The Relationship Between Health Literacy, Self-Efficacy, and Self-Care Behaviors in Older Adults With Hypertension in the North of Iran

Abstract

Background: Hypertension is the main risk factor for cardiovascular disease. Low level of health literacy is more common in people with hypertension. Evidence suggests that hypertension is preventable and can be controlled by modifying lifestyle and improving self-care behaviors. Objective: This study aimed to determine the relationship between health literacy, self-efficacy, and self-care behaviors in older adults with hypertension. Methods: The present study was a cross-sectional study conducted with 150 older adult patients with hypertension admitted to the Cardiac Care Unit (CCU) and post-CCU wards in East Guilan public hospitals in the north of Iran in 2020. Sampling was conducted using a convenience method based on inclusion criteria (age 60 years and older, high blood pressure and taking antihypertensive drugs for at least 6 months, ability to speak and communicate, having the suitable physical condition (not ill) to participate in research and answer questions, and having informed consent to participate in the study). The research instruments included a Health Literacy Questionnaire for Iranian Adults, a self-efficacy questionnaire in patients with hypertension, and a self-care behavior questionnaire for patients with hypertension. Descriptive statistics and multiple linear regression were used to analyze the data using SPSS software version 19. Key Results: The results showed that most patients had adequate health literacy with a mean score of 116.77 (standard deviation [ SD ] = 8.34), excellent self-efficacy with a mean score of 23.06 ( SD = 1.99) and relatively desirable self-care behaviors with a mean score of 51.79 ( SD = 4.37). Findings also indicated that health literacy can predict self-efficacy (beta = 0.262, p = .001) and self-care behaviors (beta = 0.639, p = .000). Conclusions: Based on results, health literacy is a predictor of self-efficacy variables and self-care behaviors. Therefore, planning to improve the health literacy of the older adult to promote self-efficacy and self-care behaviors and ultimately their health is recommended. [ HLRP: Health Literacy Research and Practice . 2022;6(4):e262–e269. ] Plain Language Summary: This study sought to determine the role of health literacy in predicting self-efficacy and self-care behaviors in older adults with hypertension admitted to CCU and post-CCU wards in East Guilan public hospitals in the north of Iran. Findings of this research demonstrate health literacy can predict self-efficacy and self-care behaviors.

Relationship between health literacy and health-related quality of life in Korean adults with chronic diseases

“…However, after adjustments for covariates, adequate health literacy is associated with the odds of reporting no problems with self-care, mobility, usual activities, and anxiety/depression only. The existing literature supports the link between these specific dimensions of HRQoL and health literacy, based on some demographic groups [ 52 , 53 ] and a few common chronic conditions [ 54 , 55 ]. For example, the significant influence of health literacy on self-care behaviors has been documented in patients with diabetes [ 54 ], hypertension [ 55 ], and heart failure [ 56 ].…”

“…The existing literature supports the link between these specific dimensions of HRQoL and health literacy, based on some demographic groups [ 52 , 53 ] and a few common chronic conditions [ 54 , 55 ]. For example, the significant influence of health literacy on self-care behaviors has been documented in patients with diabetes [ 54 ], hypertension [ 55 ], and heart failure [ 56 ]. Adequate health literacy is linked to lower disease activity and improved physical functioning among patients with rheumatic diseases [ 57 ].…”

Association between general self-efficacy and health literacy among stroke survivors 1-year post-discharge: a cross-sectional study

“…In this study, higher levels of general self-efficacy were associated with higher levels of health literacy in all statistical models. In other populations, an association between self-efficacy and health literacy has been identified for patients with diabetes 39 , 40 , patients with coronary disease 41 , patients in cardiac rehabilitation 42 , and older adults with hypertension 43 . In stroke survivors, a previous study found a positive association between health literacy and self-efficacy in the use and understanding of medication 44 .…”

Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study

“…The adoption of positive health behaviors also declines with age due to individual limitations [ 4 ] and systemic obstacles posed by poverty, isolation, poor literacy levels, and the absence of elderly-centric healthcare policies. Moreover, compromised health literacy and self-efficacy further impede the translation of healthcare messages into tailored self-care among slum geriatrics [ 5 ].…”