The relationship between health literacy, social support and the self-management of health in community dwelling rural older adults : a pilot study

Australia, like many developed countries, has a rapidly aging population. This demographic change can place a considerable burden on society as the health needs of older adults increase due to the prevalence of multiple (co‚ÄövÑv™morbid) and more complex health problems. The last decade has witnessed a growing interest in the concept of health literacy, due to its potential to increase our understanding of how people can better access and use resources to maintain their health and independence and to also reduce health care costs for individuals as well as the whole community. This study contributes to the research in this field. This thesis also proposed a functional model of health literacy, derived from analysis of the key concepts contained in 52 definitions .This model may be used to neutralise some of the debate around how health literacy should be defined and measured as well as to strengthen approaches to evaluate interventions that target health literacy. The aim of this study was to assess and describe the relationships between health literacy, social support, social networks and self‚ÄövÑv™reported self‚ÄövÑv™management of health of older residents of the Dorset shire located in the North East of Tasmania, Australia. Dorset is a rural area with an aging population and has experienced a severe economic downturn. A cross‚ÄövÑv™sectional design was used and data collected from community‚ÄövÑv™dwelling adults aged 65 years and over using structured, face‚ÄövÑv™to‚ÄövÑv™face interviews. Convenience sampling was used to recruit 102 participants through direct mail and posters placed in community meeting places. The key variables measured in this study were derived from three survey instruments: Newest Vital Sign (NVS); The Practitioner Assessment of Network Type Instrument (PANT); and Satisfaction subscale of the Duke Social Support Inventory. A single item measure of self‚ÄövÑv™management of health was also included. Data were analysed using SPSS 20.0. Descriptive statistics were used to describe, summarise and visualise the data. Nonparametric tests were used to assess the relationship between variables. The majority of respondents were born in Australia (83.3%), spoke English at home (99%), were female (68%) and lived with their spouse (59%). A little over half (52%) were aged 75 years or older and fewer than 18% reported their highest level of education at above Year 10. The sample was characterised by low levels of health literacy though participants reported strong social networks and experienced high levels of social support. No statistical relationship was detected between reported self‚ÄövÑv™management of health and either health literacy (˜ìv°2 (1, N =98), = 1.170, p = .207); social support (˜ìv°2 (1, N =102) = 1.114, p = .291) or social networks (˜ìv°2 (1, N =102) = 0.791, p = .255) Whilst it can be hypothesized that high levels of social support and social networks may buffer the negative consequences of low health literacy among older people and their ability to manage their health, in this study, this effect was not demonstrated. This may be because of how the construct was understood by participants or the way it was measured. Strategies suggested to improve health for this cohort were oriented to the roles of intimate carers and access to information and advice from health care professionals such as their General Practitioner. The main limitation of this study is the use of a non‚ÄövÑv™probability convenience sample thus the findings cannot be generalised to other groups. However, the results support previous work that demonstrates low levels of health literacy in older, rural populations, and support the existence of strong social and support networks between long‚ÄövÑv™time residents. Such networks can be seen as an asset and contribute to the success of self‚ÄövÑv™management of health among older people. Results of the research suggest the need for longitudinal studies that investigate health literacy for older people. Future research should also focus on issues of measurement and the nature and relative impact of networks on self‚ÄövÑv™management of health by older people.