Causal Model of Health Literacy in Thai Older Adults with Knee Osteoarthritis

Authors

  • Porntip Pa-in Faculty of Nursing, Chiang Mai University, Mueang, Chiang Mai, Thailand.
  • Tipaporn Wonghongkul Faculty of Nursing, Chiang Mai University, Mueang, Chiang Mai, Thailand.
  • Sirirat Panuthai Faculty of Nursing, Chiang Mai University, Mueang, Chiang Mai, Thailand.
  • Totsaporn Khampolsiri Faculty of Nursing, Chiang Mai University, Mueang, Chiang Mai, Thailand.
  • Rojanee Chintanawat Faculty of Nursing, Chiang Mai University, Mueang, Chiang Mai, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2023.262040

Keywords:

Cognitive function , Health literacy , Internet use , quality of life, knee osteoarthritis, Thai patients, structural equation modeling, Patient engagement , Social participation, Social support

Abstract

           Knee osteoarthritis is the most common form of arthritis causing disability among older adults. Proper self-care is vital and achievable with health literacy. Thai older adults with knee osteoarthritis have been found to have inadequate health literacy, and poor selfcare behaviors for this condition. The purpose of this descriptive cross-sectional study was to test a causal model of health literacy in Thai older adults with knee osteoarthritis, depicting relationships among provider-patient communication, patient engagement, cognitive function, knowledge of knee osteoarthritis, Internet use, social support, social participation, and health literacy. Participants comprised 318 older adults with knee osteoarthritis, selected using multi-stage random sampling from nine community hospitals in a northern Thai province. Data were collected using a demographic data form, the European Health Literacy Survey Questionnaire, the Provider-patient Communication Scale, the Patient Health Engagement Scale, the Montreal Cognitive Assessment-Basic, the Arthritis Knowledge Scale, the Internet Use Questionnaire, the Social Support Questionnaire, and the Community Participation of the Elderly Questionnaire. Data were analyzed using descriptive statistics, Pearson’s product moment correlation, and structural equation modeling.
           The final model fitted with empirical data and explained 36% of the variance in health literacy with Internet use as the strongest predictor directly affecting health literacy. Internet use and social participation had positive direct and indirect effects on health literacy via cognitive function. Cognitive function and social support positively directly affected health literacy. Patient engagement negatively affected health literacy indirectly via Internet use. Knowledge of knee osteoarthritis and provider-patient communication did not affect health literacy directly or indirectly. In conclusion, nurses should design interventions to promote health literacy of this population by highlighting Internet use, social participation, cognitive function, social support, and patient engagement, with testing in clinical practice.

References

Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. eClinicalMedicine. 2020;29–30:100587. doi: 10.1016/j.eclinm.2020.100587.

The Strategy and Planning Division, Ministry of Public Health. Public health statistics A.D. 2020. Nonthaburi: The Strategy and Planning Division; 2021 (in Thai).

Zolbin MG, Huvila I, Nikou S. Health literacy, health literacy interventions and decision-making: a systematic literature review. J Doc. 2022;78(7):405-28. doi:10.1108/JD-01-2022-0004.

Rakpanusit T, Khoyneung N, Isaramalai S, Kuha A. Effects of health literacy and self-perceived health status on quality of life of elderly in three southern border provinces of Thailand. SCNJ. 2020;7(3):182–94.

Teeyapan W, Mongkoldit V. Relationship between health literacy and self-care behaviors of elderly with knee osteoarthritis at health care centers in Sunpasitthiprasong Hospital, Ubon Ratchathani. J Educ Innov Res. 2022;6(2):336-51(in Thai).

Sørensen K, van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80. doi:10.1186/1471-2458-12-80.

Pinprapapan E, Panuthai S, Vannarit T, Srisuphan W. Causal model of adherence to therapeutic regimens among Thais with

hypertension. Pacific Rim Int J Nurs Res. 2013;17(3): 268–81.

Egeh B. Physician–patient communication: association with health literacy in African Americans living with type 2 diabetes mellitus [dissertation]. [Minneapolis, United States]: Walden University; 2020.

Namwong A, Panuthai S, Suwanprapisa T, Khampolsiri T. A casual model of adherence to therapeutic Thai older adults with hypertension. Pacific Rim Int J Nurs Res. 2015;19(2):107–21.

Graffigna G, Barello S, Bonanomi A, Lozza E. Measuring patient engagement: development and psychometric properties

of the Patient Health Engagement (PHE) Scale. FrontPsychol. 2015;6. doi:10.3389/fpsyg.2015.00274.

Barello S, Palamenghi L, Graffigna G. The mediating role of the patient health engagement model on the relationship

between patient perceived autonomy supportive healthcare climate and health literacy skills. Int J Environ Res Public Health. 2020;17(5):1741. doi:10.3390/ijerph17051741.

Chirumamilla S, Gulati M. Patient education and engagement through social media. Curr Cardiol Rev. 2021;17(2):137–43. doi:10.2174/1573403x15666191120115107.

Julayanont P, Tangwongchai S, Hemrungrojn S, Tunvirachaisakul C, Phanthumchinda K, Hongsawat, et al. The Montreal

Cognitive Assessment-Basic: a screening tool for mild cognitive impairment in illiterate and low-educated elderly adults. J Am Geriatr Soc. 2015;63(12):2550–4. doi:10.1111/jgs.13820.

Liu YB, Chen YL, Xue HP, Hou P. Health literacy risk in older adults with and without mild cognitive impairment. Nurs Res. 2019;68(6):433–8. doi:10.1097/nnr.0000000000000389.

