An exploratory sequential mixed-methods study on diabetes health literacy, self-management, and quality of life in primary care settings
Krishna Kumari Samantaray, Sasmita Das, Krushna Chandra Sahoo, Nageshwar Venkatesh Reddy, N. SivaBackground:
Type 2 diabetes mellitus (T2DM) is a major public health challenge, particularly in low- and middle-income countries. This study aims to explore diabetes health literacy, self-management, and quality of life (QoL) among patients with T2DM and examine their relationship in a primary healthcare setting.
Materials and Methods:
An exploratory sequential mixed-methods study was conducted at an Urban Primary Health Centre in Bhubaneswar, India. The qualitative phase included in-depth semi-structured interviews with 18 purposively selected participants and was analyzed using Braun and Clarke’s thematic analysis. Findings informed the quantitative phase, in which 252 patients were recruited through convenience sampling. Diabetes health literacy and QoL were assessed using validated questionnaires. Descriptive statistics, Pearson’s Chi-square test, Pearson’s correlation, and multiple linear regression were performed using IBM SPSS Statistics version 28.0.
Results:
Qualitative findings identified barriers to diabetes self-management, including limited understanding of medical information, financial constraints, dietary challenges, treatment burden, and psychological stress. Quantitatively, 48.8% of participants had low diabetes health literacy, while 47.6% reported poor QoL. Multiple linear regression identified education, smoking, alcohol use, duration of diabetes, and treatment burden as significant predictors of diabetes health literacy (adjusted coefficient of determination [
Conclusion:
Diabetes health literacy is a key determinant of quality of life. Integrating patient-centred health literacy interventions into primary healthcare can strengthen self-management and improve well-being among individuals with T2DM.