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As the population ages, maintaining a sufficient quality of life becomes an important public health goal so that the later years of life retain their dignity. Regarding quality of life, a sense of meaning, maintaining social relationships, and experiencing well-being regardless of one’s objective state of health are essential. Health literacy refers to an individual’s ability to find, understand, appraise, and apply health information. Sufficient health literacy enables independent health-related decision-making, whereas insufficient health literacy weakens autonomy and limits independence, freedom, and self-worth. The association between health literacy and quality of life has not been studied in the older community-dwelling Finnish population. This master’s thesis examines whether health literacy is associated with quality of life and changes in quality of life over a four-year follow-up period.
Data from the AGNES study were utilized in this thesis. Data were used from three collection points, and it was gathered in 2017–2018, 2020, and 2021–2022. The association between health literacy and quality of life was examined in a cross-sectional setting using data from the study baseline (n=934). Changes in quality of life among persons with different health literacy levels (insufficient, problematic, sufficient) were examined by comparing the changes in quality of life scores between the three data collection points (n=557). The participants were 75-, 80-, and 85-year-old community-dwelling older adults living in the Jyväskylä region. Quality of life was assessed using the OPQOL-brief instrument and health literacy was assessed using the HLS-EU-Q16 instrument.
Among all participants, 111 had insufficient, 331 had problematic, and 500 had sufficient health literacy. Higher health literacy was associated with better quality of life, and this association remained when controlled for age, gender, education, and self-reported financial situation (β 0.33, p<0.001, R²=0.190). The mean quality of life scores declined over time in all health literacy categories (p<0.001). The quality of life scores differed significantly between all health literacy level categories in all comparisons (p<0.001, η²=0.148). There was no statistically significant interaction between time and health literacy level (p=0.632). The pairwise comparison revealed that the differences in quality of life between the health literacy categories were all statistically significant (p-values <0.001). The quality of life scores were highest in the sufficient health literacy category and declined progressively when examining the results in the problematic health literacy category and lastly in the insufficient health literacy category.
Higher health literacy was associated with better quality of life in older adults, and the differences between health literacy levels were also consistent in the follow-up. Better health literacy can help maintain autonomy in personal health promotion and enable more efficient use of health-related resources. Sufficient health literacy can also strengthen one's self-efficacy and act as a source of empowerment, which can positively affect quality of life. Improving health literacy should be a public health goal, which could also have a positive effect on other health variables.
Väestön ikääntyessä hyvä elämänlaatu on tärkeä kansanterveydellinen tavoite, jotta elämän viimeisetkin vuodet olisivat arvokkaita. Elämänlaadun kannalta oleellista on merkitykselliseltä tuntuva elämä, ihmissuhteiden säilyminen ja kokemus hyvinvoinnista objektiivisesta terveydentilasta huolimatta. Terveyden lukutaidolla tarkoitetaan yksilön kykyä hankkia, ymmärtää, arvioida ja hyödyntää terveyteen liittyvää tietoa. Riittävä terveyden lukutaito mahdollistaa itsenäisen päätöksenteon omaan terveyteen liittyen, ja vastaavasti heikko terveyden lukutaito heikentää autonomiaa rajoittaen yksilön itsenäisyyttä, vapautta ja arvokkuuden tunnetta. Terveyden lukutaidon yhteyttä elämänlaatuun ei ole aiemmin tutkittu väestötasolla suomalaisella iäkkäällä otoksella. Tässä pro gradu -tutkielmassa selvitetään, onko terveyden lukutaito yhteydessä elämänlaatuun ja elämänlaadun muutoksiin neljän vuoden seurannassa.
