Health literacy experiences of multi-ethnic patients and their health-care providers in the management of type 2 diabetes in Malaysia: A qualitative study

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) require adequate health literacy to understand the disease and learn self-management skills to optimize their health. However, the prevalence of limited health literacy is high in patients with T2DM, especially in Asian countries.

OBJECTIVE: This study aimed to explore experiences related to health literacy in Asian patients with T2DM.

DESIGN: This is a qualitative study using in-depth interviews and focus group discussions. A framework analysis was used to analyse the data.

SETTING AND PARTICIPANTS: articipants (n = 24) were multi-ethnic patients with T2DM (n = 18) and their primary health-care providers (n = 6). This study was conducted in four primary health-care clinics in Malaysia.

RESULTS: Nine subthemes were identified within the four dimensions of health literacy: accessing, understanding, appraising and applying information.

DISCUSSION: Motivated patients actively sought information, while others passively received information shared by family members, friends or even strangers. Language and communication skills played important roles in helping patients understand this information. Information appraisal was lacking, with patients just proceeding to apply the information obtained. Patients' use of information was influenced by their self-efficacy, and internal and external barriers.

CONCLUSION: In conclusion, the experiences of multi-ethnic patients with T2DM regarding health literacy were varied and heavily influenced by their cultures.