Adaptation to Chronic Disease as a Mediator Between Health Literacy and Frailty in Older Adults: Implications for Public Health Nursing Practice
Gizem YağızÇelebioğlu, Melike Yalçın GürsoyABSTRACT
Objective
To examine whether adaptation to chronic disease mediates the relationship between health literacy and frailty among older adults with chronic illnesses.
Design
A cross‐sectional design.
Sample
The study included 398 older adults aged 65 years and over attending routine outpatient visits at a public hospital in western Türkiye.
Measurements
Data were collected through face‐to‐face interviews using the Turkish Health Literacy Scale‐32 (THLS‐32), Adaptation to Chronic Disease Scale (ACDS), and FRAIL Scale. Correlation and mediation analyses were conducted performed with bootstrapping (5000 resamples).
Results
Nearly half of the participants (46.0%) had inadequate health literacy, and 53.8% were classified as frail. Health literacy was positively correlated with adaptation to chronic disease ( r = 0.425, p < 0.001) and negatively correlated with frailty ( r = −0.356, p < 0.001). Adaptation to chronic disease was negatively associated with frailty ( r = −0.385, p < 0.001). Mediation analysis showed that adaptation to chronic disease partially mediated the relationship between health literacy and frailty ( β = −0.030, 95% CI [−0.038, −0.023]).
Conclusions
Adaptation to chronic disease was found to partially mediate the association between health literacy and frailty in older adults. Enhancing health literacy through nurse‐led education and counseling may support adaptation and may contribute to frailty prevention among older adults.