Health Literacy Influencing Stress Management in Hypertensive Patients in Bang Khan District, Nakhon Si Thammarat Province

Abstract

This cross-sectional study aimed to examine the levels of health literacy, stress management, and health literacy factors influencing stress management among patients with hypertension in Bang Khan District, Nakhon Si Thammarat Province. The sample consisted of 371 patients with hypertension selected through stratified random sampling. The research instrument was a questionnaire comprising three sections: general information, health literacy, and stress management behaviors. The instrument was validated for content validity by three experts, with the Index of Item-Objective Congruence (IOC) ranging from 0.67 to 1.00. Reliability was assessed using Cronbach’s alpha coefficient. The reliability coefficient was 0.85 for the health literacy questionnaire and 0.79 for the stress management behavior questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

The results revealed that most participants were female (88.41%), with a mean age of 51.55 years, and most were engaged in agricultural occupations (64.42%). The participants’ health literacy was at a high level across all skills. The skill with the highest proportion at the high level was decision-making (63.35%), followed by information access (60.11%). Regarding stress management, the highest proportion of participants had a moderate level of stress management (39.35%), followed by a high level (36.12%) and a low level (24.53%). Multiple regression analysis showed that decision-making and information access skills had a statistically significant positive influence on stress management. Together, these two variables explained 64.30% of the variance in stress management (R² = 0.643, p-value < .001). The findings suggest that health service units should promote health literacy, particularly decision-making and information access skills, alongside the development of stress management skills among patients with hypertension.