노인 관상동맥질환자의 건강정보이해능력, 건강임파워먼트가 건강행위이행에 미치는 영향

Abstract

The purpose of this descriptive study was to examine the levels of health literacy, health empowerment, and health behavior practice, and to identify the influence of health literacy and health empowerment on health behavior practice in elderly patients with coronary artery disease (CAD). The data were collected in face-to-face interview using a structured questionnaire. A total of 239 elderly patients aged 65 years and over with CAD were interviewed from December, 2016 to February, 2017 in cardiovascular centers of five hospitals. Health literacy was measured with an instrument developed by Lee, Tae Wha and Kang, Soo Jin (2008). It consisted of 12 items. Health empowerment was measured using the 8-item modified Diabetes Empowerment Scale-Short Form (DES-SF) by Park Chorong(2012). Health behavior practice was measured using an instrument modified by Son Yeoun Jung (2008) and consisted of 23 items. The data were analyzed with descriptive statistics, independent t-test, an analysis of variance (ANOVA), Scheffe' post hoc test, Pearson's correlation analysis, and hierarchical regression, using SPSS Statistics version 18. The study was conducted after receiving the approval from the Institutional Review Board of Jeju National University (JJNU-IRB-2016-028). The results of this study were as follows: 1. The total score on health literacy was 8.21 (±2.65). The item mean score on health empowerment was 3.07 (±0.91) and total score was 24.58 (±7.28). The item mean score of health behavior practice was 3.33 (±0.47) and the total score was 76.73 (±11.01). 2. There were significant differences in health literacy, health empowerment, and health behavior practices of the participants according to general characteristics. There were significant differences in health literacy by sex (t=8.38, p<.001), age (F=27.03, p<.001), education (F=66.84, p<.001), job (t=2.00, p=.047), spouse(t= 6.15, p<.001), cohabits(t=4.06, p<.001), social activity participation (F=30.16, p<.001), and perceived economic status (F=9.31, p<.001). There were also significant differences in health empowerment by sex (t=4.85, p<.001), age (F=6.02, p<.001), education (F=30.12 p<.001), spouse (t=5.25, p<.001), cohabits (t=4.08, p<.001), social activity participation (F=28.28, p<.001), and perceived economic status (F=15.31, p<.001). Lastly, there were significant differences in health behavior practice by age (F=3.99, p=.009), education (F=17.97, p<.001), spouse (t=3.83, p<.001), cohabits (t=3.60, p<.001), social activity participation (F=11.07, p<.001), and perceived economic status (F=8.75, p<.001). 3. There were significant differences in health literacy, health empowerment, and health behavior practice of the participants according to health-related characteristics. There were significant differences in health literacy by BMI (F=4.98 p=.008), comorbidities (F=3.79, p=.024), health information source (F=3.56, p=.030), perceived health status (F=5.80, p=.003), health concern (F=5.91, p=.003), and feelings when asking the medical staff (t=4.17, p<.001). There were significant differences in health empowerment by perceived health status (F=12.78, p<.001), health concern (F=6.03, p=.003), and feelings when asking the medical staff (t=4.44, p<.001). Lastly, there were significant differences in health behavior practices by perceived health status (F=9.92, p<.001), health concern (F=7.87, p<.001), and feelings when asking the medical staff (t=3.19, p=.002). 4. Health behavior practice was positively correlated with health literacy score (r=.46, p<.001) and health empowerment (r=.54, p<.001) and health literacy score was correlated with health empowerment (r=.52, p<.001). 5. Major factors having a significant impact on health behavior practice was health literacy (β=.34, p<.001) and health empowerment (β=.32, p<.001). Health literacy increased 4.8% when controlling for general and health-related characteristics. Health empowerment increased 5.9% when controlling for general and health-related characteristics, and health literacy. The two variables explained 35% of the variance in health behavior practice (F=7.74, p<.001). The results indicate that enhancing health literacy and health empowerment were vital to improving the health behavior practice of elderly patients with coronary artery disease aged 65 years and over. The main findings of this study can be utilized as the foundation for developing programs to promote health empowerment and health behavior practice of the elderly population. Furthermore, the results of the study can be used to establish health-related strategies.