Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence?

Ivana Skoumalova, Andrea Madarasova Geckova, Jaroslav Rosenberger, Maria Majernikova, Peter Kolarcik, Daniel Klein, Andrea F. de Winter, Jitse P. van Dijk and Sijmen A. Reijneveld
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Ivana Skoumalova: Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
Andrea Madarasova Geckova: Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
Jaroslav Rosenberger: Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
Maria Majernikova: FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia
Peter Kolarcik: Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
Daniel Klein: Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia
Andrea F. de Winter: Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
Jitse P. van Dijk: Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia
Sijmen A. Reijneveld: Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands

IJERPH, 2020, vol. 17, issue 21, 1-10

Abstract: Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia ( n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21–3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26–2.98) or anxiety (OR/95% CI: 1.81/1.22–2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients’ psychological distress to ensure adequate adherence with recommended diet.

Keywords: health literacy; dialyzed patients; depression; anxiety; diet non-adherence; stage 5 CKD (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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