Tutkielmassa hyödynnettiin AGNES-tutkimushankkeen vuosina 2017–2018, 2020 ja 2021–2022 kerättyä aineistoa. Terveyden lukutaidon ja elämänlaadun yhteyttä tutkittiin poikkileikkaustutkimuksena aineiston ensimmäisen aineistonkeruun datasta (n=934). Elämänlaadun muutosta terveyden lukutaidon luokissa (riittämätön, ongelmallinen, riittävä) tutkittiin vertailemalla elämänlaadun pistemäärien muutosta kolmen seurantapisteen välillä (n=557). Tutkittavat olivat 75-, 80- ja 85-vuotiaita itsenäisesti Jyväskylässä asuvia henkilöitä. Elämänlaatua arvioitiin OPQOL-brief-mittarilla ja terveyden lukutaitoa HLS-EU-Q16-mittarilla.
Tutkittavista 111:llä oli riittämätön, 331:llä ongelmallinen ja 500:lla riittävä terveyden lukutaito. Parempi terveyden lukutaito oli yhteydessä parempaan elämänlaatuun, ja yhteys säilyi ikäryhmällä, sukupuolella, koulutuksella ja itsearvioidulla taloudellisella tilanteella vakioimisen jälkeen (β 0,33, p<0,001, R²=0,190). Elämänlaatu heikkeni ajan myötä jokaisessa terveyden lukutaidon luokassa (p<0,001). Elämänlaadun pistemäärät erosivat kaikkien kolmen terveyden lukutaidon tasojen välillä (p=<0,001, η²=0,148). Ajalla ja terveyden lukutaidon tasolla ei havaittu yhdysvaikutusta (p=0,632). Parittaisten erojen vertailun perusteella jokaisen ryhmän elämänlaatu erosi toisista tilastollisesti merkitsevästi (p-arvot <0,001). Elämänlaadun pistemäärät laskivat asteittain siirryttäessä riittävän terveyden lukutaidon ryhmästä tarkastelemaan ongelmallisen ja edelleen riittämättömän terveyden lukutaidon ryhmää.
Iäkkäiden henkilöiden parempi terveyden lukutaito on yhteydessä parempaan elämänlaatuun, ja erot terveyden lukutaidon ryhmien välillä säilyvät myös seurannassa. Parempi terveyden lukutaito voi auttaa säilyttämään itsenäisen toimijuuden oman terveyden edistämisessä ja auttaa hyödyntämään terveyteen liittyviä resursseja tehokkaammin. Se voi lisäksi vahvistaa minäpystyvyyttä ja toimia voimaantumisen lähteenä, mikä voi heijastua myönteisesti elämänlaatuun. Terveyden lukutaidon kehittämisen tulisi olla yksi kansanterveydellinen tavoite, jonka avulla olisi mahdollista vaikuttaa myönteisesti myös muihin terveysmuuttujiin.
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[{"key": "dc.contributor.advisor", "value": "Eronen, Johanna", "language": null, "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Niemel\u00e4, Veera", "language": null, "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2025-05-09T10:50:30Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2025-05-09T10:50:30Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2025", "language": null, "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/101900", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "As the population ages, maintaining a sufficient quality of life becomes an important public health goal so that the later years of life retain their dignity. Regarding quality of life, a sense of meaning, maintaining social relationships, and experiencing well-being regardless of one\u2019s objective state of health are essential. Health literacy refers to an individual\u2019s ability to find, understand, appraise, and apply health information. Sufficient health literacy enables independent health-related decision-making, whereas insufficient health literacy weakens autonomy and limits independence, freedom, and self-worth. The association between health literacy and quality of life has not been studied in the older community-dwelling Finnish population. This master\u2019s thesis examines whether health literacy is associated with quality of life and changes in quality of life over a four-year follow-up period.