<p>Glycemic control in type 2 diabetes: role of health literacy and shared decision-making</p>

Abstract

Background: Improving glycemic control requires that patients actively participate in decisions about how to best live with the disease and adapt to the realities of self-care. Limited health literacy (HL) is related to poorer health outcomes and may make it difficult for patients to participate in shared decision-making (SDM). As such, understanding the relationship between HL and SDM and its impact on diabetes control is an urgent issue. Methods : A cross-sectional survey was conducted among outpatients with type 2 diabetes in a regional teaching hospital. Purposive sampling was used to recruit eligible 372 patients via self-administered questionnaires. HbA1C values were obtained from each patient’s laboratory assay. Results: Among the 372 participants, 50.4% of patients preferred physician decision-making, 39.3% preferred SDM, and 10.3% preferred patient decision-making. The physician explaining the illness in colloquial language, having adequate time for discussion, and encouragement from the healthcare provider were the major factors influencing patients’ involvement in SDM. Interactive HL and critical HL had positive correlations with patients’ perceived involvement in SDM. Educational attainment and HL were positively related. The HbA1C values for patient decision-making and physician decision-making were approximately 1.4 times and 1.24 times higher than those of SDM, respectively. Conclusion: SDM led to better glycemic control. HL increased patients’ perceived involvement in SDM. Therefore, it is necessary to improve levels of HL based on the educational attainment of patients. Physicians explaining illness in colloquial language is the key factor in promoting patients’ perceived involvement in SDM.

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

“…The HCWs' consultations cannot be altered by social media networks [37,38]. Continuous training and education have been recognized as effective approaches to improving HCWs' HL, further improving health care delivery [39,40], communication [39,41,42], shared decision making [43], and patient health outcomes [40]. Furthermore, raising awareness of behavioral pitfalls could support appropriate behavioral changes and containment of the crisis [44].…”

An Insight into Patients’ Perspectives on their Participation in Medical Decision Making in Diabetes Mellitus Care in Malawi.

“…Investing in individual or collective patients' participation in medical care decisions is a fundamental step in enhancing a patient centred care (PCC) experience (1). Patient participation during clinical encounters is considered a basic tenet for achieving patient empowerment and enabling patients to be active recipients of their care (1)(2)(3). Essential elements in patient participation involves active patient engagement and involvement that facilitate care responsiveness and respect for patient values (4).…”

“…Involving and engaging patients has been shown to improve clinical decision making, provider-patient concordance in making and achieving personalised goals of care (1). Further, participation improves patients' disease knowledge and their appreciation of risk, encourages patients' to have realistic expectations of care, enhances patient autonomy that facilitates better self-care and, ultimately experiences of satisfaction with care (1)(2)(3). Patient participation has also been associated with improved biomedical outcomes such as glycaemic control (1,3).…”

“…Further, participation improves patients' disease knowledge and their appreciation of risk, encourages patients' to have realistic expectations of care, enhances patient autonomy that facilitates better self-care and, ultimately experiences of satisfaction with care (1)(2)(3). Patient participation has also been associated with improved biomedical outcomes such as glycaemic control (1,3). In a study by Wang et al on type 2 DM patients, it showed increased odds of improved better glycaemic control if the patients perceived being involved in care decisions; and that decisions were made collaboratively (3).…”

Health Literacy and Preventive Behaviors Modify the Association between Pre-Existing Health Conditions and Suspected COVID-19 Symptoms: A Multi-Institutional Survey

“…People with low HL have difficulties communicating effectively with health care providers [ 18 ]. This requires more efforts from physicians to communicate in colloquial language to promote patients’ involvement in shared decision-making [ 19 ]. People with high HL have been shown to be more likely to adopt protective methods and have the preparedness to get protected from the COVID-19 infection [ 15 ].…”