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Original Article

Health Literacy, Diabetic Knowledge, and Diabetic Self-care among Foreign Diabetic Patients at a Hospital in South Korea

Eun Ae Koh1, Hyojung Park2
Korean Journal of Adult Nursing 2015;27(4):397-405.
Published online: August 31, 2015

1Graduate School, Ewha Womans University ․ Samsung Medical Center, Seoul

2Division of Nursing Science, Ewha Womans University, Seoul, Korea

Corresponding author: Park, Hyojung Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-2824, Fax: +82-2-3277-2850, E-mail: hyojungp@ewha.ac.kr
• Received: February 23, 2015   • Accepted: August 13, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to investigate health literacy, diabetic knowledge, and diabetic self-care among foreign diabetic patients at a hospital in South Korea.
  • Methods
    Participants was 134 foreign patients diagnosed with diabetes and who understand English. Data were analyzed by SPSS version 20.0.
  • Results
    Health literacy significantly differed with HbA1c levels, whereas diabetic knowledge significantly differed with education levels, and time since diagnosed. Diabetic self-care significantly differed with time since the diagnosis. Health literacy significantly differed with diabetic knowledge and diabetic self-care. There was a correlation between health literacy and diabetic knowledge and between diabetic knowledge and diabetic self-care but not between health literacy and diabetic self-care.
  • Conclusion
    There are significant results on health literacy, diabetic knowledge and diabetic self-care. Subject with adequate health literacy had high scores on diabetic knowledge and self-care.
  • Key Words: Immigrants; Diabetic mellitus; Health literacy; Knowledge; Self-care
Table 1.
General Characteristics and Disease related Cha racteristics (N=134
Characteristics Categories n (%)
Age (year) ≤19 12 (9.0)
20~39 19 (14.2)
40~59 71 (53.0)
≥60 32 (23.8)
Gender Male 84 (62.7)
Female 50 (37.3)
Ethnic American 121 (90.3)
European 13 (9.7)
Education level ＜High school 7 (5.2)
High school 23 (17.2)
College 71 (53.0)
Graduate school 33 (24.6)
Duration of DM (year) ＜1 32 (23.9)
≥1~＜5 49 (36.6)
≥5~＜10 18 (13.4)
≥10 35 (26.1)
Duration of staying Korea (year) ＜1 33 (24.6)
≥1~＜5 63 (47.0)
≥5~＜10 11 (8.2)
≥10 27 (20.2)
Smoking Yes 14 (10.4)
No 120 (89.6)
HbA1c ＜6.5% 128 (95.5)
≥6.5% 6 (4.5)
Table 2.
Levels of Health Literacy, Diabetic Knowledge, and Self-care (N=134)
Characteristics n (%) or M±SD Range
Health literacy 4.33±1.79 0~6
Limited literacy 13 (9.7) 0~1
Possibility of limited literacy 20 (14.9) 2~3
Adequate literacy 101 (75.4) 4~6
Diabetic knowledge 13.97±4.16 0~23
Self-care behaviors 3.77±1.27 0~7
Diet 3.94±1.41 0~7
Exercise 3.60±1.83 0~7
Blood glucose test 3.70±2.56 0~7
Foot care 3.66±1.92 0~7
Table 3.
Health Literacy, Diabetic Knowledge and Self-care according to the Participants' Characteristics (N=134
Characteristics Categories Health literacy Diabetic knowledge Self-care
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
Gender Male 4.31±1.64 -0.15 13.74±3.87 -0.80 3.85±1.32 0.91
Female 4.36±2.04 (.882) 14.36±4.62 (.426) 3.64±1.19 (.362)
Age (year) ≤19 3.42±2.07 2.34 130±5.34 1.77 4.16±0.95 2.41
20~39 3.84±1.61 (.076) 12.21±3.69 (.157) 3.39±0.85 (.070)
40~59 4.65±1.54   14.44±4.00   3.62±1.37  
≥60 4.25±2.17   14.34±4.14   4.18±1.26  
Education ＜High schoola 2.86±2.19 2.49 9.29±3.73 3.87 3.71±1.03 0.01
High scoolb 4.00±1.86 (.064) 14.87±3.48 (.011) 3.79±1.25 (.998)
Collegec 4.39±1.63   13.83±4.28 a＜b, c, d 3.78±1.19  
Graduate schoold 4.73±1.89   14.64±3.86   3.75±1.53  
Duration of DM ＜1a 4.09±2.04 0.82 13.22±3.93 4.19 3.77±1.31 2.88
≥1~＜5b 4.16±1.81 (.484) 12.90±4.13 (.007) 3.61±1.05 (.039)
≥5~＜10c 4.72±1.36   14.61±2.87 a, b＜d 3.29±1.57 c＜d
≥10d 4.57±1.74   15.83±4.39   4.25±1.25  
Duration of staying Korea ＜1a 3.76±1.77 1.85 12.12±4.69 3.39 3.56±1.16 1.24
≥1~＜5b 4.63±1.80 (.142) 14.89±4.10 (.020) 3.86±1.20 (.297)
≥5~＜10c 4.55±1.97   13.91±4.70   4.31±1.52  
≥10d 4.22±1.65   14.11±2.52   3.60±1.43  
Smoking Yes 3.86±2.28 -0.84 13.71±4.91 -0.24 3.19±1.37 -1.84
No 4.38±1.73 (.417) 14.00±4.08 (.809) 3.84±1.25 (.069)
HbA1c (%) ＜6.5% 5.83±0.41 6.83 15.83±1.83 2.33 3.79±1.28 0.89
≥6.5% 4.26±1.80 (＜.001) 13.88±4.22 (.049) 3.32±1.11 (.373)
Table 4.
Comparison of Diabetic Knowledge and Self-care according to the Health Literacy (N=134)
Variables Diabetic knowledge Self-care
M±SD t or F (p) M±SD t or F (p)
Limited literacya 10.00±2.92 13.85 2.85±1.10 4.28
Possibility of limited literacyb 11.70±4.00 (＜.001) 4.06±1.14 (.016)
Adequate literacyc 14.93±3.86 a, b＜c 3.83±1.27 a＜b, c
Table 5.
Correlation between Health Literacy, Diabetic Knowledge, and Self-care (N=134)
Variables Health literacy Diabetic knowledge Self-care
Health literacy 1.00 　 　
Diabetic knowledge .55*** 1.00  
Self-care .13 .29** 1.00　

