Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study
Objective Limited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to report the prevalence of limited health literacy in patients with T2DM and to identify factor...
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| Format: | Article |
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e039864.full |
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| author | Karuthan Chinna Chirk Jenn Ng Su May Liew Adina Abdullah Subashini Ambigapathy Paranthaman V |
| author_facet | Karuthan Chinna Chirk Jenn Ng Su May Liew Adina Abdullah Subashini Ambigapathy Paranthaman V |
| author_sort | Karuthan Chinna |
| collection | DOAJ |
| description | Objective Limited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to report the prevalence of limited health literacy in patients with T2DM and to identify factors that are associated with it.Design A cross-sectional study was conducted from January to March 2018; data on patients’ sociodemographic characteristics, diabetes knowledge, perceived social support and health literacy level were collected. Health literacy level was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47).Setting Patients were recruited from four primary care clinics in Perak, Malaysia.Participants Adult patients diagnosed with T2DM who attended the study clinics during the study period.Primary outcome variable Patients with HLS-EU-Q47 General Index of ≤33 points were classified as having limited health literacy.Results The prevalence of limited health literacy was 65.3% (n=279). In bivariate analysis, patients’ ethnicity (p=0.04), highest education level (p<0.001), monthly income (p=0.003), having health insurance (p=0.007), English language fluency (p<0.001), Malay language fluency (p=0.021), attending diabetes education sessions (p<0.001), perceived social support (p<0.001) and diabetes knowledge (p=0.019) were factors associated with limited health literacy. In logistic regression, not being fluent in English was associated with limited health literacy (OR=2.36, 95% CI 1.30 to 4.30) whereas having high perceived social support (OR=0.52, 95% CI 0.40 to 0.69) and having attended diabetes education sessions (OR=0.42, 95% CI 0.27 to 0.68) were associated with adequate health literacy.Conclusion The prevalence of limited health literacy is high among patients with T2DM in Perak, Malaysia. Strategies to improve health literacy in these patients must consider the influences of English fluency, attendance at diabetes education sessions and social support, and may need to adopt a universal approach to addressing limited health literacy. |
| format | Article |
| id | doaj-art-d801d47d52524a7992ce04c89dbd9d2d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d801d47d52524a7992ce04c89dbd9d2d2024-11-26T08:00:11ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-039864Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional studyKaruthan Chinna0Chirk Jenn Ng1Su May Liew2Adina Abdullah3Subashini Ambigapathy4Paranthaman V5School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Kuala Lumpur, MalaysiaDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysiaresearch studentDepartment of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University Malaya, Kuala Lumpur, MalaysiaHealth Clinic Buntong, Ministry of Health Malaysia, Ipoh, MalaysiaHealth Clinic Greentown, Ministry of Health Malaysia, Ipoh, MalaysiaObjective Limited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to report the prevalence of limited health literacy in patients with T2DM and to identify factors that are associated with it.Design A cross-sectional study was conducted from January to March 2018; data on patients’ sociodemographic characteristics, diabetes knowledge, perceived social support and health literacy level were collected. Health literacy level was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47).Setting Patients were recruited from four primary care clinics in Perak, Malaysia.Participants Adult patients diagnosed with T2DM who attended the study clinics during the study period.Primary outcome variable Patients with HLS-EU-Q47 General Index of ≤33 points were classified as having limited health literacy.Results The prevalence of limited health literacy was 65.3% (n=279). In bivariate analysis, patients’ ethnicity (p=0.04), highest education level (p<0.001), monthly income (p=0.003), having health insurance (p=0.007), English language fluency (p<0.001), Malay language fluency (p=0.021), attending diabetes education sessions (p<0.001), perceived social support (p<0.001) and diabetes knowledge (p=0.019) were factors associated with limited health literacy. In logistic regression, not being fluent in English was associated with limited health literacy (OR=2.36, 95% CI 1.30 to 4.30) whereas having high perceived social support (OR=0.52, 95% CI 0.40 to 0.69) and having attended diabetes education sessions (OR=0.42, 95% CI 0.27 to 0.68) were associated with adequate health literacy.Conclusion The prevalence of limited health literacy is high among patients with T2DM in Perak, Malaysia. Strategies to improve health literacy in these patients must consider the influences of English fluency, attendance at diabetes education sessions and social support, and may need to adopt a universal approach to addressing limited health literacy.https://bmjopen.bmj.com/content/10/11/e039864.full |
| spellingShingle | Karuthan Chinna Chirk Jenn Ng Su May Liew Adina Abdullah Subashini Ambigapathy Paranthaman V Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study BMJ Open |
| title | Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study |
| title_full | Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study |
| title_fullStr | Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study |
| title_full_unstemmed | Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study |
| title_short | Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study |
| title_sort | prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in perak malaysia a cross sectional study |
| url | https://bmjopen.bmj.com/content/10/11/e039864.full |
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