Health‐literacy, self‐efficacy and health‐outcomes of patients undergoing haemodialysis: Mediating role of self‐management

Abstract Background Health literacy, self‐efficacy and self‐management are known to influence health‐related well‐being. However, the precise influence of self‐management, health literacy and self‐efficacy on health outcomes in Asian countries is under‐researched. Objectives To examine the impact of health literacy and self‐efficacy (independent variables) and self‐management (mediator) on patients' health outcomes (dependent variable). Design An observational, cross‐sectional design was conducted between 1 March 2022 and 31 August 2022. Participants Outpatients receiving haemodialysis ( n = 200) at a Taiwanese medical centre were assessed. Measurements The survey included demographic questions and standardised scales: the 3‐item Brief Health Literacy Screen, the 8‐item Perceived Kidney/Dialysis Self‐Management Scale as a measure of self‐efficacy, and the 20‐item Haemodialyses Self‐Management Instrument. Health outcomes were responses on the 12‐item Short‐Form Health Survey version 2 and clinical blood results from the past 3 months. Results Participants aged over 60 exhibited common comorbidities, with 34% showing low health literacy. Biochemical markers (e.g., haemoglobin and albumin) significantly correlated with physical and mental health scores. Mediating coefficients revealed that self‐management significantly influenced associations between health outcomes, health literacy ( β = 0.31; p < 0.01), and self‐efficacy ( β = 0.19; p < 0.01). Implications for Practice Self‐management can modify the overall influence of health literacy and self‐efficacy on patients' quality of physical and emotional health. When managing a chronic condition, ‘knowing’ how to self‐manage does not always result in ‘doing so’ by the patient. Continuous monitoring and promoting self‐management behaviours and support by nurses are crucial to enhance health outcomes.