*p＜.05, **p＜.01, ***p＜.001.

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    Citations to this article as recorded by  
    • Cardiovascular Health Behavior Prediction Model in Patients With Type 2 Diabetes
      Sun Kyung Lee, Seon Young Hwang
      Journal of Cardiovascular Nursing.2025; 40(2): E72.     CrossRef
    • Effects of Health Literacy and Knowledge on Diabetic Self-care in the Elderly with DM Living Alone
      Nan Hui Kim, Youngran Yang, Myung Ha Lee
      Journal of Korean Academy of Community Health Nursing.2016; 27(4): 370.     CrossRef

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    Health Literacy, Diabetic Knowledge, and Diabetic Self-care among Foreign Diabetic Patients at a Hospital in South Korea
    Korean J Adult Nurs. 2015;27(4):397-405.   Published online August 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.4.397
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    Health Literacy, Diabetic Knowledge, and Diabetic Self-care among Foreign Diabetic Patients at a Hospital in South Korea
    Korean J Adult Nurs. 2015;27(4):397-405.   Published online August 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.4.397
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    Health Literacy, Diabetic Knowledge, and Diabetic Self-care among Foreign Diabetic Patients at a Hospital in South Korea
    Health Literacy, Diabetic Knowledge, and Diabetic Self-care among Foreign Diabetic Patients at a Hospital in South Korea

    General Characteristics and Disease related Cha racteristics (N=134

    Characteristics Categories n (%)
    Age (year) ≤19 12 (9.0)
    20~39 19 (14.2)
    40~59 71 (53.0)
    ≥60 32 (23.8)
    Gender Male 84 (62.7)
    Female 50 (37.3)
    Ethnic American 121 (90.3)
    European 13 (9.7)
    Education level ＜High school 7 (5.2)
    High school 23 (17.2)
    College 71 (53.0)
    Graduate school 33 (24.6)
    Duration of DM (year) ＜1 32 (23.9)
    ≥1~＜5 49 (36.6)
    ≥5~＜10 18 (13.4)
    ≥10 35 (26.1)
    Duration of staying Korea (year) ＜1 33 (24.6)
    ≥1~＜5 63 (47.0)
    ≥5~＜10 11 (8.2)
    ≥10 27 (20.2)
    Smoking Yes 14 (10.4)
    No 120 (89.6)
    HbA1c ＜6.5% 128 (95.5)
    ≥6.5% 6 (4.5)

    Levels of Health Literacy, Diabetic Knowledge, and Self-care (N=134)

