Health Literacy in the Population of Diabetic Patients in Iran: A Systematic Review and Meta-Analysis
Background: The present systematic review and meta-analysis were conducted to find the degree by which the Iranian diabetic patients were informed about their disease in term of health literacy.
Methods: The search was carried out in databases including the PubMed, MEDLINE (PubMed), Scopus, Embase, Cochrane Library, ProQuest, Web of Science, Science Direct and Wiley and also domestic databases including the Iranian Academic Center for Education Culture and Research (sid.ir), the Iranian Research Institute for Information Science and Technology (IranDoc.ac.ir), Barakat Knowledge Network System (barakatkns.com), the national publications database (magiran.com) and also Google Scholar and Elmnet search engines. All the original studies published by Oct 20, 2018, in Persian or English, to assess the health literacy of adults with diabetes were included in the study. Ultimately, 17 articles were included in the meta-analysis. The meta-analysis was carried out using the fixed-effects method using Stata-11.2.
Results: The pooled mean score of health literacy was 56.65 out of score of 100, and its 95% CI was estimated as 49.85 to 63.45. No significant heterogeneity could be reported for the articles included in the meta-analysis (I-squared=21.3%, P=0.177). The pooled mean scores with the CI of 95% by gender based on the study population in women and men were estimated as 47.97and 50.06 respectively.
Conclusion: Health literacy is not high in Iranian diabetic patients and is rather inadequate in most of them in both genders. Diabetic women have somewhat lower health literacy compared to diabetic men.
2. Cheng SW, Wang CY, Chen JH, Ko Y (2018). Healthcare costs and utilization of diabetes-related complications in Taiwan: A claims database analysis. Medicine (Baltimore), 97(31): e11602.
3. Herman WH, Braffett BH, Kuo S et al (2018). What are the clinical, quality-of-life, and cost consequences of 30 years of excellent vs. poor glycemic control in type 1 diabetes? J Diabetes Complications, 32(10):911-15.
4. Elgart JF, Asteazaran S, De La Fuente JL et al (2014). Direct and indirect costs associated to type 2 diabetes and its complications measured in a social security institution of Argentina. Int J Public Health, 59(5):851-7.
5. Dorsey RR, Songer TJ (2004). Social and economic consequences of diabetes complications. Am J Epidemiol, 159(11):43.
6. Kinmonth AL, Lindsay MK, Baum JD (1983). Social and Emotional Complications In A Clinical-Trial Among Adolescents With Diabetes-Mellitus. Br Med J (Clin Res Ed), 286(6369):952-4.
7. Zendehtalab H, Vaghei S, Emamimoghadam Z (2013). Effect of intervention based on BASNEF model on quality of life in patients with type 2 diabetes. Evidence Based Care,3(1):7-16.
8. WHO (2016). Diabetes country profiles WHO2016. Available from: https://www.who.int/diabetes/country-profiles/irn_en.pdf?ua=1
9. Grabowski D, Andersen TH (2018). Barriers to intra-familial prevention of type 2 diabetes: A qualitative study on horizons of significance and social imaginaries. Chronic Illn, 10.1177/1742395318789464.
10. Thomas JJ, Lutes L, Smirnova E et al (2019). Self-Concept in the Context of Diabetes Prevention: Development of the Lifestyle Health-Related Self-Concept Questionnaire. Am J Health Promot, 33(3):452-6.
11. Forough AS, Esfahani PR (2017). Impact of pharmacist intervention on appropriate insulin pen use in older patients with type 2 diabetes mellitus in a rural area in Iran. J Res Pharm Pract, 6(2):114-9.
12. Moslemirad M, Madmoli M, Madmoli Y, Niksefat M (2018). Prevalence of Type 1 and Type 2 Diabetes and its Related Factors in Diabetic Patients Hospitalized in Khatam-ol-Anbia Hospital in Shoushtar, 2014-15: A Retrospective Study. J Res Med Dent Sci, 6(3):421-6.
13. Tol A, Pourreza A, Tavasoli E, Rahimi Foroshani A (2012). Determination of knowledge and health literacy among women with type 2 diabetes in teaching hospitals of TUMS. Journal of Hospital, 11(3):45-52 (In Persian).
14. Ramasamy D, Singh AK, Mohan SK, Meenakshi N (2016). Association of sociodemographics, technology use and health literacy among type 2 diabetic individuals living in an Indian setting: an exploratory cross-sectional study. Int J Diabetes Dev Ctries, DOI: 10.1007/s13410-015-0444-7.
15. Shayan N, Ozcebe H, Arici M (2018). Evaluation of health literacy (hl) and quality of life (qol) in hemodialysis patients: is it different in diabetic patients?. Nephrol Dial Transplant, 33(1):273
16. Singh S, Acharya SD, Kamath A et al (2018). Health Literacy Status and Understanding of the Prescription Instructions in Diabetic Patients. J Diabetes Res, 2018: 4517243.
17. Chahardah-Cherik SM, Gheibizadeh MP, Jahani SP, Cheraghian BP (2018). The Relationship between Health Literacy and Health Promoting Behaviors in Patients with Type 2 Diabetes. Int J Community Based Nurs Midwifery, 6(1):65-75.
