients. Moreover, a lack of health literacy may lead to depression. In this study, we explored the correlation between health literacy and depression in diabetic women.METHODS:In this cross-sectional study, 152 women with type 2 diabetes mellitus were recruited from the outpatient clinic of a regional teaching hospital in Taiwan. The data were collected through medical records and a self-reported structured questionnaire, which included items on basic attributes, self-rated health status, the Center for Epidemiologic Studies Depression Scale (CES-D), and Chinese Health Literacy Scale for Diabetes (CHLSD). The results were analyzed using descriptive statistical analyses, bivariate correlation tests, and linear regression analyses.RESULTS:One hundred thirty-five valid questionnaires were obtained. Approximately 20% of the participants had a higher tendency toward depression as per their CES-D score, and the CHLSD results showed that 13.33% had poor health literacy. There was a negative correlation between health literacy and depressive tendencies after adjusting for self-rated health status, economic satisfaction status, employment status, and education level using multivariate linear regression analyses. For each 1-point rise in the CHLSD score, the CES-D score decreased by 0.17 points (z=−2.05, p=0.042).CONCLUSIONS:A negative correlation was identified between health literacy and depression. Self-rated health status, economic satisfaction, employment status, and higher education level are factors that also affect depressive tendency among diabetic women.
Highlights
In recent years, there has been a significant upward trend in the prevalence of diabetes mellitus (DM) in Taiwan
Questionnaires were issued to 152 women; 8 questionnaires were returned incomplete, no blood samples were obtained for 8 women, and one woman was discovered to have type 1 DM, all of which led to exclusion
The Chinese Health Literacy Scale for Diabetes (CHLSD) score had a negative correlation with the Center for Epidemiologic Studies Depression Scale (CES-D) score, and the results showed that an elevation of one-point in the CHLSD score was related to a decrease of 0.17 points in the CES-D score (z= À 2.05, p=0.042); this indicates that increasing Health literacy (HL) of these patients may lessen their depressive tendency
Summary
There has been a significant upward trend in the prevalence of diabetes mellitus (DM) in Taiwan. The number of women with DM has increased from 3.34% of the total population in 2000 to 5.24% in 2009. In 2009, the prevalence of DM in 40–59, 60–79, and X80-year-old women was 5.47%, 21.97%, and 23.97%, respectively [1]. DM is a chronic disease with complications involving multiple organs; 21.3% of patients develop retinopathy; 6.2%, cardiovascular disease; 2.3%, cerebrovascular disease; 0.6%, complications requiring amputation; and 0.67%, blindness. 1.55% of patients eventually suffer from endstage renal disease [2]. Depression is common among diabetic patients, with a prevalence of 50% in certain countries [3].
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