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Abstract
Purpose
This study was to identify factors explaining health empowerment of older adults with high-risk of cardio-cerebrovascular diseases.
Methods
Using a structured questionnaire, data were collected from 148 older adults residing in two areas who have one or more of the following diseases; hypertension, diabetes mellitus, hyperlipidemia, and atherosclerosis. Data were analyzed using descriptive statistics, independent t-test, analysis of variance (ANOVA), Pearson correlation analysis, and hierarchical multiple regression.
Results
Health empowerment had a positive correlation with health literacy and social support. Perceived health status and social activity participation showed significant contribution in explaining health empowerment.
Conclusion
This study showed that enhancing perceived health status and social activity participation are vital in an effort to improve health empowerment of the population. Main findings of this study can contribute to developing health empowerment interventions to improve health behavior practices of the older adults.
References
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Table 1.
Personal and Social-Contextual Characteristics (N=148)
| Variables | Categories | n (%) or M±SD | Range |
|---|---|---|---|
| Age (year) | 75.6±6.18 | 65~90 | |
| 65~＜75 | 63 (42.5) | ||
| 75~＜85 | 71 (48.0) | ||
| ≥85 | 14 (9.5) | ||
| Gender | Male | 50 (33.8) | |
| Female | 98 (66.2) | ||
| Spouse | No | 85 (57.4) | |
| Yes | 63 (42.6) | ||
| Type of household | With family | 90 (60.8) | |
| Alone | 58 (39.2) | ||
| Education | None Elementary school | 21 (14.2) 55 (37.2) | |
| Middle school | 24 (16.2) | ||
| ≥High school | 48 (32.4) | ||
| Occupation | No | 114 (77.0) | |
| Yes | 34 (23.0) | ||
| Living standard | Poor | 62 (41.9) | |
| Average Wealthy | 78 (52.7) 8 (5.4) | ||
| Perceived health status | Not healthy | 63 (42.6) | |
| Fair Healthy | 47 (31.7) 38 (25.7) | ||
| Type of high risk diseases† | Hypertension | 126 (85.1) | |
| Hyperlipidemia Diabetes mellitus | 46 (31.1) 36 (24.3) | ||
| Arteriosclerosis | 4 (2.7) | ||
| Health literacy (total score) | 7.51±3.46 | 0~12 | |
| Health-related terms | 3.72±1.54 | 0~5 | |
| Comprehension and numeracy | 3.79±2.22 | 0~7 | |
| Health insurance | National health insurance Medicaid | 115 (77.7) 21 (14.2) | |
| Do not know | 12 (8.1) | ||
| Social activity participation | Low Average | 39 (26.3) 75 (50.7) | |
| Good | 34 (23.0) | ||
| Type of leisure activity | Group Individual | 92 (62.2) 33 (22.3) | |
| None | 23 (15.5) | ||
| Source of daily support | Spouse/children Organizations | 87 (58.8) 35 (23.6) | |
| Friends/neighbors None | 14 (9.5) 12 (8.1) | ||
| Institution for healthcare visit | Local hospitals/clinics | 82 (55.4) | |
| Public health centers Tertiary/general hospitals | 46 (31.1) 20 (13.5) | ||
| Main reason for healthcare visit | Drug prescription | 108 (73.0) | |
| Health check-up Treatment/procedure | 30 (20.3) 10 (6.7) | ||
| Frequency of healthcare visit | ＞Bimonthly | 89 (60.1) | |
| Bimonthly~Quarterly | 49 (33.1) | ||
| ＜Quarterly | 10 (6.8) | ||
| Social support | |||
| Structural support (person) | 4.24±4.46 | 0~30 | |
| Functional support (total score) | 56.41±25.16 | 0~100 | |
| Tangible | 56.93±28.38 | 0~100 | |
| Affectionate | 57.71±28.66 | 0~100 | |
| Positive social | 55.70±28.38 | 0~100 | |
| Emotional/information support | 55.28±24.37 | 0~100 |
Table 2.
Distribution of Health Empowerment (N=148)
Table 3.
Health Empowerment by Personal and Social-Contextual Characteristics (N=148)
| Variables | Categories | M±SD | t of F (post-hoc) | p |
|---|---|---|---|---|
| Age (year) | 65~＜75a | 3.60±0.54 | 4.06 | .019 |
| 75~＜85b | 3.29±0.72 | (a＞b)† | ||
| ≥85c | 3.26±0.79 | |||
| Spouse | No | 3.31±0.68 | 2.40 | .018 |
| Yes | 3.57±0.63 | |||
| Type of household | With family | 3.52±0.62 | -2.35 | .020 |
| Alone | 3.26±0.71 | |||
| Education | Nonea | 3.28±0.78 | 4.10 | .008 |
| Elementary schoolb | 3.25±0.67 | (b＜d)† | ||
| Middle schoolc | 3.42±0.69 | |||
| ≥High schoold | 3.68±0.54 | |||
| Living standard | Poora | 3.25±0.64 | 3.82 | .024 |
| Averageb | 3.53±0.67 | (a＜b)‡ | ||
| Wealthyc | 3.67±0.62 | |||
| Perceived health status | Not healthya | 3.22±0.69 | 6.47 | .002 |
| Fairb | 3.46±0.59 | (a＜c)‡ | ||
| Healthyc | 3.69±0.64 | |||
| Social activity participation | Lowa | 2.96±0.64 | 14.92 | ＜.001 |
| Averageb | 3.56±0.61 | (a＜b, c)‡ | ||
| Goodc | 3.64±0.58 | |||
| Frequency of healthcare visit | ＞Bimonthlya | 3.29±0.69 | 4.79 | .010 |
| Bimonthly~Quarterlyb | 3.65±0.60 | (a＜b)‡ | ||
| ＜Quarterlyc | 3.48±0.54 |
Table 4.
Correlations between Health Empowerment, Health Literacy, and Social Support (N=148)
| Variables | HE (r) | HL (r) | SS (r) | FS (r) |
|---|---|---|---|---|
| Health empowerment (HE) | ||||
| Health literacy (HL) | .21* | |||
| Structural support (SS) | .17* | .25** | ||
| Functional support (FS) | .29** | .36** | .43** |
Table 5.
Hierarchical Multiple Regression for Health Empowerment (N=148)
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