The Association of Health Literacy with Self-Care in Older Adults in Jamaica

 

Purposes/Aims: This study was designed to determine whether relationships exist among aspects of health literacy and self-care practices while controlling for potential socio-demographic influences in a sample of community-dwelling adults 60 and older living in Jamaica.

Background: Older adults are the fastest growing segment of the population in Jamaica. With an increase from 10% (252,225) of the total Jamaican population in 1995 to 11% (279,051) in 2005, the rate is expected to rise to 25% by 2025. Thus, it is critically important to understand factors that may contribute to health maintenance, disease prevention, and wellness promotion. Two such factors, not studied extensively in Jamaica, are health literacy and self-care. This study was guided by the Orem Self-care Model providing a sociocultural orientation that outlines the factors that can influence a person to self-care. These factors include beliefs, personal characteristics and knowledge (a pre-requisite for health literacy skills). Health literacy suggests that persons not only obtain the knowledge but the ability to process and use the information to self-care.

Methods: A cross-sectional and correlational design with multistage sampling and a survey were used to meet the research aim. The Health Literacy Questionnaire measures nine aspects of health literacy (e.g., gathering, reading, and understanding health information, social support, and healthcare provider and system engagement). Self-care was measured with an established scale, the Appraisal of Self-care Agency Scale. Demographic characteristics and self-reported health status were collected in the survey.

Results:A sample of 200 community-dwelling elders 60 years and older living in a rural section of Jamaica completed the survey. There was variation in scores across the nine aspects of health literacy, and among the highest scores were those for social support and active engagement with healthcare providers.  Scores for self-care were relatively high, with 84% of the sample scoring in the high perceived capacity range (based on an established cut off score).  As predicted, there was a strong positive correlation between health literacy and self-care. Regression analysis revealed three of the health literacy scales - critical appraisal, social support and ability to engage the healthcare provider - to be statistically significant predictors for self-care after controlling for education, region, health status, age, and gender.

Implications: It is reasonable to conclude that gains in health literacy can facilitate improvements in older adults’ self-care ability thus promoting health equity. Nurses can play pivotal roles in this by assessing health literacy, providing education and information, improving access to care and, particularly, fostering genuine understanding of relevant health information in order for older adults to care for themselves.