Association between Health Literacy, Self-Care Behaviors, and Clinical Outcomes among People with Chronic Kidney Disease in Primary Care Units

Abstract

Introduction Chronic Kidney Disease (CKD) is a major complication of non-communicable diseases (NCDs). Slowing down kidney deterioration is crucial in preventing end-stage renal disease. Health literacy plays a vital role in promoting desirable behaviors and achieving positive clinical outcomes. 

Objectives 1) To describe health literacy among people with chronic kidney disease receiving services at primary care units, 2) To describe self-care behaviors among people with chronic kidney disease receiving services at primary care units, and 3) To examine the relationships between health literacy, self-care behaviors, estimated glomerular filtration rate, and proteinuria among people with chronic kidney disease receiving services at primary care units. 

Design Descriptive correlational research 

Methodology In this study, the sample comprised people with stage 2-3 chronic kidney disease receiving services at NCD clinics in four Sub-district Health Promoting Hospitals located in Nonthaburi and Nakhon Pathom provinces. A total of 108 participants were selected through purposive sampling, based on the inclusion criteria. Data were collected using demographic information, health literacy, and self-care behaviors questionnaires, and health record form. Data analysis consisted of descriptive statistics, Pearson product-moment correlation, and Spearman's Rank correlation. 

Results People with CKD had overall high health literacy levels. When considering each aspect, the participants had medium-level communication skills and low-level information-sharing skills. Self-care behaviors of participants were at a high level. Health literacy was found to have a significant association with self-care behaviors (rs = .580, p < .001) and estimated glomerular filtration rate (rs = .215, p = .025). However, no significant associations were observed between health literacy and proteinuria (rs = -.047, p = .633), or between self-care behaviors and estimated glomerular filtration rate (r = .107, p = .271) and proteinuria (rs = -.008, p = .931). 

Recommendations This study highlights the importance of improving health literacy, particularly communication skills with healthcare professionals and the ability to convey information. Enhanced health literacy can promote effective self-care behaviors among people with CKD, ultimately slowing disease progression.