Journal List > J Korean Acad Community Health Nurs > v.28(4) > 1058483

Son and Kim: Health Empowerment of Older Adults with High-risk of Cardio-cerebrovascular Diseases

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

Plural response.

Table 2.
Distribution of Health Empowerment (N=148)
Variable Items M±SD Range
Health empowerment 28 3.42±0.67 1~5
 Managing the psychosocial aspects of diseases 9 3.56±0.82 1~5
 Assessment of dissatisfaction and readiness to change 9 3.30±0.60 1~5
 Setting and achieving disease management goals 10 3.40±0.84 1~5
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

Dunnett T3;

Scheffé test.

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**

* p<.05,

** p<.01.

Table 5.
Hierarchical Multiple Regression for Health Empowerment (N=148)
Variables Categories Model 1 Model 2
β SE t β SE t
Age (year) (Ref: 65~<75) 75~<85 .01 0.20 0.07 -.02 0.19 -0.11
≥85 .08 0.22 0.47 .01 0.21 0.08
Spouse (Ref: Yes) No -.08 0.15 -0.66 -.06 0.15 -0.54
Type of household (Ref: Alone) With family .07 0.15 0.69 .01 0.15 0.13
Education (Ref: None) Elementary school -.12 0.18 -0.91 -.09 0.18 -0.73
Middle school -.06 0.23 -0.52 -.09 0.22 -0.77
≥High school .04 0.22 0.26 .03 0.22 0.20
Living standard (Ref: Poor) Average .13 0.11 1.50 .04 0.11 0.42
Wealthy .09 0.25 1.03 .07 0.24 0.85
Perceived health status (Ref: Not healthy) Fair .13 0.13 1.48 .11 0.12 1.23
Healthy .24 0.14 2.61* .19 0.14 2.07*
Health literacy .06 0.02 0.57 .07 0.02 0.73
Social activity participation (Ref: Low) Average .36 0.13 3.63**
Good .38 0.15 3.98**
Frequency of healthcare visit (Ref: >Bimonthly) Bimonthly~Quarterly .14 0.12 1.65
<Quarterly -.02 0.22 -0.27
Structural support -.09 0.01 -0.94
Functional support .10 0.00 0.93
R2=.18 R2=.31
Adjusted R2=.11 Adjusted R2=.22
F=2.53, p=.005 F=3.27, p<.001

Ref=reference group; *p<.05, **p<.01.

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