18. Ariza Bolivar A, Lanteri ME, Cicero CY et al (2017). Health literacy and diabetes control in patients attending a university outpatient clinic in Argentina. Medicina (B Aires), 77(3):167-72.
19. Juul L, Rowlands G, Maindal HT (2018). Relationships between health literacy, motivation and diet and physical activity in people with type 2 diabetes participating in peer-led support groups. Prim Care Diabetes, 12(4):331-7.
20. Berkman ND, Davis TC, McCormack L (2010). Health literacy: what is it? J Health Commun, 15 Suppl 2:9-19.
21. WHO (2012). Social determinants of health. Commission on Social Determinants of Health-final report. Commission on Social Determinants of Health, Geneva: World Health Organization.
22. La Vonne AD, Zun LS (2008). Assessing adult health literacy in urban healthcare settings. J Natl Med Assoc, 100 (11): 1304-8.
23. Ferguson B (2008). Health literacy and health disparities: The role they play in maternal and child health. Nurs Womens Health, 12 (4): 286-98.
24. Peerson A, Saunders M (2009). Health literacy revisited: what do we mean and why does it matter? Health Promot Int, 24 (3): 285-96.
25. Mohammadi Z, Tehrani Banihashemi A, Asgharifard H, et al (2015) Health literacy and its influencing factors in Iranian diabetic patients. Med J Islam Repub Iran, 29: 230.
26. Reisi M, Mostafavi F, Javadzade H, et al (2016). Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes. Oman Med J, 31 (1): 52-9.
27. Arbabi H, Mansouri A, Nooshirvani S, et al (2017). The Relationship Between Health Literacy and General Health in Patients with Type II Diabetes Referring to Diabetes Clinic of Zabol in 2016. J Diabetes Nurs, 5 (1): 29-39 (In Persian).
28. Seyedoshohadaee M, Kaghanizade M, Nezami M, et al (2016). The Relationship Between Health Literacy And General Health In Patients With Type 2 Diabetes. J Diabetes Metab Disord, 15 (5): 312-9 (In Persian).
29. Reisi M, Mostafavi F, Javadzade H, et al (2016). Communicative and critical health literacy and self-care behaviors in patients with type 2 diabetes. J Diabetes Metab Disord, 14 (3):199-208 (In Persian).
30. Rafiezadeh GS, Tabarsy B, Hassanjani S, et al (2015). Relationship between the health literacy with selfefficacy of the diabetic patient's type 2 referred to Gorgan city clinic in 2014. Diabetes Nurs, 3 (2): 30-42 (In Persian).
31. Khodabakhshi KA, Mostafa B, Falsafinejad MR, et al (2015). The relationship of quality of life with health literacy in male patients with type II diabetes: a cross-sectional study in HARSIN city, 2015. J Diabetes Nurs, 4 (4): 10-20 (In Persian).
32. Kooshyar H, Shoorvazi M, Dalir Z, et al (2014). Health literacy and its relationship with medical adherence and health-related quality of life in diabetic community-residing elderly. J Mazandaran Univ Med Sci, 23 (1): 134-43 (In Persian).
33. Salimi M, Sarchahi S, Zolfaghari P, et al (2017). Health Literacy among Patients with Diabetes Mellitus Type 2 in Northeast Area of Iran. International Journal of Health Studies, 3 (1): 14-8.
34. Rahmanian M, Targhi MG (2016). A Survey on Health Literacy of Referred Diabetic Patients to Yazd Diabetes Research Center. Toloo-e-Behdasht, 15 (3): 176-86.
35. Dadipoor S, Ramezankhani A, Aghamolaei T, et al (2018). Evaluation of Health Literacy in the Iranian Population. Health Scope, 7 (3): e62212.
36. Saeed H, Saleem Z, Naeem R, et al (2018). Impact of health literacy on diabetes outcomes: a cross-sectional study from Lahore, Pakistan. Public Health, 156: 8-14.
37. Hussein SH, Almajran A, Albatineh AN (2018). Prevalence of health literacy and its correlates among patients with type II diabetes in Kuwait: A population based study. Diabetes Res Clin Pract, 141: 118-25.
38. Quartuccio M, Simonsick EM, Langan S, et al (2018). The relationship of health literacy to diabetes status differs by sex in older adults. J Diabetes Complications, 32 (4): 368-72.
39. Niknami M, Mirbalouchzehi A, Zareban I, et al (2018). Association of health literacy with type 2 diabetes mellitus self-management and clinical outcomes within the primary care setting of Iran. Aust J Prim Health, 24 (2): 162-70.
40. Borji M, Tarjoman A, Otaghi M, et al (2017). The relationship between health literacy and general health status of patients with type II diabetes. Biosci Biotech Res Comm, 10 (2): 138-42.
41. Zuercher E, Diatta ID, Burnand B, et al (2017). Health literacy and quality of care of patients with diabetes: A cross-sectional analysis. Prim Care Diabetes, 11 (3): 233-40.