Abstract
Development of a health literacy model to enhance self-management behaviors and health outcomes among older adults with coexisting type 2 diabetes mellitus and hypertension in primary care cluster Saraburi province was a research and development. The main purposes of this study were to develop health literacy model of older adults with coexisting type 2 diabetes mellitus and hypertension and to determine the effects of this model. A sample of 150 older adults with coexisting type 2 diabetes mellitus and hypertension visiting in primary care cluster Saraburi province was randomly entered into the experimental and control group, 75 participants for each group. The experimental group participated in the health literacy developmental activities for a period of 12 weeks, whereas the control group obtained regular care. The instruments employed in this research included 1) the health literacy developmental model and supporting documents and 2) the self-management behavior questionnaire. The percentage, mean, standard deviation, t-test, and content analysis were used to analyzed the data. The results showed that: 1. The health literacy developmental model to promote self-management behavior and health outcomes among older adults with coexisting type 2 diabetes mellitus and hypertension consisted of 5 stages as followed: 1) confidence to change, 2) access and understand our disease, 3) communicate and make decisions for health, 4) set the direction for self-change, and 5) continuously perform towards good health outcomes. 2. The effects of the health literacy developmental model to promote self-management behavior and health outcomes were found: 2.1 Post-test mean score of self-management behavior of the experimental group was significantly higher than the control group (p < 0.001). Post-test mean of HbA1c and systolic blood pressure of the experimental group were significantly lower than the control group (p <0.01 and p <0.001, respectively), whereas mean of diastolic blood pressure of the experimental groups were lower than the control group, but there was no statistical significance. 2.2 Post-test mean score of self-management behavior of the experimental group was significantly higher than pre-test (p <0.001), whereas mean HbA1c, systolic blood pressure, and diastolic blood pressure of post-test was significantly lower than pre-test (p <0.001). The results of this study can be employed to develop health literacy to promote self-management behaviors and control HbA1c, and blood pressure among older adults with coexisting type 2 diabetes mellitus and hypertension.
