Purpose This study aimed to develop and apply a self-management competency enhancement program based on Johnson’s Model of Health Care Empowerment for vulnerable elderly women with hypertension. Methods: A quasi-experimental, non-equivalent control group design was used. Participants were 38 elderly women aged 65 and older receiving customized home visiting health care in G city. They were assigned to either the intervention or control group. The program consisted of eight 60-minute sessions, and was held twice a week for four weeks. Blood pressure (BP) and lipid levels, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured at three time points: before, immediately after, and four weeks after the intervention. Health literacy, self-efficacy, and depressive symptoms were assessed using structured questionnaires. Data were analyzed using repeated measures analysis of variance (ANOVA), independent t-tests, the Friedman test, and the Mann-Whitney test. Results: The program significantly improved health literacy (p<0.01) and self-efficacy (p<0.01). However, no significant differences were observed between groups in blood pressure, lipid levels, or depressive symptoms. Conclusion: The health care empowerment program is a viable community health nursing intervention for enhancing health literacy and self-efficacy in vulnerable elderly women with hypertension.
Purpose The aim of this study was to identify the serial mediation effect of social support and health literacy in the relationship between self care capacity and health-related quality of life.
Methods Participants were 169 elderly people who lived in rural areas and were diagnosed with chronic diseases. Data collection was conducted from July 10, 2024 to August 30, 2024 through self-reported questionnaires. The data were analyzed by IBM SPSS Statistics 27 and SPSS PROCESS Macro 4.2 program.
Results The direct effect of self care capacity on health-related quality of life was significant (β = .21, p = .023). The indirect effect of self care capacity on health-related quality of life was β = .14 (95% confidence interval [CI] = =0.01~0.29). The double mediating effect of social support and health literacy in the relationship between self care capacity and health-related quality of life was β = .02 (95% CI=0.01~0.06).
Conclusion It was found that the social support and health literacy of the elderly diagnosed with chronic diseases living in rural areas were affected by self care capacity, which in turn affected health-related quality of life. It is necessary to approach successful aging by improving health-related quality of life through a system that can improve self care capacity, social support, and health literacy by efficiently utilizing community resources.
Purpose This study aimed to explore the relationship between digital health literacy, self-efficacy, and self-care behaviors, and to identify the effects of digital health literacy and self-efficacy on self-care behaviors among the community-dwelling elderly.
Methods This descriptive study used self-reported questionnaires and was conducted from January to April 2024. This study included 197 participants aged 65 or older, residing in nine cities and counties within Gyeongsangbuk-do. Data were analyzed using SPSS/WIN 23.0, employing descriptive statistics, t-test, One-way ANOVA, Scheffé tests, Pearson correlation coefficients, and hierarchical regression analysis.
Results The average scores were as follows: digital health literacy, 21.97±8.38 (out of 40 points); self-efficacy, 3.27±0.72 (out of 5 points); and self-care behaviors, 70.22±10.55 (out of 96 points). Self-efficacy (β=.32, p<.001) was identified as the primary factor influencing self-care behaviors. Additionally, job (β=-.20, p=.002) and gender (β=-.18, p=.007) were also significant factors. These factors explained 22.8% of the variance of self-care behaviors.
Conclusion Based on the above study results, we found that to promote self-care behaviors of community-dwelling elderly people, developing and implementing training programs that enhance self- efficacy are imperative. Furthermore, efforts should be made to overcome regional disparities by developing and implementing various policies and programs at the government, local government, and community levels to enhance the digital health literacy of the elderly.
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The Influence of e-Health Literacy, Technostress, and Subjective Health Status on Health Promotion Behaviors among Older Adults Whang Sun A Journal of Korea Society for Simulation in Nursing.2025; 13(1): 71. CrossRef
Purpose This study aimed to examine the level of digital health literacy and identify factors associated with digital health literacy among older adults living alone in South Korea.
Methods A cross-sectional study was conducted on 140 older adults aged 65 and above who live alone. Descriptive statistics and non-parametric methods were used to explore the relationship between digital health literacy and independent variables. A generalized linear model was used to identify factors associated with digital health literacy.
Results Among 140 smartphone-owning older adults living alone, 52.1% were using the Internet via digital devices, and the participants’ average digital health literacy score was 6.64±7.46. Univariate analysis results showed significant differences in digital health literacy according to age, education level, and multimorbidity. The factors associated with digital health literacy were identified as gender (B=−0.36, p=.031), age (B=−0.06, p<.001), education level (B=0.12, p<.001), and sleep problems (B=−0.06, p=.006).
Conclusion Despite widespread Internet and smartphone use, older adults living alone with chronic diseases showed low levels of digital health literacy, which were significantly associated with gender, age, education level, and sleep problems. Enhancing digital health literacy among vulnerable populations is crucial for the effective implementation of digital health services. Collaborative efforts, including tailored digital health interventions to enhance the digital health literacy of vulnerable populations and supportive policies, are essential to bridge the digital divide and promote health equity.
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Purpose The purpose of this study was to evaluate the validity and reliability of the Korean version of the Health Literacy Assessment Tool (K-HLAT-8) for Korean adults.
Methods The survey was conducted from April 1, 2020 to May 30, 2020 at a university hospital, a university, and one community picnic area with adults who understood the purpose of the study and voluntarily agreed to participate. A total of 220 adults participated in this study. After forward and backward translation of the original version of the Health Literacy Assessment Tool 8 (HLAT-8) into Korean, construct validity (confirmatory factor analysis), convergent validity, and reliability were evaluated. Convergent validity was confirmed through the correlation between the K-HLAT-8 and the Self-As Carer Inventory (SCI).
