The Effect of Health Literacy on Health-Related Quality of Life Among Saudi Women With Chronic Diseases

BackgroundWomen have unique health concerns in the context of chronic illness. Although health literacy has been linked to health-related quality of life, the pathway by which some factors mediate this relationship has not been well examined among Saudi women with chronic disease.PurposeThis study was designed to examine the relationship between health literacy and health-related quality of life and determine the mediating roles of healthy lifestyle and patient-centered care in explaining this relationship.MethodsA cross-sectional study was used. A random sample of 20 primary healthcare centers in Saudi Arabia was selected. A convenience sample of 300 women diagnosed with a chronic illness was recruited from these centers. Structural equation modeling was used to test the proposed relationships.ResultsControlling for women's age and education, the hypothesized model adequately fit the data. Health literacy and its dimensions were found to positively and directly affect both patient-centered care (beta = 0.614, B = 0.189, p < .001) and healthy lifestyle behaviors (beta = 0.550, B = 1.211, p < .001). Furthermore, both patient-centered care (beta = 0.390, B = 1.301, p < .001) and healthy lifestyle behaviors (beta = 0.322, B = 0.150, p < .001) were found to positively and directly affect health-related quality of life, whereas health literacy had significant, direct (beta = 0.285, B = 0.292, p < .001) and indirect (beta = 0.417, B = 0.428, p < .001) effects on health-related quality of life through patient-centered care and healthy lifestyle behaviors.Conclusions/Implications for PracticeSpecial consideration should be given to health literacy, patient-centered care, and healthy lifestyle behaviors to enhance health-related quality of life in women with chronic illness. Gender-specific health services and interventions are needed to improve women's health literacy.