Relationship between Uncertainty in Illness, Subjective Health Status, and Compliance with Sick Role Behavior according to Levels of Health Literacy in Hemodialysis Patients

Abstract

Purpose: This study aimed to investigate the relationships between uncertainty in illness, subjective health status, and compliance with sick role behavior according to levels of health literacy in hemodialysis patients. Methods: Participants were 172 hemodialysis patients, selected from outpatient dialysis clinics at 9 dialysis centers located in Gwangju metropolitan city and Chonnam province, from October to December 2016. Data were collected using self-reported questionnaires that included the Uncertainty in Illness Scale, Subjective Health Status Scale, Sick Role Behavior Scale, and Health Literacy Scale. Data were analyzed using the SPSS/WIN 23.0 program, with x²-test, Pearson correlation coefficient, and multivariate analysis of covariance. Results: The results revealed that uncertainty was negatively correlated with subjective health status (r=-.30, p<.001) and compliance with sick role behavior (r=-.20, p=.012). In addition, compliance with sick role behavior was positively correlated with health literacy (r=.17, p=.034) and subjective health status (r=.24, p=.003). Participants’ levels of health literacy differed significantly based on sick role behaviors (F=5.355, p=.006), with a partial eta squared of .070, indicating high explanatory power. Conclusion: This study suggests that hemodialysis patients do not understand health - related medical information appropriately in their daily life. Therefore, efforts should be made to identify the level of health literacy of hemodialysis patients and improve the performance of sick role behaviors.