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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.

  • 1.Statistics Korea. Statistics of a Resident Alien [Internet]. Seoul: Statistics Korea; 2011. [cited 2014 November 11]. Available from:.http://kosis.kr/statHtml/statHtml.doh?orgId=111&tblId=DT_1B040A4&conn_path=I2.
  • 2.Korea Health Industry Developmental Institute. Statistics on international patients in Korea, 2012 [Internet]. Korea Health Industry Developmental Institute; 2012. [cited 2014 November 11]. Available from:.http://www.khidi.or.kr/board/view?linkId=100746&menuId=MENU00085.
  • 3.Kim JH, Chang SA. Effect of diabetes education program on glycemic control and self management for patients with type 2 diabetes mellitus. Diabetes & Metabolism Journal. 2009;33(6):518-25.
  • 4.Institute of Medicine. Health literacy: a prescription to end confusion. The National Academic Press: Washington D.C;; 2004. p31-59..
  • 5.Commission on Social Determinants of Health. Closing the gap in a generation: healthy equity through action on the social determinants on health. Final report of the commission on social determinants on health. Geneva: World Health Organization; 2008.
  • 6.Rockville MD. Health literacy universal precaution toolkit. Agency for Healthcare Research and Quality 2010.
  • 7.Cutilli CC. Health literacy in geriatric patients: an integrative review of the literature. Orthopedic Nursing. 2007;26(1):43-8.
  • 8.Davis TC, Wolf MS, Bass PF, Middle BM, Kennen E, Baker DW, et al. Low literacy impairs comprehension of prescription drug warning labels. Journal of General Internal Medicine. 2006;21(8):847-51.
  • 9.Scott TL, Gazmararian JA, Williams MV, Baker DW. Health literacy and preventive health care use among medicare en-rollees in a managed care organization. Medical Care. 2002;40(5):395-404.
  • 10.Baker DW. The meaning and the measure of health literacy. Journal of General Internal Medicine. 2006;21(8):878-83. http://dx.doi.org/10.1111/j.1525-1497.2006.00540.x.
  • 11.Carol H. Health literacy: the sixth vital sign. Journal of Academy of Nurse Practitioners. 2010;24(12):218-23. http://dx.doi.org/10.1111/j.1745-7599.2012.00698.x.
  • 12.Office of Minority Health. Eliminating racial & ethnic health disparities [Internet]. Office of Minority Health; 2009. [cited 2014 November 10]. Available from:.http://www.cdc.gov/omhd/about/disparities.htm.
  • 13.Park JY, June KJ. Influencing factors on functional health literacy among the rural elderly. Journal Korean Academic Community Health Nursing. 2011;22(1):75-85.
  • 14.Lee SH, Chang KH, Han HS, Park BK, Kim SS. The relationship of health literacy of female married migrants in Busan with their attitudes toward health. Journal of Women's Studies. 2012;22(1):165-200.
  • 15.McCleary-Jones V. Health literacy and its association with diabetes knowledge, self-efficacy and disease self-management among african americans with diabetes mellitus. Journal of the Association of Black Nursing Faculty. 2011;22(2):5-32.
  • 16.Ishikawa H, Yano E. The relationship of patient participation and diabetes outcomes for patients with high vs. low health literacy. Patient Education and Counseling. 2011;84(3):393-7. http://dx.doi.org/10.1016/j.pec.2011.01.029.
  • 17.Josephine M. Impact of health literacy and patient trust on glycemic control in urban U.S.A population. Nursing and Health Sciences. 2010;12(1):94-104. http://dx.doi.org/10.1111/j.1442-2018.2009.00506.x.
  • 18.Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. Journal of the American Medical Association. 2002;288(4):475-82. http://dx.doi.org/10.1001/jama.288.4.475.
  • 19.Hu J, Amirehsani K, Wallace DC, Letvak S. Perceptions of barriers in managing diabetes: perspectives of Hispanic immigrant patients and family members. The Diabetes Educator. 2013;39(4):),494-503. http://dx.doi.org/10.1177/0145721713486200.
  • 20.American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care. 2011;34:S11-S61. http://dx.doi.org/10.2337/dc11-S011.
  • 21.Choi KI, Jung DY. The Relationships between knowledge of diabetes, barrier and compliance with sick role behavior of diabetic patients. Nursing Science. 2010;22(2):13-26.
  • 22.Karakurt P, Kaşikçi MK. The effect of education given to patients with type 2 diabetes mellitus on self-care. International Journal of Nursing Practice. 2011;18(12):170-9. http://dx.doi.org/10.1111/j.1440-172X.2012.02013.x.
  • 23.Weiss BD, Mays MZ, Martz W, Castro KM, Dewalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: the newest vital sign. Annal of Family Medicine. 2005;3(6):514-22. http://dx.doi.org/10.1370/afm.405.
  • 24.Fitzerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706-10. http://dx.doi.org/10.2337/diacare.21.5.706.
  • 25.Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure. Diabetes Care. 2000;23(7):943-50. http://dx.doi.org/10.2337/diacare.23.7.943.
  • 26.Kim S, Love F, Quistberg DA, Shea JA. Association of health literacy with self-management behavior in patients with diabetes. Diabetes Care. 2004;27(12):2980-2. http://dx.doi.org/10.2337/diacare.27.12.2980.
  • 27.Bains SS, Egede LE. Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes. Technology & Therapeutics. 2011;13(3):335-41. http://dx.doi.org/10.1089/dia.2010.0160.
  • 28.Peyrot M, Rubin RR, Lauritzen T, Snoek FJ, Matthews DR, Skovlund SE. Psychosocial problems and barriers to improved diabetes management: results of the cross-national diabetes attitudes, wishes and needs(DAWN) study. Diabetic Medicine. 2005;22(10):1379-85. http://dx.doi.org/10.1111/j.1464-5491.2005.01644.x.
  • 29.Daly JM, Arthur JH, Xu Y, Barcey TL, James PA, Merchant ML, et al. An assessment of attitudes, behaviors, and outcomes of patients with type 2 diabetes. Journal of the American Board of Family Medicine. 2009;22(3):280-2. http://dx.doi.org/10.3122/jabfm.2009.03.080114.

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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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