The Influence of Literacy on Patient-Reported Experiences of Diabetes Self-Management Support
NLM Title Abbreviation
Background: Variability in disease-related outcomes may relate to how patients experience self-management support in clinical settings. Objectives: The purpose of this study was to identify factors associated with experiences of self-management support during primary care encounters. Methods: A cross-sectional survey was conducted of 208 patients seen in a multidisciplinary diabetes program in an academic medicine clinic. Multiple regression analysis was used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care) and race, gender, insurance status, literacy, duration of diabetes, and intensity of care management. Results: The Patient Assessment of Chronic Illness Care ratings decreased with age (r = -.235, p = .001), were higher for women than for men (3.95 vs. 3.65, t = 2.612, p = .010), and were greater for those with more education (F = 3.927, p = .009) and greater literacy skills (t = 3.839, p < .001). The ratings did not vary between racial (t = -1.108, p = .269) or insurance (F = 1.045, p = .374) groups and were unaffected by the duration of diabetes (r = .052, p = .466) and the intensity of care management (F = 1.028, p = .360). In multivariate models, literacy was the only variable contributing significantly to variation in self-management support ratings. Discussion: Even when considering the objective intensity of health services delivered, literacy was the sole variable contributing to differences in patient ratings of self-management support. Although conclusions are limited by the cross-sectional nature of this study, the results emphasize the need to consider literacy when developing and communicating treatment plans requiring self-management skills.
Nursing research, 59:5 (2010) pp.356-363.
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