ArticlePloS one2022
Cognition, educational attainment and diabetes distress predict poor health literacy in diabetes: A cross-sectional analysis of the SHELLED study.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 20 citations in OpenAlex.
- Clinical Correlates of Type 2 Diabetes Self-Management in Adults: A Cross-Sectional Study.Diseases (Basel, Switzerland) · 2026Article
- Economic, cultural and social inequalities in potentially inappropriate medication-An Austrian perspective.Wiener klinische Wochenschrift · 2026Article
- Quality of life and health literacy in individuals with diabetes-related wounds.Acta diabetologica · 2026Observational
- Diabetes Distress and its Associated factors among Patients Attending a Tertiary Care Center in Eastern India.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Article
- An overview of PLOS curated collection in health literacy.PloS one · 2026Article
- Association of social determinants of health and cardiovascular complications in type 2 diabetes in Colombia.World journal of diabetes · 2025Article
- Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study.BMC public health · 2025Article
- A Composite Indicator for Primary Diabetes Care: A Cross-Sectional Study in Hungary.Healthcare (Basel, Switzerland) · 2025Article
- Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments.Open medicine (Warsaw, Poland) · 2025Review
- The effect of diabetes in the multifaceted relationship between education and cognitive function.BMC public health · 2024Article
- Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: a path analysis study.Diabetology & metabolic syndrome · 2024Article
- COVID-19 pandemic-related healthcare interruptions and diabetes distress: a national study of US adults with diabetes.BMC public health · 2024Article
- Factors influencing survival outcomes in patients with stroke at three tertiary hospitals in Zimbabwe: A 12-month longitudinal study.PloS one · 2024Article
- Analysis of Influencing Factors Related to Health Literacy of Diabetic Patients: A Survey Based on DHLEIS.Journal of diabetes research · 2024Article
- Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review.Healthcare (Basel, Switzerland) · 2023Article
- Article
- Trends in type 2 diabetes, prediabetes, and hyperglycemic recognition among menopausal women: A 20-year analysis of sociodemographic disparities.Women's health (London, England)Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify factors that predict poor health literacy amongst people with diabetes.
designCross-sectional analysis of baseline data from a prospective study of diabetic foot disease.
settingPatients attending a tertiary hospital diabetes outpatient clinic in Tasmania, Australia.
participants222 people with diabetes mellitus, aged >40 years, with no history of foot ulceration, psychotic disorders or dementia. OUTCOME MEASURES: Health literacy was measured using the short form Test of Functional Health Literacy in Adults (functional health literacy), and the Health Literacy Questionnaire (HLQ), which measures nine domains of health literacy. Predictors included demographic characteristics, cognition, diabetes distress, depression, and educational attainment.
resultsIn multivariable analysis, greater educational attainment (OR 0.88, 95% CI 0.76, 0.99) and poorer cognition (OR 0.71, 95% CI 0.63, 0.79) were associated with poorer functional health literacy. Age was negatively associated with domains of appraisal of health information and ability to find good health information (both beta = -0.01). Educational attainment was positively associated with four domains, namely having sufficient information to manage my health, actively managing my health, appraisal of and ability to find good health information (beta ranging from +0.03 to 0.04). Diabetes distress was negatively associated with five domains: having sufficient information to manage my health, social support for health, ability to actively engage with healthcare providers, navigating the healthcare system and ability to find good health information (beta ranging from -0.14 to -0.18).
conclusionPoorer cognition and poorer educational attainment may be detrimental for an individual's functional health literacy, and education, diabetes distress and older age detrimental across multiple health literacy domains. Clinicians and policy makers should be attuned to these factors when communicating with people with diabetes and in designing healthcare systems to be more health-literacy friendly in order to improve diabetes outcomes.
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