The Research On The Relationship Between Health Information Literacy,Diabetes Self-management Behavior And Health Outcome In Patients With Type 2 Diabetes Mellitus

Objectives1.To evaluate the health information literacy of patients with type 2 diabetes mellitus.and to understand the status and influencing factors of the health information literacy of patients with type 2 diabetes mellitus2.To explore the correlation between health information literacy,diabetes knowledge and diabetes self-management behavior in patients with type 2 diabetes mellitus.3.To construct a influence model to explore the effects of health information literacy on diabetes self-management behavior and health outcome based on information-motivation-behavior skill model(IMB)in patients with type 2 diabetes mellitusMethods1.From November 2018 to May 2019,352 patients with type 2 diabetes mellitus hospitalized in the Endocrinology Department of a three-level hospital in Yangzhou City were interviewed according to inclusion and exclusion criteria.2.The general condition.health information literacy,diabetes knowledge,self-management behavior,health beliefs,social support,diabetes self-efficacy and diabetes-specific quality of life was assessed by self-designed general situation questionnaire.the Health Information Literacy Self-assessment Questionnaire,the Diabetes Knowledge Test(DKT),the Summary of Diabetes Self-care Activities(SDSCA),the Diabetes Health Beliefs Scale,the Social Support Assessment Scale(SSAS),the Diabetes Self-efficacy Scale(DSES)and the Diabetes-Specific Quality of Life Scale(DSQLS).Metabolic indicators such as HbAlc,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were obtained from the patient's medical history.3.Epidata3.1 was used to input data,and SPSS21.0,PROCESS v2.16 plug-in and AMOS24.0 were used for date statistics and analysis.Statistical methods included descriptive analysis,independent sample t-test,non-parametric test,one-way analysis of variance,multiple linear stepwise regression analysis,spearman correlation analysis.Bias-Corrected Bootstrap mediation effect test and the structural equation modelResults1.Current status and influencing factors of health information literacy of patients with type 2 diabetes mellitus.The lowest score of health information literacy in patients with type 2 diabetes mellitus was 5.33,and the highest score was 26,with an average score of 14.41 12.91.The average score of health information cognition,health information search,health information evaluation,health information application and health information morality were 2.5310.70,4.57±2.10.2.801±0.80,2.25±0.75 and 2.26±0.42,respectively.The results of single factor analysis of the influencing factors of health information literacy in patients with type 2 diabetes mellitus showed that there were significant differences in gender,age,education level,people living together,job,income,drinking,availability of Internet electronic devices,using electronic devices on health,diabetes-related health education and course of disease(P<0.05).The results of multiple linear stepwise regression analysis showed that education.job,income,course of disease,using electronic devices on health and diabetes-related health education were independent influencing factors of health information literacy in patients with type 2 diabetes mellitus and the cumulative contribution of the total variation was 49.20%2.The correlation between health information literacy,diabetes knowledge and self-management behavior in patients with type 2 diabetes mellitusIn this study,the lowest total average score of self-management behavior of 352 patients with type 2 diabetes mellitus was 0.40,the highest score was 6.70,the median score was 3.50,and 75%of the patients were in the low and middle level.The self-management score of drug treatment dimension is the highest,and the score of foot care dimension is the lowest.Under different grades of self-management behavior,there were significant differences in health information literacy among patients with type 2 diabetes mellitus(P<0.05).Except for health information morality,there were significant differences in other dimensions of health information literacy under different levels of self-management behavior(P<0.05).There was a positive correlation between health information literacy and self-management behavior and its dimensions(P<0.05).Health information literacy has a significant mediating effect between the diabetes knowledge and self-management behavior of patients with type 2 diabetes mellitus.3.Construct a influence model to explore the effects of health information literacy on diabetes self-management behavior and health outcome based on information-motivation-behavior skill model in patients with type 2 diabetes mellitus.In this study,a influence model was constructed based on IMB model to explore the effect of health information literacy on diabetes self-management behavior and health outcome in patients with type 2 diabetes mellitus.After gradual modification.the model fitted well.and the fitting result of the model wasx'=248.8.df=60,x'/df?4.1 5.GFI=0.924.AGFI=0.904,CFI=0.910.RMSEA=0.074.The influence path of health information literacy on diabetes self-management behavior and health outcome of patients with type 2 diabetes is as follows:health information literacy?self-efficacy?self-management behavior?health outcome,and the path coefficient is statistically significant(P<0.05).Conclusion1.The overall level of health information literacy of patients with type 2 diabetes mellitus is not ideal.Education.people living together,income,course of disease,using electronic devices on health and diabetes-related health education are the influencing factors of health information literacy in patients with type 2 diabetes mellitus.Health educators should take intervention measures according to the above factors.2.There is a correlation between health information literacy and self-management behavior of patients with type 2 diabetes mellitus.The higher the health information literacy,the better the self-management behavior.Health information literacy is the intermediary factor between diabetes knowledge and self-management behavior,and can effectively promote the practical application of diabetes knowledge.3.Health information literacy can be incorporated into the IMB model,and the influence model of health information literacy on diabetes self-management behavior and the health outcome of patients with type 2 diabetes mellitus fits well,which can be used for follow-up intervention guidance for patients with type 2 diabetes mellitus.