Aree-Ue S, Piyakajornrot N. Outcomes of health education and home-based exercise program for patients with knee osteoarthritis. TJNC. 2008;23(3):72–84 (in Thai).

Yeh JZ, Wei CJ, Weng SF, Tsai CY, Shih JH, Shih, et al. Disease-specific health literacy, disease knowledge, and adherence behavior among patients with type 2 diabetes in Taiwan. BMC Public Health. 2018;18(1). doi:10.1186/s12889-018-5972-x.

Kheokao J, Krirkgulthorn T, Yingrengreung S, Chamnansua P, Chumchai P. Online social media uses and eHealth literacy of Cambodian workers in Thailand. TLA Research J. 2017;10(1):33–46 (in Thai).

Trainattawan W, Wirojratana V, Watanakukrilert D. Factors influencing health literacy among older adults. J Health Sci Res. 2019;13(2):41–51 (in Thai).

Yu X, Mu A, Wu X, Zhou L. Impact of internet use on cognitive decline in middle-aged and older adults in China: longitudinal observational study. J Med Internet Res. 2022;24(1):e25760. doi: 10.2196/25760.

Schaefer C, Coyne JC, Lazarus RS. The health-related functions of social support. J Behav Med. 1981;4(4):381–406. doi:10.1007/bf00846149.

Hosseingholizadeh N, Sadeghi R, Ardebili HE, Foroushani AR, Taghdisi MH. The correlation of self-efficacy and social support with social participation: a cross-sectional study among the elderly. J Med Life. 2019;12(3):239–46. doi:10.25122/jml-2019-0010.

Linsuwanont P. A study of depression in the elderly Rongmuang sub-district, Pratumwan, Bangkok metropolis [Thesis]. [Bangkok, Thailand]: Mahidol University; 2000 (in Thai).

Amoah PA. Social participation, health literacy, and health and well-being: a cross-sectional study in Ghana. SSM Popul Health. 2018;4:263–70. doi:10.1016/j.ssmph.2018.02.005.

Fernández I, García-Mollá A, Oliver A, Sansó N, Tomás JM. The role of social and intellectual activity participation in older adults’ cognitive function. Arch Gerontol Geriatr. 2023;107:104891. doi:10.1016/j.archger.2022.104891.

Kline RB. Principles and practice of structural equation modeling. 4th ed. New York: Guilford Publications; 2016.

Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433-41. doi:10.1111/j. 1532-5415.1975.tb00927.x.

Sørensen K, van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13(1). doi:10.1186/1471-2458-13-948.

Brislin RW. Back-translation for cross-cultural research. J Cross-Cult Psychol. 1970;1(3):185-216. doi:10.1177/ 135910457000100301.

Jitauraungkoon P, Wanitkun N, Danaidusadeekul S, Tocharoenchok T. Predictors of quality of life during 6–18 weeks among patients with post coronary artery bypass graft. Nurs Sci J Thail. 2017;35(3):106–19 (in Thai).

Chew F. Can eHealth literacy promote health and bridge the healthcare divide in the United States? World Association for Public Opinion Research 68th Conference, Buenos Aires, Argentina; 2015.

Hanucharurnkul S. Social support, self-care, and quality of life among cancer patients receiving radiation in Thailand [dissertation]. [Detroit, United States]: Wayne State University; 1988.

Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 8th ed. Hampshire, UK: Cengage Learning; 2019.

Gohir SA, Eek F, Kelly A, Abhishek A, Valdes AM. Effectiveness of internet-based exercises aimed at treating knee osteoarthritis. JAMA Netw Open. 2021;4(2): e210012. doi:10.1001/jamanetworkopen.2021.0012.

Feng Z, Cramm JM, Nieboer AP. Social participation is an important health behavior for health and quality of life among chronically ill older Chinese people. BMC Geriatr. 2020;20(1). doi:10.1186/s12877-020-01713-6.

Liu YB, Chen YL, Xue HP, Hou P. Health literacy risk in older adults with and without mild cognitive impairment. Nurs Res. 2019; 68(6):433–8. doi:10.1097/nnr.000000000 0000389.

Kamsan SS, Singh DKA, Tan MP, Kumar S. The knowledge and self-management educational needs of older adults with knee osteoarthritis: a qualitative study. PLOS ONE. 2020;15(3): e0230318. doi:10.1371/journal.pone.0230318.

Wells TS, Rush SR, Nickels LD, Wu L, Bhattarai GR, Yeh CS. Limited health literacy and hearing loss among older adults. Health Lit Res Pract. 2020;4(2):e129–37. doi:10.3928/24748307-20200511-01.

Seifollahzadeh S, MotalebiSA, Amirzadeh Iranagh J, Mafi M, Mohammadi F. Predictors of health literacy in community-dwelling elderly. Soc Health Behav. 2019; 2:139-44. doi:10.4103/shb.shb_27_19.

Davis SN, Wischhusen JW, Sutton SK, Christy SM, Chavarria EA, Sutter ME, et al. Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older black Americans Patient Educ Couns. 2020;103(2):385–91. doi:10.1016/j.pec.2019.08. 026.

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Published

2023-03-27

How to Cite

1.
Porntip Pa-in, Tipaporn Wonghongkul, Sirirat Panuthai, Totsaporn Khampolsiri, Rojanee Chintanawat. Causal Model of Health Literacy in Thai Older Adults with Knee Osteoarthritis. PRIJNR [Internet]. 2023 Mar. 27 [cited 2024 Dec. 23];27(2):303-16. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/262040

Issue

Vol. 27 No. 2 (2023): April- June, 2023

Section

Original paper

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