الفهرس 
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Abstract
Health literacy is a critical determinant of health. Inadequate health literacy disproportionately affects the older adults. Low health literacy among elderly has been associated with unfavorable health behaviors and health outcomes, such as poor compliance with physical activity guidelines, poor medication adherence, higher prevalence of chronic conditions and difficulty in managing them, higher hospitalization rates, more healthcare expenditures. On the other hand, good health literacy is an important factor that contributes to development of autonomy and empowerment. So, good health literacy enables older people to make independent health decisions and engage in the activities that promote and sustain health. Community health nurse plays an important role in improving the level of elderly health literacy, which in turn leads to improving their level of adherence to health promoting behaviors. The aim of the study: The aim of this study was to assess the relation between health literacy and health promoting behaviors of elderly at Tanta city. Material and methods: Study design: A descriptive correlational study design was utilized in this study. Study Setting and Subjects: This study was conducted at the outpatient clinics of health insurance at Tanta city. A convenience sample of 400 elderly was included in this study. Tool of data collection: In order to collect the necessary data, a structured interview schedule was used in this study which consisted of four parts as the following: Part I: Socio-demographic characteristics and medical history of the elderly: This part included data about socio-demographic characteristics and medical history. The socio-demographic characteristics data included age, sex, marital status, level of education, previous occupation, family income and place of residence. The medical history data included the presence of chronic diseases, duration of illness, medication taken, number of medications taken daily, number of previous hospital admission and smoking and its duration. Part II: Assessment of health literacy for the elderly: This part was developed by the researcher based on the related health literacy scales (81-84). It included 34 statements that covered the following items: access to health information (6 statements), reading of health information (6 statements), understanding the health information (8statements), appraisal of health care (5 statements), use of health services (4statements) and communication with health care providers (5 statements). Part III: The Health Promotion Lifestyle Profile II (HPLP-II): This part assessed the health promoting lifestyle. The researcher adapted the Health Promotion Lifestyle Profile II (HPLP-II) that was designed by Walker et al., 1995 based on Pender’s health promotion model to measure health promoting lifestyle behaviors (HPBs). It included 42 statements which encompassed six healthy lifestyle dimensions: Health responsibility (11 statements), physical activity (3statements), nutrition (10statements), interpersonal relations (6statements) rest & stress management (5 statements) and spiritual growth (7 statements). Part IV: Assessment of the elderly knowledge about the basic health information: This part was developed by the researcher to assess the elderly knowledge about the basic health information such as the normal body temperature, normal pulse rate, normal level of blood pressure, normal blood glucose level, complications of diabetes mellitus, complications of hypertension, risks of obesity and the causes of osteoporosis. Results: The results of the current study can be summarized as the following: The age of the studied elderly ranged from 60-75 years with a mean age 64.45±5.37 years. About half (50.1%) of the studied elderly were illiterates and read and write. About three quarters (73.3%) of the studied elderly were working before retirement and nearly one third (29.4) of them were farmers. Nearly one half (50.2 %) of the studied elderly were living in rural areas. The majority (96.5%) of the studied elderly were suffering from chronic diseases, nearly half (50.5% and 47.7%) of them had been suffering from diabetes mellitus (DM) and hypertension respectively with a mean duration (9.68±5.93 and 8.72±6.23 years respectively). Less than two thirds (61.0 %) of the studied elderly had poor level of health literacy, slightly more than one quarter (27.3%) of them had fair level of health literacy while only 11.8 % of them had good level of health literacy. The total mean score of the health literacy scores was (93.22±28.04). More than half (59.5%) of the studied elderly had moderate level of adherence to health promoting behaviors, slightly more than one third (37.0%) of them had low adherence level while only 3.5% of them had high adherence level. The total mean score of health promoting behaviors’ scores was (109.67±14.28). Slightly more than half (52.3%) of the studied elderly had poor knowledge level about the basic health information, slightly more than one third (36.0%) of them had fair level of knowledge while only 11.8% of the studied elderly had good level of knowledge. There was statistical significant relationship between level of total health literacy among the studied elderly and their total knowledge level about the basic health information (p=0.0001). There was statistical significant relationship between level of total adherence to health promoting behaviors among the studied elderly and their total knowledge level about the basic health information (p=0.0001). There was significant positive correlation between total health literacy scores, total health promoting behaviors scores, and total knowledge score about basic health information among the studied elderly (P<0.005). There was a positive correlation between total health literacy scores and total health promotion behaviors scores among the studied elderly. There was a statistically significant relationship between total health literacy level and level of total adherence to health promoting behaviors among the studied elderly patients (p=0.0001). There was significant relationship between total health literacy level among the studied elderly in relation to their age, marital status, educational level, occupation, type of work, monthly income and residence (p< 0.005). There was statistically significant relationship between total score of adherence to health promoting behaviors among the studied elderly and their age, educational level, type of work, family income and residence (P<0.05). There was statistically significant relationship between total level of adherence to health promoting behaviors of the studied elderly and previous hospital admission & smoking (P<0.05).