Journal List > Korean J Adult Nurs > v.29(5) > 1096445

Hwang: Impacts of Colorectal Cancer Knowledge and Health Literacy on Self-management Behaviors among Elderly Women in Rural Areas

Abstract

Purpose

Korean elderly women residing in rural areas still appear to be marginalized from health services for cancer prevention. The purposes of this study were to measure the degrees of colorectal cancer (CRC) knowledge, health literacy, and self-management behaviors among the elderly women in rural areas and to identify the influences of their CRC knowledge and health literacy on self-management behaviors.

Methods

Total 121 elderly women aged 65 or older living in rural areas were recruited for this descriptive study and answered survey questionnaires.

Results

The participants’ mean age was 78.2±7.51 years old. Of participants, 49.6% completed CRC screening and age of non-screening group was significantly older than that of screening group (x2=35.31, p<.001). The screening group showed higher levels of CRC knowledge (t=3.76, p<.001) and cancer preventive behaviors (t=2.68, p=.008) than non-screening group. Age (B=0.15) and CRC knowledge (B=-0.36) were identified as influencing factors on the CRC screening. Health literacy (β=.37) and CRC knowledge (β=.30) were found as the most influencing factors on the cancer preventive behaviors.

Conclusion

The results of this study could be used as a basis for developing educational interventions and effective strategies specifically for the elderly women residing rural areas in Korea.

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Table 1.
Colorectal Cancer Self-management Behaviors by Characteristics of Participants (N=121)
Variables Categories n (%) CRC screening Cancer preventive behaviors
Yes (n=60) No (n=61) x2 (p) M± SD t or F (p)
n (%) n (%)
Age (year) 65~69 19 (15.7) 14 (11.6) 5 (4.1) 35.31 (<.001) 70.63±10.08 1.67 (.192)
70~79 47 (38.8) 35 (28.9) 12 (9.9) 69.47±10.26
over 80 55 (45.5) 11 (9.1) 44 (36.4) 66.78±8.19
Formal education Never 68 (56.2) 30 (24.8) 38 (31.4) 1.86 (.173) 66.16±9.61 -3.12 (.002)
Yes 53 (43.8) 30 (24.8) 23 (19.0) 71.34±8.32
Presence of spouse No 65 (53.7) 34 (28.1) 31 (25.6) 0.42 (.519) 68.49±10.81 0.08 (.937)
Yes 56 (46.3) 26 (21.5) 30 (24.8) 68.36±7.51
Living status Alone 74 (61.2) 33 (27.3) 41 (33.9) 1.90 (.168) 68.43±10.45 0.00 (.997)
With family 47 (38.8) 27 (22.3) 20 (16.5) 68.43±7.55
Current smoker No 104 (86.0) 49 (40.5) 55 (45.5) 1.81 (.179) 69.01±9.20 1.69 (.093)
Yes 17 (14.0) 11 (9.1) 6 (5.0) 64.88±10.09
Perceived health status Poor 51 (42.1) 23 (19.0) 28 (23.1) 1.59 (.452) 66.94±10.91 1.16 (.318)
Moderate 47 (38.8) 23 (19.0) 24 (19.8) 69.28±6.02
Good 23 (19.0) 14 (11.6) 9 (7.4) 70.00±11.22
Presence of disease diagnosed No 16 (13.2) 8 (6.6) 8 (6.6) 0.00 (.972) 68.00±11.30 -0.20 (.845)
Yes 105 (86.8) 52 (43.0) 53 (43.8) 68.50±9.13

CRC=colorectal cancer.

Table 2.
Colorectal Cancer Knowledge, Health Literacy, and Colorectal Cancer Self-Management Behaviors (N=121)
Variables Possible range Min. Max. M± SD CRC screening
Yes (n=60) No (n=61) t (p)
M± SD M± SD M± SD
CRC knowledge 0~5 0 4 1.36±1.26 1.77±1.20 0.95±1.19 3.76 (<.001)
Health literacy 16~80 18 66 37.83±9.86 38.47±8.88 37.20±10.78 0.71 (.481)
Cancer preventive behaviors 20~100 31 94 68.43±9.39 70.68±7.75 66.21±10.36 2.68 (.008)

CRC=colorectal cancer.

Table 3.
Correlations between Colorectal Cancer Knowledge, Health Literacy, and Cancer Preventive Behaviors (N=121)
Variables CRC knowledge Health literacy Cancer preventive behaviors
Variables r (p) r (p) r (p)
CRC knowledge 1 .04 (.701) .32 (<.001)
Health literacy 1 .38 (<.001)
Cancer preventive behaviors 1

CRC=colorectal cancer.

Table 4.
Factors Influencing Colorectal Cancer Screening using Stepwise Logistic Analysis (N=121)
Variables B SE Wald Sig. Exp (B) 95% CI
(Constant) -10.94 2.77
Age (year) 0.15 0.04 17.71 <.001 1.16 1.08~1.24
CRC knowledge -0.36 0.17 4.33 .037 0.70 0.50~0.98
x2=35.66 (p<.001), Cox & Snell R2=.255, Nagelkerke R2=.340, Hosmer-Lemeshow test: x2=7.07 (p=.529)

CRC=colorectal cancer.

Table 5.
Factors Influencing Cancer Preventive Behaviors using Stepwise Multiple Regression Analysis (N=121)
Variables B SE β t p
(Constant) 51.96 3.07
CRC knowledge 2.27 0.60 .30 3.77 <.001
Health literacy 0.35 0.08 .37 4.63 <.001
Adj. R2=.225, F=18.46, p<.001

CRC=colorectal cancer.

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