Health literacy, anxiety and stress among people during Coronavirus-2019 pandemic at the northern of Thailand

Abstract

COVID-19 outbreaks have caused anxiety and stress for the world and Thailand. Low health literacy can cause higher mortality rates. This study investigated stress levels, anxiety, health literacy and predictive factors, creating an equation to predict stress in the upper northern region of Thailand. The sample was 400 people aged over 18 years in Phayao Province, Northern Thailand, selected by multi-stage cluster sampling. The instruments were interview guidelines. Data were collected on 1-30 January 2021 and analyzed with descriptive analysis and univariate analysis by using chi-square test, Phi, Cramer’s V, Spearman’s Rank Correlation and multiple logistic regression for the multivariate analysis. According to the findings, the study participants (52.2%) had high stress. The univariate analysis showed the independent variables correlated with stress with statistical significance to be gender (p-value < 0.01), occupation (p-value < 0.01), income (p-value < 0.001), number of vulnerable family members (r = 0.170), health literacy (r = -.275), economic anxiety (p-value < 0.05), anxiety about illness (p-value < 0.05) and anxiety about social activity (p-value < 0.01). From multiple logistic regression analysis, negative predictive factors were male gender (OR = 0.543, 95% CI = 0.340-0.868), number of family members (OR = 0.870, 95% CI = 0.758-1.00) and Covid-19 health literacy (OR = 0.941, 95% CI = 0.913-0.969). Positive predictive factors consisted of the sample with occupations as farmers (OR = 2.068, 95% CI = 1.259-3.395), number of vulnerable family members (OR = 1.546, 95% CI = 1.039-2.303) and economic anxiety (OR = 1.156, 95% CI = 1.005-1.330). Constant (2.015) = OC (0.726) + VUL (0.436) + AECON (0.145) - CVHL (0.061) – FAM (0.139) – SEX (0.611) The findings can be used to promote care for families with vulnerable family members by considering socioeconomic factors with activities to promote COVID-19 health literacy and policy-setting on healthcare development.