J Korean Acad Community Health Nurs.  2011 Mar;22(1):75-85. 10.12799/jkachn.2011.22.1.75.

Influencing Factors on Functional Health Literacy among the Rural Elderly

• Park JY
• June KJ

• KMID: 2292867
• DOI: http://doi.org/10.12799/jkachn.2011.22.1.75

Abstract

PURPOSE
The purpose of this study was to describe the status of the functional health literacy of the elderly living in a rural community and to identify the influencing factors on the functional health literacy.
METHODS
Subjects (n=238) aged over 60 years were selected for data collection. Functional health literacy was measured by Korean Health Literacy, which consisted of 15 items including eight numeracy and seven comprehension items. Descriptive statistics, t-test, ANOVA with Scheffe test, and stepwise multiple regression were used to analyze the data.
RESULTS
The mean score of total functional health literacy was 6.66+/-3.31, numeracy was 3.52+/-1.76, and comprehension was 3.41+/-2.10. Of the subjects, 39.1% showed a low score below the median split. In the results of stepwise multiple regression, the factors affecting functional health literacy were basic literacy, age, number of chronic diseases, self-reported health status, and gender. These factors accounted for 33.0% of functional health literacy.
CONCLUSION
These results suggest that interventions for improving functional health literacy are necessary to enhance elders' ability of self-care management. In addition, it is needed to take into account the individual characteristics of the subjects depending on their gender, age, and health status.

Keyword

Health literacy; Aged; Rural health service

MeSH Terms

Aged*
Chronic Disease
Comprehension
Data Collection
Health Literacy*
Humans
Rural Health Services
Rural Population
Self Care

Reference

1. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs. Health literacy: Report of the council on scientific affairs. JAMA. 1999; 281(6):552–557.

2. Baker DW, Parker RM, Williams MV, Clark WS, Nurss JR. The relationship of patient reading ability to self-reported health and use of health services. Am J Public Health. 1997; 87:1027–1030.

3. Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, et al. Health literacy and use of outpatient physician services by medicare managed care enrollees. J Gen Intern Med. 2004; 19:215–220.

4. Cho YI, Lee SY, Arozullah AM, Crittenden KS. Effects of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med. 2008; 66:1809–1816.

5. Cutilli CC. Health literacy in geriatric patients an integrative review of the literature. Orthop Nurs. 2007; 26(1):43–48.

6. Gazmararian JA, Williams MV, Peel J, Baker DW. Health literacy and knowledge of chronic disease. Patient Educ Couns. 2003; 51:267–275.

7. Howard DH, Gazmararian JA, Parker MV. The impact of low health literacy on the medical costs of Medicare managed care enrollees. Am J Med. 2005; 118(4):371–377.

8. Kim CW, Soe H, Yun JC, Lee KK, Jung KJ, Kim S. National general literacy survey report. Seoul: National Institute of Korean Language;2008.

9. Kim S, Love F, Quistberg DA, Shea JA. Association of health literacy with self-management behavior in patient with diabetes. Diabetes Care. 2004; 27(12):2980–2982.

10. Kim KS. A study of need for administration education and measure to elderly patient according to aging. Seoul: Chung-Ang University;2006. Unpublished master's thesis.

11. Kim SH, Lee EJ. The influence of functional literacy on perceived health status in Korean older adults. J Korean Acad Nurs. 2008; 38(2):195–203.

12. Kim SS, Kim SH, Lee SY. Health literacy: Development of a Korean health literacy assessment tool. J Korean Soc Health Educ Promot. 2005; 22(4):215–227.

13. Kim SY, Park YW, Shin HC, Kim CH, Sung EJ, Lee SH. Readability of patient information on hypertension in Korea. J Korean Acad Fam Med. 2007; 28:346–351.

14. Kong EH, Choi JS. Health literacy regarding educational materials on hypertension. Kosin Med J. 2007; 22(1):81–88.

15. Lee DY. Development and evaluation of preventive education program for medication misuse of the community dwelling elderly. Seoul: Yonsei University;2001. Unpublished doctoral dissertation.

16. Lee HS, Lee JH, Ahn DH, Byun JI, Park SO, Kwon JH, et al. Korean adult illiteracy survey. Seoul: Korean Educational Development Institute;2002.

17. Lee SA. A study on relationships between health literacy, drug knowledge, and drug misuse of rural elderly. Daegu: Keimyung University;2009. Unpublished master's thesis.

18. Lee SY, Arozullah AM, Cho YI. Health literacy, social support, and health: A research agenda. Soc Sci Med. 2004; 58:1309–1321.

19. Lee SY, Gazmararian JA, Arozullah AM. Health literacy and social support among elderly medicare enrollees in a managed care plan. J Appl Gerontol. 2006; 25(4):324–337.

20. Lee TW, Kang SJ. Health literacy in the Korean elderly and influencing factors. J Korean Gerontol Soc. 2008; 28(4):847–863.

21. Ministry of Health and Welfare. National health statistics (4th Round, 2nd Year). 2008. Retrieved May 31, 2010. from http://knhanes.cdc.go.kr/.

22. Mun HJ. Factors related to antihypertensive medication adherence and blood pressure control among older adults. Seoul: Yonsei University;2008. Unpublished master's thesis.

23. Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. JAMA. 2002; 288(4):475–482.

24. Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, et al. Limited literacy and mortality in the elderly: The health, aging, and body composition study. J Gen Intern Med. 2006; 21:806–812.

25. Uhm SM. A study on the status of prescription and non-prescription drug use in elderly. Seoul: Ewha Womans University;2005. Unpublished master's thesis.

26. von Wagner CV, Knight K, Steotoe A, Wardle J. Functional health literacy and health-promoting behavior in a national sample of British adults. J Epidemiol Community Health. 2007; 61:1086–1090.

27. White S. Assessing the Nation's Health Literacy. Washington, DC: American Medical Association Foundation;2008.

28. Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patient's knowledge of their chronic disease: A study of patients with hypertension and diabetes. Arch Intern Med. 1998; 158(2):166–172.

29. Wolf MS, Gazmararian JA, Baker DW. Health literacy and functional health status among older adults. Arch Intern Med. 2005; 165:1946–1952.

30. Zahnd WE, Scaife SL, Francis ML. Health literacy skills in rural and urban populations. Am J Health Behav. 2009; 33(5):550–557.