Korean J Adult Nurs.  2018 Aug;30(4):437-446. 10.7475/kjan.2018.30.4.437.

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

• Cho YM
• Seo YH
• Park MJ

• KMID: 2418986
• DOI: http://doi.org/10.7475/kjan.2018.30.4.437

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 χ2-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.

MeSH Terms

Compliance*
Diagnostic Self Evaluation*
Dialysis
Gwangju
Health Literacy*
Health Status
Humans
Jeollanam-do
Literacy
Multivariate Analysis
Outpatients
Renal Dialysis*
Sick Role*
Uncertainty*

Reference

1. ESRD Registry Committee. Current renal replacement therapy in Korea-insan memorial dialysis registry 2016 [Internet]. Seoul: the Korean Society of Nephrology;cited 2017 February 2. Available from: https://www.ksn.or.kr/rang_board/list.html?code=sinchart.

2. Ryu DR, Kim YJ, Sui AR, Kim JM, Lee NR, Son SK, et al. Outcomes research of peritoneal dialysis and hemodialysis for endstage renal disease. Subject Competition Research Report. Seoul City: National Evidence-based Healthcare Collaborating Agency;2017. 06. Report No. NA16-002.

3. Cho YM, Yum KS. The relationship between of uncertainty, depression, physiologic index and basic psychological need of hemodialysis patients. J Digit Converg. 2017; 15(10):281–291. DOI: 10.14400/JDC.2017.15.10.281.

4. Suh SR, Cho IH. Influence of hemodialysis patient's stress and acceptance on their psychosocial adaptation and quality of life. J Korea Contents Assoc. 2014; 14(11):829–837. DOI: 10.5392/JKCA.2014.14.11.829.

5. Kim JE. Measuring the level of health literacy and influence factors: targeting the visitors of a university hospital's outpatient clinic. J Korean Clin Nurs Res. 2011; 17(1):27–34.

6. Jung EY, Hwang SK. Health literacy and health behavior compliance in patients with coronary artery disease. Korean J Adult Nurs. 2015; 27(3):251–261. DOI: 10.7475/kjan.2015.27.3.251.

7. Bains SS, Egede LE. Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes. Diabetes Technol Ther. 2011; 13(3):335–341. DOI: 10.1089/dia.2010.0160.

8. Jeong JH, Kim JS. Health literacy, health risk perception and health behavior of elders. J Korean Acad Community Health Nurs. 2014; 25(1):65–73. DOI: 10.12799/jkachn.2014.25.1.65.

9. Shibuya A, Inoue R, Ohkubo T, Takeda Y, Teshima T, Imai Y, et al. The relation between health literacy, hypertension knowledge, and blood pressure among middle-aged Japanese adults. Blood Press Monit. 2011; 16(5):224–230. DOI: 10.1097/MBP.0b013e32834af7ba.

10. Jang HS, Lee CS, Yang YH. Influence of uncertainty and uncertainty appraisal on self-management in hemodialysis patients. J Korean Acad Nurs. 2015; 45(2):271–279. DOI: 10.4040/jkan.2015.45.2.271.

11. Mo MH, Chung BY. Influencing factors on uncertainty of patients undergoing chemotherapy for lung neoplasms. J Korea Acad Ind Coop Soc. 2017; 18(4):248–259. DOI: 10.5762/KAIS.2017.18.4.248.

12. Kwon MJ, Kim YJ. Analysis of convergent factors on subjective health status of patients with depression. J Digit Converg. 2016; 14(6):309–316. DOI: 10.14400/JDC.2016.14.6.309.

13. Choi YH. Is subjective health reliable as a proxy variable for true health?: a comparison of self-rated health and self-assessed change in health among middle-aged and older south Koreans. Health Soc Welf Rev. 2016; 36(4):431–459. DOI: 10.15709/hswr.2016.36.4.431.

14. Wennberg P, Rolandsson O, Jerden L, Boeing H, Sluik D, Kaaks R, et al. Selt-rated health and mortality in individuals with diabetes mellitus: prospective cohort study. BMJ Open. 2012; 15(1):e000760. DOI: 10.1136/bmjopen-2011-000760.

