الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Health literacy (HL) is an important determinant of public as well as individual health, and seen as a core element of client centered care (Sørensen et al., 2021). In recent years, there is a growing effort to identify and respond to the health care needs of populations that expected to improve health care quality and equality; and mutual transitions in health care governance and financing as well as service planning and delivery. It’s also expected to enhance access to health care services for vulnerable populations (Bhatt & Bathija, 2018). People with sufficient health literacy tend to have healthy lifestyle, less likely to smoke, exercise more frequently, self- rate their health status as better, and having increased concern about national as well as global health status of society (Awad et al., 2018; Huang et al., 2021). chronic diseases are group of conditions that are not mainly caused by an acute infection (Pan American Health Organization [PAHO]/ World Health Organization [WHO], 2021), and considered as the leading cause of lobal mortality. These diseases including cancers, cardiovascular disease, diabetes, hypertension, obesity and atherosclerosis. Many of chronic diseases can be prevented by reducing common risk factors that may include tobacco use, harmful alcohol use, physical inactivity and eating unhealthy diets (Budreviciute et al., 2020);which intern increase the chances to develop chronic diseases.The aim of the study Determine the relationship between health literacy and health related behaviors among clients with chronic diseases.Research Questions1. What is the health literacy level among clients with chronic diseases?2. What is reported health-related behavior level among clients with chronic diseases?
Is there a relationship between health literacy and reported health- related behaviors among clients with chronic diseases?4. Is there a relation between demographic variable, health literacy and health-related behavior?
Research design:Descriptive correlational design was used to achieve the aim of this study.
Study settings:This study was conducted in three outpatient clinics of governmental hospitals in Menofia governorate, Egypt. That selected by using multistage random technique.
Study sample:A purposive sample of 241 clients with chronic diseases attending the previously mentioned settings.Instruments of the study:The data was collected using a structured interview schedule. That consisted of 3parts:First part:This part consisted of three sections. These sections are socio-demographic characteristics, medical history and sources of health information for the study participants.Second part:Health Literacy scale that was used to assess participants health literacy level about chronic diseases. It consisted of 16 questions with likert scale of 3 responses and total score ranged from 0 to 32 that categorized into poor health literacy when total score ≤50%, fair health literacy when total score 51-75% and good health literacy when total score ≥76%.Third part:Health-related behaviors scale that was utilized to assess health related behaviors of the participants. The scale consists 27 statements describing certain health behaviors in four subscales with likert scale of 3 responses and total score of the scale ranged from0 to 54 that categorized into low health- related behavior when total score ≤50%,moderate health-related behavior when total score 51-75% and high health-related behavior when total score ≥76%.
- Data was collected through a period of 6 months from the beginning of October2020 to the end of March 2021.
Results
• The mean age of the study sample was 43.54 ± 10.57 57, the majority of them (69,7%)had secondary and university education, 78.0% were married
• A statistically significant positive relationship between health literacy and health related behaviors (P = 0.395).
• There was negative correlation between age of the studied sample and health- related behaviors (P=0.004).
• No difference was found between male and female regarding health literacy scale and Health related behaviors scale.
• There was a positive correlation between occupation and total mean score of health literacy scale and also between health-related behaviors scale.• There was a positive correlation between level of education and total mean score of health literacy scale and also between health- related behaviors scale.Conclusion Based on the findings of the present study, it can be concluded that slightly less than half of studied sample with chronic condition had good health literacy level, sixty-one percentage of them had moderate level of reported health- related behaviors. Astatistically significant positive correlation between health literacy and reported health-related behaviors was found. Also, there were a positive relationship between occupations, level of education and total mean score of health literacy and health-related behaviors, there was negative correlation between age of the studied sample and health-related behaviors.Recommendations Based on the findings of the current study the following recommendations were suggested:• Design and implement programs to improve health literacy and health- related behaviors of clients with chronic condition are essential in different health care setting.• Conduct further studies to investigate the effect of educational program on health literacy level and practice of health-related behavior• Each health facility needs to develop and use health literacy assessment tool that assists in measuring health literacy in order to response to individuals with chronic diseases.• Nurses and health professionals need to improve health literacy in health care settings. They must embed health literacy in program, policies, strategic plan and research activities.