HEALTH LITERACY AND PATIENT ACTIVATION AMONG ADULTS WITH CHRONIC DISEASES IN SINGAPORE: A CROSS-SECTIONAL STUDY

Abstract

Background: With an aging population, there has been an increasing prevalence and exacerbation of chronic diseases. Past studies have shown that centralising self-management of chronic diseases can be through health literacy and patient activation, as they predict health behaviours, choices, and clinical outcomes. However, there are complex interactions between health literacy and patient activation, and the interventions to increase patient activation remains relatively new. Aims: This study investigated the following among outpatient adults with chronic diseases in Singapore: (1) Health literacy proficiency, (2) Patient activation levels, (3) Association between domain-specific health literacy and patient activation, and (4) The significant predictors (independent variables) that could influence patient activation (dependent variable). The domain-specific health literacies are: Finding Health Information (FHI), Understanding Health Information (UHI), Actively Managing my Health (AMH), Appraising Health Information (AHI), and eHealth Literacy. Methods: A cross-sectional design with convenience sampling was utilised to recruit 200 chronic-diseased participants in the outpatient clinics of an acute government hospital. A Socio-demographic Questionnaire, Health Literacy Questionnaire (HLQ), eHealth Literacy Scale (eHEALS), and Patient Activation Measure (PAM) measured the study variables. Descriptive and inferential statistics were used for data analysis. Results: Significant and positive correlations between patient activation and FHI (r=0.573, p<0.01), UHI (r=0.526, p<0.01), AMH (r=0.468, p<0.01), eHealth Literacy (r=0.460, p<0.01), and AHI (r=0.453, p<0.01) were revealed based on Pearson Correlation Coefficient. AMH (?=7.702, p<0.001) and UHI (?=5.188, p=0.016) were identified as significant predictors on the General Linear Model (GLM). These accounted for 39.1% of the variance. 2 Conclusion: A preliminary foundation of the different health literacy skills’ and patient activation level among outpatient adults with chronic diseases in Singapore was laid. Essentially, it enables clinicians to develop and offer tailored self-management support interventions according to an individual’s health literacy skills and patient activation level gap. This can hold promise to improve clinical outcomes.