The Development of Health Literacy for Health Management of Older Persons with Diabetes and Hypertension in Primary Care Cluster Context: Case Study in Phetchaburi Province
Keywords:
health literacy, health management, older people, diabetes and hypertension, primary careAbstract
This research and development aimed: 1) to examine health literacy and health management situation of older people with diabetic and hypertension; 2) to develop health literacy and health management program for older people with diabetic and hypertension; 3) to assess the effectiveness of health literacy and health management program for older people with diabetic and hypertension; and 4) to develop policy recommendations on health literacy and health management of older people with diabetic and hypertension. The samples were 140 early older people for quantitative study, and 18 healthcare providers such as family medicine doctors, nurses in primary care cluster (PCC), province and district public health offices. The 140 early older people were divided into 70 for experimental group and 70 for control group to assess effectiveness of the program. Data on health literacy, health management, A1c, and blood pressure were analyzed by using descriptive statistic. Paired t-test was used to compare between pre and post intervention. Independent t-test was used to compare mean between experimental and control group. Results: 1) The overall health literacy of the older people with diabetes and hypertension at the PCC was found to be insufficient at 52.7% (n = 78) and sufficient at 44.3% (n = 62), respectively. The health management scores were at moderate level ( = 2.15). The highest score was the ‘continuing care’ (
= 2.53), followed by a moderate level of ‘stress management’ (
= 2.22), ‘drug use pattern’ (
= 2.13) and ‘food consumption behavior’ (
= 2.12). The ‘exercise’ had the lowest mean score (
= 2.01). Regarding the effectiveness of health literacy program, the average A1c in the experimental group was lower than the control group (p < 0.01). The average systolic blood pressure (SBP) of the experimental group was lower than the control group (p < 0.001). Likewise, the health management scores of the experimental group were higher than the control group (p < 0.001), as well as the health literacy score (p < 0.001). The PCC should consider applying this program in order to help older people and family to better control A1c and blood pressure to reduce the risk of complications.
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