\n\nData from the AGNES study were utilized in this thesis. Data were used from three collection points, and it was gathered in 2017\u20132018, 2020, and 2021\u20132022. The association between health literacy and quality of life was examined in a cross-sectional setting using data from the study baseline (n=934). Changes in quality of life among persons with different health literacy levels (insufficient, problematic, sufficient) were examined by comparing the changes in quality of life scores between the three data collection points (n=557). The participants were 75-, 80-, and 85-year-old community-dwelling older adults living in the Jyv\u00e4skyl\u00e4 region. Quality of life was assessed using the OPQOL-brief instrument and health literacy was assessed using the HLS-EU-Q16 instrument.\n\nAmong all participants, 111 had insufficient, 331 had problematic, and 500 had sufficient health literacy. Higher health literacy was associated with better quality of life, and this association remained when controlled for age, gender, education, and self-reported financial situation (\u03b2 0.33, p<0.001, R\u00b2=0.190). The mean quality of life scores declined over time in all health literacy categories (p<0.001). The quality of life scores differed significantly between all health literacy level categories in all comparisons (p<0.001, \u03b7\u00b2=0.148). There was no statistically significant interaction between time and health literacy level (p=0.632). The pairwise comparison revealed that the differences in quality of life between the health literacy categories were all statistically significant (p-values <0.001). The quality of life scores were highest in the sufficient health literacy category and declined progressively when examining the results in the problematic health literacy category and lastly in the insufficient health literacy category.\n\nHigher health literacy was associated with better quality of life in older adults, and the differences between health literacy levels were also consistent in the follow-up. Better health literacy can help maintain autonomy in personal health promotion and enable more efficient use of health-related resources. Sufficient health literacy can also strengthen one's self-efficacy and act as a source of empowerment, which can positively affect quality of life. Improving health literacy should be a public health goal, which could also have a positive effect on other health variables.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "V\u00e4est\u00f6n ik\u00e4\u00e4ntyess\u00e4 hyv\u00e4 el\u00e4m\u00e4nlaatu on t\u00e4rke\u00e4 kansanterveydellinen tavoite, jotta el\u00e4m\u00e4n viimeisetkin vuodet olisivat arvokkaita. El\u00e4m\u00e4nlaadun kannalta oleellista on merkitykselliselt\u00e4 tuntuva el\u00e4m\u00e4, ihmissuhteiden s\u00e4ilyminen ja kokemus hyvinvoinnista objektiivisesta terveydentilasta huolimatta. Terveyden lukutaidolla tarkoitetaan yksil\u00f6n kyky\u00e4 hankkia, ymm\u00e4rt\u00e4\u00e4, arvioida ja hy\u00f6dynt\u00e4\u00e4 terveyteen liittyv\u00e4\u00e4 tietoa. Riitt\u00e4v\u00e4 terveyden lukutaito mahdollistaa itsen\u00e4isen p\u00e4\u00e4t\u00f6ksenteon omaan terveyteen liittyen, ja vastaavasti heikko terveyden lukutaito heikent\u00e4\u00e4 autonomiaa rajoittaen yksil\u00f6n itsen\u00e4isyytt\u00e4, vapautta ja arvokkuuden tunnetta. Terveyden lukutaidon yhteytt\u00e4 el\u00e4m\u00e4nlaatuun ei ole aiemmin tutkittu v\u00e4est\u00f6tasolla suomalaisella i\u00e4kk\u00e4\u00e4ll\u00e4 otoksella. T\u00e4ss\u00e4 pro gradu -tutkielmassa selvitet\u00e4\u00e4n, onko terveyden lukutaito yhteydess\u00e4 el\u00e4m\u00e4nlaatuun ja el\u00e4m\u00e4nlaadun muutoksiin nelj\u00e4n vuoden seurannassa.