{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:29:51Z","timestamp":1789468191844,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,5]],"date-time":"2018-07-05T00:00:00Z","timestamp":1530748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the relationships of health literacy to diabetes self\u2010care behaviors (diet, physical exercise, foot care and blood glucose monitoring) through empowerment controlling for diabetes education.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Potential mechanisms of how health literacy links to health outcomes have not clearly elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross\u2010sectional study design was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were recruited from three community health centers in South Korea from September 2016 to April 2017 using a convenience sampling method. A total of 136 people with diabetes aged 60 and above were participated in this study. The main study variables of health literacy, empowerment and diabetes self\u2010care activities were assessed using self\u2010reported questionnaires. This study applied a simple mediation analysis with a single covariate using the <jats:styled-content style=\"fixed-case\">PROCESS<\/jats:styled-content> macro, with health literacy entered as an antecedent variable, empowerment as a mediator, diabetes self\u2010care behaviors as outcome variables and diabetes education as a covariate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After controlling for diabetes education, the indirect effects of health literacy to self\u2010care behaviors through empowerment were significant when the self\u2010care behaviors were particularly diet and physical exercise. Whereas, the indirect effects were not significant when the self\u2010care behaviors were foot care and blood glucose monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study indicates that the people with higher health literacy were more empowered and those with higher empowerment were more likely to eat healthy foods and exercise. In the light of these findings, a health literacy\u2010tailored empowerment enhancing program may be important targets for interventions promoting diabetes self\u2010care behaviors of diet and physical exercise.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jan.13738","type":"journal-article","created":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T06:45:34Z","timestamp":1528785934000},"page":"2363-2372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Relationships of health literacy to self\u2010care behaviors in people with diabetes aged 60 and above: Empowerment as a\u00a0mediator"],"prefix":"10.1111","volume":"74","author":[{"given":"Kyung Suk","family":"Shin","sequence":"first","affiliation":[{"name":"Graduate School of Public Health Ajou University Suwon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7188-3857","authenticated-orcid":false,"given":"Eun\u2010Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health Ajou University Suwon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090198111436341"},{"key":"e_1_2_9_3_1","volume-title":"The art of empowerment, stories and strategies for diabetes educators","author":"Anderson B.","year":"2000"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2009.07.025"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.23.6.739"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/edn.87"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145721714540220"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1745-7599.12017"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-10-200805200-00006"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.12.028"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-130"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006416-200403000-00015"},{"key":"e_1_2_9_14_1","first-page":"e010186","article-title":"Do health literacy and patient empowerment affect self\u2010care behaviour? 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