Literacy and Its Relationship with Self-efficacy, Trust, and Participation in Medical Decision Making

The objective of this study was to look at the relationship between literacy and diabetes outcomes, specifically glycemic control and quality of life. Trust, self-efficacy, and involvement in medical decision-making were posited to be mediating variables in the relationship between literacy and diabetes outcomes. Study participants were 268 patients from an internal medicine clinic. All participants had type 2 diabetes, took at least one medication for diabetes, and were above 18 years of age. Participants were administered surveys by a research assistant.

Key Findings:

  • There were 215 patients in the higher literacy group and 53 patients in the lower literacy group.
  • Neither diabetes outcome—glycemic control or quality of life—was related to literacy.
  • No relationship existed between literacy and trust or self-efficacy.
  • Lower-literacy patients reported less of an inclination to be involved in medical decision-making and lower levels of diabetes-related knowledge.
  • Self-efficacy was positively related to each subscale in the diabetes-related quality-of-life measure.