The mediating role of diabetes self-efficacy in the effect of health literacy on quality of life in geriatric diabetic patients in Turkey


TÜRKOĞLU N., Türkmen N.

BMC Geriatrics, cilt.26, sa.1, 2026 (SCI-Expanded, SSCI, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1186/s12877-025-06845-1
  • Dergi Adı: BMC Geriatrics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, MEDLINE, Directory of Open Access Journals
  • Anahtar Kelimeler: Diabetes self-efficacy, Health literacy, Mediation, Quality of life, Type 2 diabetes
  • Van Yüzüncü Yıl Üniversitesi Adresli: Evet

Özet

Background: This study investigates the impact of health literacy on the quality of life among geriatric patients in Turkey, focusing on the mediating role of self-efficacy. The main objective is to understand how health literacy and self-efficacy contribute to the quality of life of older adults, and how self-efficacy shapes this relationship and influences health management in the elderly. Methods: This cross-sectional study included 493 geriatric diabetic patients treated at Van Yüzüncü Yıl University Dursun Odabaş Medical Center in Turkey. Data were collected in March–April 2024 using self-reported questionnaires: the Personal Information Form, Health Literacy Scale, Diabetes Self-Efficacy Scale, and Quality of Life in the Elderly Scale (CASP-19). Descriptive statistics and Pearson correlation analyses were analyzed with SPSS 27. Mediation analysis, which examines whether the effect of one variable on another occurs through a third variable, was performed using PROCESS Macro v4.3. Results: The mean Diabetes Self-Efficacy Scale score was 66.47 ± 13.13, the mean CASP-19 score was 17.17 ± 7.81, and the mean Health Literacy Scale score was 43.51 ± 8.38. These values indicate moderate-to-good levels of diabetes self-efficacy, low-to-moderate quality of life, and moderate health literacy among participants. There were positive, moderate, and significant correlations between health literacy, self-efficacy, and quality of life. Health literacy showed a positive association with diabetes self-efficacy (B = 0.45, 95% CI [0.322, 0.569]) and with quality of life (total effect B = 0.37, 95% CI [0.291, 0.447]). An indirect association via self-efficacy was observed (indirect B = 0.11, 95% bootstrap CI [0.071, 0.159]. All results were statistically significant (p < 0.001). Conclusion: Health literacy is a key determinant of quality of life in elderly diabetic patients, with self-efficacy partially mediating this relationship. These findings suggest that structured health literacy and self-efficacy training—delivered by multidisciplinary teams such as diabetes nurse educators and community health workers, through regular group sessions and individualized coaching—may improve quality of life and diabetes management among older adults. Interventions should be tailored to the digital and cognitive capabilities of the elderly population to maximize accessibility and effectiveness.