The role of medication adherence in the association between health literacy and diabetes self-care among reproductive-aged women with diabetes mellitus: A Structural Equation Model

Background: The increasing global burden of diabetes, especially in developing nations, highlights the imperative to know more about medication adherence and self-care practices among reproductive-age women with diabetes. The objective of this research was to assess the interrelations between health literacy, medication adherence, and diabetes self-care among reproductive-age women with diabetes Methods: In this cross-sectional study, ۲۱۴ diabetic women (۳۰.۲۹ ± ۶.۵۲ years old) visited a diabetes clinic in Tehran, Iran (December ۲۰۲۲–March ۲۰۲۳). Convenience sampling was conducted, and the participants responded to questionnaires on demographics, diabetes self-care (DSCA), health literacy (HELIA), and medication adherence (MMAS-۸). Structural equation modeling (SPSS۲۶/AMOS۲۴) examined variable relationships (significance: p < ۰.۰۵). Results: Adherence to medication was low (۸۳.۷%), with no demographic correlations of note. Health literacy was positively related to adherence (r = ۰.۳۸۹, p < ۰.۰۰۱) and self-care (r = ۰.۳۱۵, p < ۰.۰۰۱). Adherence to medication mediated the relationship between health literacy and self-care (β = ۰.۴۴۷, p < ۰.۰۰۱). Health literacy was directly related to better adherence (β = ۰.۴۰۱, p < ۰.۰۰۱) and self-care (β = ۰.۳۳۱, p < ۰.۰۰۱). Conclusion: Poor adherence to medication continues to exist among women of reproductive age with diabetes. Health literacy improves adherence and self-care, with adherence acting as a mediator. Interventions aimed at health literacy could potentially enhance diabetes care in this group.

کلیدواژه ها:

Medication adherence ، Diabetes Mellitus ، reproductive health ، health literacy ، self-care.