ArticleBelitung nursing journal2026
Health literacy and self-efficacy as predictors of self-care behaviors in patients with hematological malignancies: A multicenter cross-sectional study in northeastern Thailand.
Article in Belitung nursing journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Self-care is vital for patients with hematological malignancies (HMs) to manage the severe side effects of chemotherapy. While social support is a traditional focus of care, internal psychological resources may be more critical for sustaining treatment adherence in isolated therapeutic settings. Objective: To determine the prevalence of self-care behaviors and evaluate the extent to which health literacy and self-efficacy predict these behaviors among patients with HMs in northeastern Thailand. Methods: This multicenter, cross-sectional study, conducted from August to December 2025, utilized convenience sampling to recruit 350 patients with HMs from three tertiary hospitals in northeastern Thailand. Data were collected via self-administered questionnaires and analyzed using descriptive statistics and binary logistic regression. The predictive model's performance was evaluated using the Area Under the Curve (AUC), with significance set at Results: The prevalence of high self-care behaviors was 61.2% (95% CI = 55.8-66.3). Bivariable analysis showed that social support was initially associated with higher self-care. However, binary logistic regression identified only health literacy (AOR = 18.05, 95% CI = 14.40-20.10) and self-efficacy (AOR = 10.79, 95% CI = 5.70-11.40) as significant independent predictors. Social support did not remain a significant predictor in the final model. The model exhibited excellent discriminant ability with an AUC of 0.86 (95% CI = 0.78-0.91, Conclusion: High self-care behaviors are common among patients with HMs in northeastern Thailand. Our results show that internal factors, specifically health literacy and self-efficacy, are stronger predictors of self-care than external social support in this treatment-intensive context. These findings underscore the need for oncology nurses to screen for both health literacy and self-efficacy during clinical assessments, enabling early identification of at-risk patients and delivery of targeted interventions to promote effective self-management.
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