    Characteristics n (%) or M±SD Range
    Health literacy 4.33±1.79 0~6
    Limited literacy 13 (9.7) 0~1
    Possibility of limited literacy 20 (14.9) 2~3
    Adequate literacy 101 (75.4) 4~6
    Diabetic knowledge 13.97±4.16 0~23
    Self-care behaviors 3.77±1.27 0~7
    Diet 3.94±1.41 0~7
    Exercise 3.60±1.83 0~7
    Blood glucose test 3.70±2.56 0~7
    Foot care 3.66±1.92 0~7

    Health Literacy, Diabetic Knowledge and Self-care according to the Participants' Characteristics (N=134

    Characteristics Categories Health literacy Diabetic knowledge Self-care
    M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
    Gender Male 4.31±1.64 -0.15 13.74±3.87 -0.80 3.85±1.32 0.91
    Female 4.36±2.04 (.882) 14.36±4.62 (.426) 3.64±1.19 (.362)
    Age (year) ≤19 3.42±2.07 2.34 130±5.34 1.77 4.16±0.95 2.41
    20~39 3.84±1.61 (.076) 12.21±3.69 (.157) 3.39±0.85 (.070)
    40~59 4.65±1.54   14.44±4.00   3.62±1.37  
    ≥60 4.25±2.17   14.34±4.14   4.18±1.26  
    Education ＜High schoola 2.86±2.19 2.49 9.29±3.73 3.87 3.71±1.03 0.01
    High scoolb 4.00±1.86 (.064) 14.87±3.48 (.011) 3.79±1.25 (.998)
    Collegec 4.39±1.63   13.83±4.28 a＜b, c, d 3.78±1.19  
    Graduate schoold 4.73±1.89   14.64±3.86   3.75±1.53  
    Duration of DM ＜1a 4.09±2.04 0.82 13.22±3.93 4.19 3.77±1.31 2.88
    ≥1~＜5b 4.16±1.81 (.484) 12.90±4.13 (.007) 3.61±1.05 (.039)
    ≥5~＜10c 4.72±1.36   14.61±2.87 a, b＜d 3.29±1.57 c＜d
    ≥10d 4.57±1.74   15.83±4.39   4.25±1.25  
    Duration of staying Korea ＜1a 3.76±1.77 1.85 12.12±4.69 3.39 3.56±1.16 1.24
    ≥1~＜5b 4.63±1.80 (.142) 14.89±4.10 (.020) 3.86±1.20 (.297)
    ≥5~＜10c 4.55±1.97   13.91±4.70   4.31±1.52  
    ≥10d 4.22±1.65   14.11±2.52   3.60±1.43  
    Smoking Yes 3.86±2.28 -0.84 13.71±4.91 -0.24 3.19±1.37 -1.84
    No 4.38±1.73 (.417) 14.00±4.08 (.809) 3.84±1.25 (.069)
    HbA1c (%) ＜6.5% 5.83±0.41 6.83 15.83±1.83 2.33 3.79±1.28 0.89
    ≥6.5% 4.26±1.80 (＜.001) 13.88±4.22 (.049) 3.32±1.11 (.373)

    Comparison of Diabetic Knowledge and Self-care according to the Health Literacy (N=134)

    Variables Diabetic knowledge Self-care
    M±SD t or F (p) M±SD t or F (p)
    Limited literacya 10.00±2.92 13.85 2.85±1.10 4.28
    Possibility of limited literacyb 11.70±4.00 (＜.001) 4.06±1.14 (.016)
    Adequate literacyc 14.93±3.86 a, b＜c 3.83±1.27 a＜b, c

    Correlation between Health Literacy, Diabetic Knowledge, and Self-care (N=134)

    Variables Health literacy Diabetic knowledge Self-care
    Health literacy 1.00 　 　
    Diabetic knowledge .55*** 1.00  
    Self-care .13 .29** 1.00　

    *p＜.05, **p＜.01, ***p＜.001.
    Table 1. General Characteristics and Disease related Cha racteristics (N=134

    Table 2. Levels of Health Literacy, Diabetic Knowledge, and Self-care (N=134)

    Table 3. Health Literacy, Diabetic Knowledge and Self-care according to the Participants' Characteristics (N=134

    Table 4. Comparison of Diabetic Knowledge and Self-care according to the Health Literacy (N=134)

    Table 5. Correlation between Health Literacy, Diabetic Knowledge, and Self-care (N=134)

    *p＜.05, **p＜.01, ***p＜.001.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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