Chronic kidney disease (CKD) has been known for its ‘silent epidemic’ and becomes an important public health issue. It is believed that patient’s health literacy level plays a key factor for the patient’s safety, mental health, quality of life, appropriate use of medical resources, and possible compliance behavior. Knowing the factors that affect patient’s literacy and knowledge could promote patient’s self-care ability and health outcome. However, there are few health literacy instrument to measure disease –specific health literacy. Therefore, the purpose of this study is to develop questionnaire for measuring disease-specific health literacy for CKD patients.
This study used cross-sectional design to interview CKD patients with age above 20 years. Sampling was based on the proportional probability sampling on total CKD patients registered in National Health Insurance Database. The survey collected eligible 1155 questionnaires, and the data were analyzed using SPSS 22.0 and LISREL 9.2. The reliability of all dimensions of the questionnaire reported are as follows: disease awareness was 0.650, health literacy was 0.680, CKD knowledge was 0.831, and provider-patient communication was 0.815.
The findings of this survey indicated that the health literacy of patients with chronic kidney disease in Taiwan is low. The CKD population tend to be weaker on topic of CKD reading and diet. Regression analysis showed that factors affected CKD patient’s health literacy, CKD knowledge, and compliance behavior were age, education, and provider-patient communication. The severity of CKD was also highly associated with CKD knowledge. Furthermore, stepwise regression showed that critical literacy was negatively associated with compliance behavior; medication safety knowledge was associated positively with compliance behavior. We therefore recommend the policy makers to provide the knowledge of nutrition, diet and medication safety for CKD patients in order to increase their health literacy and knowledge, and the ability for self-care.