Introduction: Health literacy is widely considered to be a determinant of self-care behavior in people with diabetes. However, the mechanisms underlying how health literacy is linked to self-care behaviors have not been clearly elucidated. The aim of the present study was to explore the mediating roles of access to healthcare, provider-patient interaction, motivation, self-efficacy in the effect of health literacy on diabetes self-care behaviors among diabetic patients with physical disabilities and investigate the moderating effect of age in a moderated mediation model.
Methods: The online survey was participated by a total of 214 diabetic patients with physical disabilities from November to December 2021. The moderated mediation analysis was examined using the Hayes' PROCESS macro modeling tool based on the bias-corrected bootstrapping method.
Results: After controlling for education, the results yielded a significant indirect effect of health literacy on diabetes self-care through motivation and self-efficacy. A partially mediating relationship also was confirmed, as there is a positive direct effect of health literacy on diabetes self-care. Furthermore, age groups (i.e., age <40 and ≥ 40) functioned as a moderator of the mediating effects of motivation and self-efficacy between health literacy and diabetes self-care.
Conclusion: This study emphasized the important role of motivation and self-efficacy which play in linking health literacy and self-care behavior, especially for younger diabetic patients with physical disabilities. In the light of these findings, a health-literacy tailored motivation and self-efficacy enhancing program may be key targets for interventions promoting diabetes self-care behaviors in people with physical disabilities.
Copyright: © 2024 Nam, Yoon. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.