Health-literacy, self-efficacy and health-outcomes of patients undergoing haemodialysis: Mediating role of self-management.

Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 101392167 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-6686 (Electronic) Linking ISSN: 17556678 NLM ISO Abbreviation: J Ren Care Subsets: MEDLINE

Publication: Malden, MA : Wiley-Blackwell
Original Publication: Paris : EDTNA/ERCA

Health Literacy*/standards ; Health Literacy*/statistics & numerical data ; Self Efficacy* ; Renal Dialysis*/psychology ; Renal Dialysis*/methods ; Self-Management*/methods ; Self-Management*/psychology; Humans ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; Aged ; Taiwan ; Surveys and Questionnaires ; Adult

Background: Health literacy, self-efficacy and self-management are known to influence health-related well-being. However, the precise influence of self-management, health literacy and self-efficacy on health outcomes in Asian countries is under-researched.
Objectives: To examine the impact of health literacy and self-efficacy (independent variables) and self-management (mediator) on patients' health outcomes (dependent variable).
Design: An observational, cross-sectional design was conducted between 1 March 2022 and 31 August 2022.
Participants: Outpatients receiving haemodialysis (n = 200) at a Taiwanese medical centre were assessed.
Measurements: The survey included demographic questions and standardised scales: the 3-item Brief Health Literacy Screen, the 8-item Perceived Kidney/Dialysis Self-Management Scale as a measure of self-efficacy, and the 20-item Haemodialyses Self-Management Instrument. Health outcomes were responses on the 12-item Short-Form Health Survey version 2 and clinical blood results from the past 3 months.
Results: Participants aged over 60 exhibited common comorbidities, with 34% showing low health literacy. Biochemical markers (e.g., haemoglobin and albumin) significantly correlated with physical and mental health scores. Mediating coefficients revealed that self-management significantly influenced associations between health outcomes, health literacy (β = 0.31; p < 0.01), and self-efficacy (β = 0.19; p < 0.01).
Implications for Practice: Self-management can modify the overall influence of health literacy and self-efficacy on patients' quality of physical and emotional health. When managing a chronic condition, 'knowing' how to self-manage does not always result in 'doing so' by the patient. Continuous monitoring and promoting self-management behaviours and support by nurses are crucial to enhance health outcomes.
(© 2024 European Dialysis and Transplant Nurses Association/European Renal Care Association.)

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Keywords: haemodialysis; health literacy; quality of life; self‐efficacy; self‐management

Date Created: 20240324 Date Completed: 20241112 Latest Revision: 20241127

20241202

10.1111/jorc.12493

38522017