ABSTRACT
Objectives: Diabetic patients with higher health literacy [HL] may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetesrelated behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus [T2DM] in Iran
Methods: We conducted a crosssectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire
Results: Participants who received diabetes education [t = 5.79, p<0.001] and were married [F = 3.04, p<0.050] had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL [r = 0.455, p<0.010], critical HL [r = 0.297, p<0.010], self-efficacy [r = 0.512, p<0.010] and outcome expectations [r = 0.387, p<0.010]. Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively
Conclusions: This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient's HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance