Health literacy and patient activation among adults with chronic diseases in Singapore: A cross-sectional study.
Laura Yuqi Huang, Yongxing Patrick Lin, George Frederick Glass and 1 others
PMID 33942559WHAT IT FOUND
Actively managing health, understanding health information and finding good health information were linked to greater ability to manage their condition in 200 Singapore outpatients with chronic disease.
Age, education and income were not linked in the main analysis.
Key findings
01In the main model, actively managing health, understanding health information and finding good health information were linked to higher patient activation.
02The mean activation score was 58.8 out of 100; the highest health literacy domain was understanding health information and the lowest was appraising health information.
03eHealth literacy was in the main model but did not meet the study's threshold for a clear association with activation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot show whether health literacy came before activation or vice versa. Participants were recruited by convenience sampling from outpatient clinics at one hospital, so they may not represent all adults with chronic disease. All measures were self-reported, so they captured perceived skills and activation rather than observed behaviour. The study excluded people with cognitive impairment, psychiatric treatment, terminal disease, or severe sensory impairments, and required English or Mandarin, so it may not apply to more complex or non-English or non-Mandarin speakers. The analysis was exploratory and used model selection, so the retained variables may not be stable in other samples.
Declared interests
The authors declared no conflicts of interest. The supplied text does not report who funded the work.
The easy way to misread this
Do not conclude that improving health literacy will raise patient activation or improve chronic disease control. The study measured both at one time and did not test an intervention.