Self-Management Skills in Chronic Disease Management: What Role Does Health Literacy Have?
Open accessAbstract
Background. Self-management–based interventions can lead to improved health outcomes in people with chronic diseases, and multiple patient characteristics are associated with the development of self-management behaviors. Low health literacy (HL) has been implicated in poorer self-management behaviors and increased costs to health services. However, the mechanisms behind this relationship remain unclear. Therefore, the aim of the current review is to assess the association between HL and patient characteristics related to self-management behaviors (i.e., disease-related knowledge, beliefs, and self-efficacy). Methods. The review comprised 3 phases: 1) database searches, 2) eligibility screening, and 3) study quality assessment and strength of evidence. Inclusion criteria specified that a valid HL screening tool was used, that at least one self-management behavior was assessed, and that patients had a chronic condition. Results. An initial search generated a total of 712 articles, of which 31 studies fulfilled the eligibility criteria. A consistent association was found between low HL and poorer disease-related knowledge in respiratory diseases, diabetes, and multiple disease categories. A significant association between low HL and poorer self-efficacy was reported in cardiovascular diseases, diabetes, human immunodeficiency virus, and multiple disease categories. HL was significantly associated with poorer beliefs in respiratory, musculoskeletal, and cardiovascular diseases. Discussion. The findings from the current review suggest that low HL may affect behaviors necessary for the development of self-management skills. Given that self-management strategies are core components for effective treatment of a range of chronic diseases, low HL poses a considerable health concern. Further research is needed to understand the mediating influence of HL on disease-related knowledge, self-efficacy, and beliefs. From this, HL-sensitive, self-management interventions ought to be devised and implemented.
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Patients require specialized cognitive and behavioral skills to deal with their condition.
“In addition, patients require specialized cognitive and behavioral skills to deal with their condition [4,5].”
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References 77 · Cited by 339
Research works printed but not linked: 3
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- Authors
- Mackey, L. M., Doody, C., Werner, E. L., & Fullen, B.
- Affiliations
- University College Dublin (IE)
- University College Dublin, Belfield, Dublin, Ireland (LMM, CD, BMF)
- Corresponding author
- Mackey, Laura M.
- Venue
- Medical Decision Making
- Publisher
- SAGE Publications
- Published
- 2016-04-06
- Volume
- 36
- Issue
- 6
- Pages
- 741-759
- ISSN
- 0272-989X (ISSN-L)
- 1552-681X
- OpenAlex
- W2332078948
- Cited by
- 339
- References
- 77
- Citations by year
- 2026: 35 · 2025: 39 · 2024: 47 · 2023: 55 · 2022: 32 · 2021: 38 · 2020: 23 · 2019: 28 · 2018: 24 · 2017: 13 · 2016: 4 · 2012: 1
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Medical Decision Making (publishedVersion)
- PubMed (publishedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Research Repository UCD (University College Dublin) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- self-management, chronic disease, health literacy, self-efficacy, disease knowledge, patient beliefs, diabetes mellitus, respiratory diseases, cardiovascular disease, HIV, musculoskeletal disorders
- MeSH terms
- Chronic Disease, Humans, Self Care, Disease Management, Self Efficacy, Health Literacy
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