Study On Health Literacy And Preparation For Future Care Of Elderly Chronic Disease Patients In Wuhan Community

Objective:This study was to understand the general status,health literacy level,preparation for future care of the elderly patients with chronic diseases in Wuhan community,to probe the relationship between health literacy and preparation for future care,as well as to explore the factors affecting the preparation for future care among the elderly patients with chronic diseases,so as to provide a theoretical basis for the research and nursing intervention of the elderly preparation for future care for chronic diseases.Methods:The convenience sampling method was used to investigate 340 elderly patients with chronic diseases in 10 communities in Jiangan District,Qiaokou District and Dongxihu District of Wuhan city.The measurement tools included the general information questionnaire,the health literacy scale for chronic patients,the preparation scale for future care needs,and the activities of daily living.SPSS 24.0 software was used for data analysis,and descriptive statistical analysis,non-parametric test,chi-square test,spearman correlation test and multiple linear stepwise regression were used to analyze the data.Results:(1)The total score of health literacy of elderly patients with chronic diseases was 101.00(91.00,108.00),66.6% of them had health literacy.The score of each dimension is from the highest to the lowest,which is economic support willingness,information acquisition ability,health improvement willingness,and communication and interaction ability.There was statistical difference in the level of health literacy among different age,educational level,marital status,occupation before retirement,personal monthly income,number of children,living with whom,medical insurance,self-rated health status,own health behavior,and ADL(P < 0.05);There were statistical differences among different genders in the dimensions of health literacy(P < 0.05),and there were statistical differences among different numbers of chronic diseases in the scores of information acquisition ability,health improvement willingness and economic support willingness(P < 0.05).(2)There were 165 elderly patients with chronic diseases who had a high level of preparation for future care,accounting for 52.1%.Among them,the dimension with the highest proportion of high level was consciousness(69.7% patients had high consciousness),and the lowest proportion of high level was concrete planning(17.7% patients had high concrete planning).There was statistical difference in the level of preparation for future care among different educational level,occupation before retirement,personal monthly income and medical insurance(P < 0.05).(3)There was a positive correlation between health literacy and preparation for future care of elderly patients with chronic diseases(r=0.373,P < 0.01).The health literacy of elderly patients with chronic diseases was positively correlated with preparation for future care(r=0.373,P < 0.01),consciousness(r=0.404,P < 0.01),gathering information(r=0.302,P < 0.01),decision making(r=0.232,P < 0.01),and concrete planning(r=0.232,P < 0.01).Preparation for future care was significantly positively correlated with information acquisition ability(r=0.143,P < 0.05),communication and interaction ability(r=0.342,P <0.01)and health improvement willingness(r=0.372,P < 0.01).(4)Through multiple linear stepwise regression analysis,it was found that the independent influencing factors of patients’ preparation for future care were communication and interaction ability,health improvement willingness,medical insurance,personal monthly income and educational level,which could explain 29.9% variation of preparation for future care.Conclusion:(1)The health literacy level of elderly patients with chronic diseases is at the medium level,and there are significant differences in ages,educational level,marital status,occupation before retirement,personal monthly income,number of children,living with whom,medical insurance,self-assessed health status,health behaviors,and ADL.(2)The elderly patients with chronic diseases have a low level of preparation for future care,and there are significant differences in education level,occupation before retirement,personal monthly income and medical insurance.(3)The health literacy of elderly patients with chronic diseases is positively correlated with preparation for future care.The higher the level of health literacy,the more adequate the preparation for future care of the elderly patients with chronic diseases.(4)The main influencing factors of preparation for future care of elderly patients with chronic diseases are communication and interaction ability,health improvement willingness,medical insurance,personal monthly income and educational level.