Evaluation of health literacy (HL) and quality of life (GOL) among diabetic and non-diabetic in hemodialysis patients

Health literacy (HL) is inadequate for most of chronic kidney patients. The level of HL may help to improve disease management, thus QOL. In this study, the impact of diabetes mellitus on HL and QOL indices was investigated in hemodialysis patients. In this descriptive study, in 14 different (4 public, 10 private) dialysis centers data we collected through face-to-face interviews from 223 cases (91 women and 132 men) with diabetes and 223 (91 women and 132 men) without diabetes. Test of Functional Health Literacy in Adult (TOFHLA) was used to assess HL and SF-36 to assess QOL. Adequate level of HL was found only in 5.4% of diabetic patients and 17.5% of non-diabetic cases (P <0.001). Higher HL levels were observed in patients with advanced age, higher degrees of education, in males and non-diabetics. The QOL scores of non-diabetic patients were higher than diabetics in all categories. The levels of QOL showed differences according to the level of HL in diabetic and non-diabetics. Among patients with inadequate HL, non-diabetics have statistically higher QOL scores than diabetics in physical functioning, energy, general health status, and mental health status categories. Among patients with limited HL, QOL in non-diabetics is higher in terms of general health dimensions. In patients with adequate HL no difference has been found in the QOL scores among diabetic and non- diabetic patients. This is the first study that has investigated the relationship between health literacy and quality of life of diabetic and non-diabetic hemodialysis patients. It has been found that health literacy influences some quality of life parameters. There is an urgent need for improving HL in diabetic and non-diabetic patients with chronic kidney disease.