Relationships of health literacy to self-care behaviors in people with diabetes aged 60 and above: Empowerment as a mediator.

AIM: To examine the relationships of health literacy to diabetes self-care behaviors (diet, physical exercise, foot care and blood glucose monitoring) through empowerment controlling for diabetes education. BACKGROUND: Potential mechanisms of how health literacy links to health outcomes have not clearly elucidated. DESIGN: A cross-sectional study design was used. METHODS: Participants were recruited from three community health centers in South Korea from September 2016 to April 2017 using a convenience sampling method. A total of 136 people with diabetes aged 60 and above were participated in this study. The main study variables of health literacy, empowerment and diabetes self-care activities were assessed using self-reported questionnaires. This study applied a simple mediation analysis with a single covariate using the PROCESS macro, with health literacy entered as an antecedent variable, empowerment as a mediator, diabetes self-care behaviors as outcome variables and diabetes education as a covariate. RESULTS: After controlling for diabetes education, the indirect effects of health literacy to self-care behaviors through empowerment were significant when the self-care behaviors were particularly diet and physical exercise. Whereas, the indirect effects were not significant when the self-care behaviors were foot care and blood glucose monitoring. CONCLUSIONS: This study indicates that the people with higher health literacy were more empowered and those with higher empowerment were more likely to eat healthy foods and exercise. In the light of these findings, a health literacy-tailored empowerment enhancing program may be important targets for interventions promoting diabetes self-care behaviors of diet and physical exercise.

The factors associated with Vitamin D deficiency in community dwelling elderly in Korea.

BACKGROUND/OBJECTIVES: Recent studies showed vitamin D deficiency is linked to chronic diseases in addition to skeletal metabolism which could threaten the elderly. We analyzed health conditions and socio-demographic factors associated with vitamin D deficiency in community dwelling people aged 65 years and older. SUBJECTS/METHOD: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010 to 2012 were obtained. A total of 2,687 subjects aged 65 years and older were participated. The cutoff value of the Vitamin D deficiency was considered as serum 25-hydroxyvitamin D [25(OH)D] ≤ 20 ng/mL (50 nmol/L). RESULTS: The overall prevalence rate of vitamin D deficiency in the elderly was 62.1%. The factors such as female, obesity, metabolic syndrome, current smoker, and skipping breakfast were positively associated with vitamin D deficiency, but high intensity of physical activity and more than 9 hours of sleep duration were negatively associated with vitamin D deficiency (all P < 0.05). CONCLUSIONS: It is important that health professions know that the factors proved in this study are connected to vitamin D deficiency thus provide information and intervention strategies of vitamin D deficiency to old aged people.