15. Brewer NT, Tzeng JP, Lillie SE, Edwards AS, Peppercorn JM, Rimer BK. Health literacy and cancer risk perception: implications for genomic risk communication. Med Decis Making. 2009; 29(2):157–166. DOI: 10.1177/0272989X08327111.

16. Park SO, Kim HS, Kim BK. Factors associated with health literacy among residents living in rural communities. J Korean Data Anal Soc. 2015; 17(3):1667–1681.

17. Kim SK, Park HJ, Yang DH, Jeong HY. Influences on the performance based frailty of physical performance, exercise selfefficacy, decisional balance, and health related quality of life in adults undergoing hemodialysis. Korean J Adult Nurs. 2018; 30(2):149–160. DOI: 10.7475/kjan.2018.30.2.149.

18. Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005; 3(6):514–522.

19. Mishel MH. The measurement of uncertainty in illness. Nurs Res. 1981; 30(5):258–263.

20. Kim SY, So HS. A study on factors related depression of pretreatment patients with uterine cervical cancer. Asian Chonnam J Nurs Sci. 1996; 1:85–104.

21. Lawton MP, Moss M, Fulcomer M, Kleban MH. A research and service oriented multi level assessment instrument. J Gerontol. 1982; 37:91–99.

22. Shin YS, Kim EH. A study on health behaviors, health status and anxiety about aging for the elderly: focused on the elderly in senior center. J Korean Acad Community Health Nurs. 2009; 20(2):179–188.

23. Kim JY. A study on the health knowledge and compliance of hemodialysis patients [master's thesis]. Chonnam: Chonnam National University;1988.

24. Hong KY. A study of the relationships among dialysis related knowledge, self efficacy and compliance of patient role behavior in hemodialysis patients [master's thesis]. Seoul: Hanyang University;1999.

25. Shin KM, Chu SH, Jang YS, Kang SM. Relationships between health literacy, knowledge and self-care behaviors in elderly patients with heart failure. J Korean Clin Nurs Res. 2016; 22(1):28–37.

26. Kwon MS, Noh GY, Jang JH. A study on relationships between health literacy, disease-related knowledge and compliance to medical recommendations in patients with hypertension. J Korean Public Health Nurs. 2013; 27(1):190–202. DOI: 10.5932/JKPHN.2013.27.1.190.

27. Lee MS. Health Literacy and health behaviors among older adults with cardio-cerebrovascular disease residing in rural areas. Korean J Adult Nurs. 2017; 29(3):256–265. DOI: 10.7475/kjan.2017.29.3.256.

28. Heijmans M, Waverijn G, Rademakers J, van der Vaart R, Rijken M. Functional, communicative and critical health literacy of chronic disease patients and their importance for selfmanagement. Patient Educ Couns. 2015; 98(1):41–48. DOI: 10.1016/j.pec.2014.10.006.

29. Lee MS, Kang YH. Correlation of uncertainty, coping and health-promoting behavior in patient with gastric cancer following gastrectomy. J Korean Clin Nurs Res. 2015; 21(2):223–233. DOI: 10.22650/JKCNR.2015.21.2.223.

30. Kim YJ, Choi HJ. The influence of uncertainty and social support on general well-being among hemodialysis patients. Korean J Rehabil Nurs. 2012; 15(1):20–29. DOI: 10.7587/kjrehn.2012.20.

31. Liu T, Xu YJ, Zhang YH, Yan QH, Song XL, Xie HY, et al. Associations between risk perception, spontaneous adaptation behavior to heat waves and heatstroke in Guangdong province, China. BMC Public Health. 2013; 13(1):913. DOI: 10.1186/1471-2458-13-913.

32. Ko YH. The relationships among the physical competence, subjective health status, and health promoting behavior of elderly participating in health activity program. J Digit Converg. 2016; 14(12):571–581. DOI: 10.14400/JDC.2016.14.12.571.

33. Oh JH, Park EO. The impact of health literacy on self-care behaviors among hypertensive elderly. Korean J Health Educ Promot. 2017; 34(1):35–45. DOI: 10.14367/kjhep.2017.34.1.35.

34. Dewalt DA, Pignone MP. The role of literacy in health and health care. Am Fam Physician. 2005; 72(3):387–388.