Health literacy and depression in women with type 2 diabetes mellitus

Abstract

The prevalence of diabetes mellitus has recently increased in Taiwan, and depression is common among these patients. Moreover, a lack of health literacy may lead to depression. In this study, we explored the correlation between health literacy and depression in diabetic women. METHODS: In this cross-sectional study, 152 women with type 2 diabetes mellitus were recruited from the outpatient clinic of a regional teaching hospital in Taiwan. The data were collected through medical records and a self-reported structured questionnaire, which included items on basic attributes, self-rated health status, the Center for Epidemiologic Studies Depression Scale (CES-D), and Chinese Health Literacy Scale for Diabetes (CHLSD). The results were analyzed using descriptive statistical analyses, bivariate correlation tests, and linear regression analyses. RESULTS: One hundred thirty-five valid questionnaires were obtained. Approximately 20% of the participants had a higher tendency toward depression as per their CES-D score, and the CHLSD results showed that 13.33% had poor health literacy. There was a negative correlation between health literacy and depressive tendencies after adjusting for self-rated health status, economic satisfaction status, employment status, and education level using multivariate linear regression analyses. For each 1-point rise in the CHLSD score, the CES-D score decreased by 0.17 points (z= À 2.05, p=0.042). CONCLUSIONS: A negative correlation was identified between health literacy and depression. Self-rated health status, economic satisfaction, employment status, and higher education level are factors that also affect depressive tendency among diabetic women.

The Mediation Effect of Health Literacy on Social Support with Exchange and Depression in Community-Dwelling Middle-Aged and Older People in Taiwan

“…Inadequate health literacy in middle-aged and older people was associated with the deterioration of physical and mental health, including increased depression. This finding aligns with those previously reported [ 9 , 10 , 31 , 54 ], and therefore it can be stated that insufficient health literacy is strongly related to depression. Gazmararian’s team in their seminal study of 3260 elderly people found that individuals with inadequate health literacy were 2.7 times (95% CI, 2.2–3.4) more likely to be depressed, compared with individuals with adequate health literacy [ 9 ].…”

“…Social support is one such factor found to be associated with depression [ 8 ]. Moreover, high rates of low health literacy among older adults, along with a high prevalence of chronic conditions may lead to increased levels of depression symptoms [ 9 , 10 ]. However, the relationship between the level of health literacy, social support with exchange, and depression remains largely unknown and unexplored.…”

“…Many studies have shown that poor health literacy is significantly associated with increased incidences of depression [ 9 , 10 , 15 , 29 , 30 , 31 , 32 ], including middle-aged and older adults. A study of 3260 older people showed that, compared with persons with sufficient health literacy skills, those with insufficient health literacy were 1.2 times more likely to be depressed (95% CI: 0.9–1.7).…”

“…However, this was mostly explained by the bidirectional relationship between health literacy and depression, which may be mediated by health status [ 9 ]. Hsu et al found that improving the health literacy of diabetic women elicited reduced psychological distress in those with depression, as shown by the negative correlation between health literacy and depressive tendencies [ 10 ]. In fact, for each 1-point rise in the Chinese Health Literacy Scale for Diabetes score, the Center for Epidemiologic Studies Depression Scale (CES-D) score decreased by 0.17 points ( z = −2.05, p = 0.042) [ 10 ].…”

“…Hsu et al found that improving the health literacy of diabetic women elicited reduced psychological distress in those with depression, as shown by the negative correlation between health literacy and depressive tendencies [ 10 ]. In fact, for each 1-point rise in the Chinese Health Literacy Scale for Diabetes score, the Center for Epidemiologic Studies Depression Scale (CES-D) score decreased by 0.17 points ( z = −2.05, p = 0.042) [ 10 ]. Thus, extrapolating from the general population to a more specific age group, the present study evaluated the relationship between health literacy and depression in middle-aged and older adults, with the working hypothesis that health literacy is inversely associated with depression (Hypothesis 3).…”