Results Construct validity, evaluated using confirmatory factor analysis, showed good fit. The K-HLAT-8 showed a positive correlation with the SCI score. In terms of internal consistency, Cronbach’s α of the K-HLAT-8 was 0.85. For test-retest reliability, the intraclass correlation coefficient (ICC) was .99 (95% CI: 0.97~0.99).
Conclusion The reliability and validity were confirmed, so K-HLAT-8 can be applied to evaluate the health literacy of Korean adults. Furthermore, these assessment results should be used as basic data to implement programs that can improve health literacy.
Purpose This review aims to summarize the characteristics of currently used questionnaires measuring eHealth literacy and assess the quality of their psychometric properties in self-reported assessments within community settings.
Methods The systematic analysis was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments checklist to evaluate the methodological quality of studies on measurement properties.
Results A total of 21 studies, including 19 questionnaires, were reviewed. The findings indicated that the quality of psychometric assessments for eHealth literacy was generally rated as 'good,' with most studies addressing multiple aspects of reliability and validity. Internal reliability, content validity, hypothesis testing, and responsiveness were particularly well-supported, each receiving over 10 sufficient ratings. However, there was limited evidence regarding measurement errors, test-retest reliability, criterion validity, and analyses of floor and ceiling effects.
Conclusion This study contributes to the enhancement of eHealth literacy measurement tool selection and improves the reporting of their validity and reliability, thereby increasing the credibility of future research.
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Purpose The purpose of this study is to examine the effects of the rural elderly suicide literacy level upon suicide stigma and coping advice with suicidal crises (recommending professional help for a suicidal person). In particular, this study investigates the role of cultural norms (perceived social expectations for the experience of negative emotions) on suicide stigma and coping ability.
Methods A survey was conducted addressing elderly people (N=119) living in rural areas. Regression analysis using SPSS PROCESS macro was used to examine the relationships among the key variables.
Results Participants with higher suicide literacy showed lower suicide stigma, and this perception had a significant effect on enhancing their coping advice with suicidal crises. Also, perceived social expectations significantly influenced the relationship between suicide stigma and coping advice. With lower levels of social expectations, the mediating effect of suicide stigma on the relationship between suicide literacy and recommending professional help did not exist whereas the indirect effect was significant when it pertained to high levels of social expectations.
Conclusion This result signifies that suicide stigma serves as a barrier deterring Koreans from reaching out for professional help regarding their mental health. Moreover, these findings underscore the importance of cultural psychological factors such as perceived social expectations in terms of developing suicide prevention strategies.
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Purpose This study investigated the health literacy level of, the hypertension knowledge of, the self-management behaviors of, and the factors influencing self-management behaviors of the hypertensive elderly population residing in the urban and rural areas. Methods Data were collected from November to December 2017 by the trained research staff. For two months, a total of 160 subjects in urban and rural areas who had been taking antihypertensive medications consented to participate in the project. 157 participants completed the survey. Results: The health literacy score of the hypertensive elderly subjects was at 48.38±8.13, the hypertension knowledge score at 8.90±2.01 points, and the self-management behaviors score at 52.96±8.08. The factor that influenced the self-management behaviors of the hypertensive elderly subjects the most was the health literacy, followed by the residential area, and the hypertension knowledge. Conclusion The research findings suggest that a health promotion program for the hypertensive elderly population should be designed in consideration of the health literacy, the area of residence and the hypertension knowledge of the elderly.
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Purpose The aim of this study was to evaluate the validity and reliability of the Korean version of Short-form Health Literacy Scale (HLS-SF-K12) for Adults. Methods The English HLS-SF12 was translated into Korean with forward and backward translation. Survey data were collected from 204 adults who visited two hospitals in Korea. Content validity, construct validity, and known-groups validity were evaluated. Cronbach's ⍺ for internal consistency and test-retest were used to assess reliability. SPSS 21.0 and AMOS 21.0 software were used for data analysis. Results The HLS-SF-K12 was composed of 12 items, and three subscales (health care, disease prevention, and health promotion). The instrument explained reliable internal consistency with Cronbach’s ⍺ for the total scale of .89, and .74~.81 for subscales. The model of three subscales for the HLS-SF-K12 was validated by confirmatory factor analysis (Normed x 2 =2.14 (p<.001), GFI=.92, RMR=.04, RMSEA=.08, CFI=.94, TLI=.92, IFI=.94). The hypothesis testing which analyzed the differences in health literacy by age and education level was satisfied. Conclusion The HLS-SF-K12 is a valid and reliable instrument for measuring health information comprehension for adults in Korea.
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PURPOSE This study developed a self-report measure for easy assessing of the health literacy of Asian immigrant women in South Korea. METHODS After a literature review, focus group interviews, and content validity evaluation, 14 preliminary items were generated. These were translated into Chinese, Vietnamese, and English. Data were collected from 229 Asian immigrant women. Validity and reliability tests were conducted. RESULTS Factor analysis yielded final 10 items in three factors: primary functional and interactive health literacy, secondary functional and interactive health literacy, and critical health literacy, which explained 61.90% of the total variance of health literacy. In known-group comparisons, health literacy was significantly lower in recent immigrants, those with a low education level, and those with low Korean language proficiency. For convergent validity, health literacy was positively associated with health specific self-efficacy and maternal health knowledge. For criterion-related validity, health literacy was positively associated with the REALM-SF. The overall reliability coefficient (Cronbach's alpha) of the instrument was .773. CONCLUSION The Health Literacy Assessment Scale for Asian Immigrant Women (HLAS) represents a multidimensional construct which encompasses functional, interactive, and critical health literacy. This self-report HLAS can be a useful and convenient method for appraising the health literacy of Asian immigrant women.
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