Mediating Effect Of Illness Perception On Health Literacy And Treatment Burden In Elderly Diabetic Patients

Objective:To analyze the status quo and correlation of illness perception,health literacy and treatment burden in elderly patients with type 2 diabetes,explore the influencing factors of treatment burden,and clarify the mediating effect of illness perception between health literacy and treatment burden in elderly patients with type 2diabetes,so as to provide new reference for reducing the treatment burden of patients in future clinical work.Methods:A convenience sampling method was used to select 300 elderly patients with type 2 diabetes who were hospitalized in a ’third-class’ hospital in Yanji from June to October 2021.General information questionnaire,the brief illness perception questionnaire,health literacy management scale and treatment burden questionnaire were used to investigate.SPSS 26.0 and AMOS 21.0 were used for statistical analysis;frequency,percentage,mean,standard deviation,t test,ANOVA single factor analysis,Pearson correlation analysis,multiple linear regression analysis and structural equation model were used for statistical data processing.Results:(1)The total score of illness perception in elderly patients with type 2 diabetes was(45.45±5.50).There were significant differences in illness perception among different ages,educational levels,work conditions,family per capita monthly income,duration of illness,treatment methods,number of hospitalizations in recent 6 months,complications,Combined with the types of chronic diseases and taking drugs(P< 0.05).(2)The total score of health literacy in elderly patients with type 2 diabetes was(84.70±12.00),and The overall possession rate of health literacy is 21%.There were statistically significant differences in health literacy among different ages,education levels,work conditions,family per capita monthly income,payment methods of medical expenses,and Combined with the types of chronic diseases(P<0.05).(3)The total score of treatment burden of elderly patients with type 2 diabetes was(59.30±10.13),and 21.3% of patients reported severe treatment burden.There were significant differences in treatment burden among different gender,age,marital status,education level,work conditions,family per capita monthly income,medical expenses paymentmethod,illness time,treatment method,hospitalization times in recent six months,complications and Combined with the types of chronic diseases(P<0.05).(4)Correlation analysis showed that illness perception was negatively correlated with health literacy in elderly patients with type 2 diabetes(r=-0.525,P<0.01);illness perception was positive correlation with treatment burden(r=0.618,P<0.01);health literacy was negatively correlated with treatment burden(r=-0.604,P<0.01).(5)Multiple linear regression analysis showed that five variables,namely,payment method of medical expenses,types of combined chronic diseases,complications,illness perception,and health literacy,entered the regression equation,with F value of 10.235,P<0.01,and explanatory variability of 48.9%.(6)The mediating effect analysis showed that illness perception was the mediating variable between health literacy and treatment burden in elderly patients with type 2diabetes,and the mediating effect value was 40%.Conclusion:(1)The illness perception of elderly patients with type 2 diabetes is above the middle level;the overall health literacy rate is low,and the level of health literacy needs to be further improved.The overall treatment burden was at a mild to moderate level.(2)The higher the health literacy level of elderly patients with type 2 diabetes,the less negative illness perception and the lighter the treatment burden.(3)Medical cost payment method,Combined with the types of chronic diseases,complications,illness perception,and health literacy are the factors affecting the tre atment burden of elderly patients with type 2 diabetes.(4)The health literacy of elderly patients with type 2 diabetes can not only directly affect the treatment burden of patients,but also indirectly affect the treatment burden level of patients through illness perception.