Investigation of health literacy, self-management and patient empowerment levels in hemodialysis patients

This study is a descriptive study conducted to investigate the health literacy, self-management and patient empowerment levels of patients receiving hemodialysis. The population of the study consisted of 377 patients receiving hemodialysis (HD) in dialysis centers of Başkent University Ankara Hospital. The sample of the study consisted of 219 patients who received treatment in these centers between 25.01.2024-15.05.2024 and met the inclusion criteria. The data of the study were collected by using "Patient Descriptive Information Form", "Health Literacy Scale in Hemodialysis Patients (HLS-HD)", "Chronic Disease Self-Management Scale" and "Patient Empowerment Scale". In the study, the mean score of the patients' health literacy (HLS) scale was 62.19±8.96 and their health literacy (HLS) levels were found to be above the average. The mean scores of HLS-HD the patients aged 18-44 years, university graduates, employed, with an income higher than their expenses, without any additional disease, having regular medical check-ups, receiving previous education about the disease and finding the education adequate were found to be higher. While the mean item score of the Self-Management Scale in Chronic Diseases was 3.34±0.48, the mean scores of the sub-dimensions of the scale were self-stigmatization 2.28±1.14, coping with stigmatization 3.37±0.86, health care effectiveness 3.39±0.96, and treatment compliance 4.32±0.83. The self-management level of the patients was above average. The mean score of the self-stigmatization sub-dimension item of the chronic disease self-management scale was found to be lower in working patients. Patients aged 75 years and older had a low mean score on the health care effectiveness sub-dimension and patients with a diagnosis of renal failure of 16 years or more had a high mean score. The mean total score of the Patient Empowerment Scale was 129.92±25.08, the mean item score was 3.49±0.68, and the mean scores of the sub-dimensions were identity/identity 3.33±0.83, personal control 3.66±0.73, decision making 3.72±0.61, knowing and understanding 3.60±0.77, and interaction with others 3.11±1.11. The empowerment level of the patients was found to be above average. The empowerment level of patients with comorbidities was found to be lower. Patients diagnosed with 16 years or more of renal failure had a higher level of empowerment. The level of empowerment increased as the education level of the patients increased. Empowerment level of working patients was higher than non-working patients. Patients whose income is higher than their expenses have higher empowerment levels than patients whose income is lower than their expenses. The empowerment level of patients who received education before and found the education adequate was higher. A moderate positive correlation was found between the patients' level of SOI and the level of patient empowerment (r: 0.604; p<0.01). As the SOY level of the patients increased, the level of treatment compliance, self-health management and patient empowerment increased, and the level of self-stigmatization decreased. The management of chronic diseases can be achieved through patient empowerment activities. Therefore, it is thought that studies to improve both patient empowerment and health literacy levels should be carried out together in order to ensure that chronic patients can manage their diseases and exhibit appropriate health behaviors by taking their own health decisions.