\n\nTutkielmassa hy\u00f6dynnettiin AGNES-tutkimushankkeen vuosina 2017\u20132018, 2020 ja 2021\u20132022 ker\u00e4tty\u00e4 aineistoa. Terveyden lukutaidon ja el\u00e4m\u00e4nlaadun yhteytt\u00e4 tutkittiin poikkileikkaustutkimuksena aineiston ensimm\u00e4isen aineistonkeruun datasta (n=934). El\u00e4m\u00e4nlaadun muutosta terveyden lukutaidon luokissa (riitt\u00e4m\u00e4t\u00f6n, ongelmallinen, riitt\u00e4v\u00e4) tutkittiin vertailemalla el\u00e4m\u00e4nlaadun pistem\u00e4\u00e4rien muutosta kolmen seurantapisteen v\u00e4lill\u00e4 (n=557). Tutkittavat olivat 75-, 80- ja 85-vuotiaita itsen\u00e4isesti Jyv\u00e4skyl\u00e4ss\u00e4 asuvia henkil\u00f6it\u00e4. El\u00e4m\u00e4nlaatua arvioitiin OPQOL-brief-mittarilla ja terveyden lukutaitoa HLS-EU-Q16-mittarilla.\n\nTutkittavista 111:ll\u00e4 oli riitt\u00e4m\u00e4t\u00f6n, 331:ll\u00e4 ongelmallinen ja 500:lla riitt\u00e4v\u00e4 terveyden lukutaito. Parempi terveyden lukutaito oli yhteydess\u00e4 parempaan el\u00e4m\u00e4nlaatuun, ja yhteys s\u00e4ilyi ik\u00e4ryhm\u00e4ll\u00e4, sukupuolella, koulutuksella ja itsearvioidulla taloudellisella tilanteella vakioimisen j\u00e4lkeen (\u03b2 0,33, p<0,001, R\u00b2=0,190). El\u00e4m\u00e4nlaatu heikkeni ajan my\u00f6t\u00e4 jokaisessa terveyden lukutaidon luokassa (p<0,001). El\u00e4m\u00e4nlaadun pistem\u00e4\u00e4r\u00e4t erosivat kaikkien kolmen terveyden lukutaidon tasojen v\u00e4lill\u00e4 (p=<0,001, \u03b7\u00b2=0,148). Ajalla ja terveyden lukutaidon tasolla ei havaittu yhdysvaikutusta (p=0,632). Parittaisten erojen vertailun perusteella jokaisen ryhm\u00e4n el\u00e4m\u00e4nlaatu erosi toisista tilastollisesti merkitsev\u00e4sti (p-arvot <0,001). El\u00e4m\u00e4nlaadun pistem\u00e4\u00e4r\u00e4t laskivat asteittain siirrytt\u00e4ess\u00e4 riitt\u00e4v\u00e4n terveyden lukutaidon ryhm\u00e4st\u00e4 tarkastelemaan ongelmallisen ja edelleen riitt\u00e4m\u00e4tt\u00f6m\u00e4n terveyden lukutaidon ryhm\u00e4\u00e4.\n\nI\u00e4kk\u00e4iden henkil\u00f6iden parempi terveyden lukutaito on yhteydess\u00e4 parempaan el\u00e4m\u00e4nlaatuun, ja erot terveyden lukutaidon ryhmien v\u00e4lill\u00e4 s\u00e4ilyv\u00e4t my\u00f6s seurannassa. Parempi terveyden lukutaito voi auttaa s\u00e4ilytt\u00e4m\u00e4\u00e4n itsen\u00e4isen toimijuuden oman terveyden edist\u00e4misess\u00e4 ja auttaa hy\u00f6dynt\u00e4m\u00e4\u00e4n terveyteen liittyvi\u00e4 resursseja tehokkaammin. Se voi lis\u00e4ksi vahvistaa min\u00e4pystyvyytt\u00e4 ja toimia voimaantumisen l\u00e4hteen\u00e4, mik\u00e4 voi heijastua my\u00f6nteisesti el\u00e4m\u00e4nlaatuun. Terveyden lukutaidon kehitt\u00e4misen tulisi olla yksi kansanterveydellinen tavoite, jonka avulla olisi mahdollista vaikuttaa my\u00f6nteisesti my\u00f6s muihin terveysmuuttujiin.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by jyx lomake-julkaisija (jyx-julkaisija.group@korppi.jyu.fi) on 2025-05-09T10:50:30Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2025-05-09T10:50:30Z (GMT). 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