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Background and objective: It is unclear how health literacy is associated with health-related quality of life. The aim of this study was to examine the mediating role of treatment regimen adherence between health literacy and health-related quality of life (HRQoL) in older adults with type 2 diabetes mellitus (T2DM). Material and methods: In this cross-sectional study, a multi-stage cluster sampling method was used to recruit 300 diabetic patients aged 60 years and over with diabetes. The abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and the Swedish Health-related Quality of Life (SWED-QUAL) instrument were used to measure health literacy and HRQoL, respectively. In addition, the Morisky Medication Adherence Scale (MMAS), the diet and exercise adherence questionnaire, were used to assess treatment regimen adherence. The four steps of Baron and Kenny’s procedure were implemented to test the mediation hypotheses. Results: The mean age of the respondents was 64.92 years. In addition, the mean of the respondents’ health literacy score was 52.82. The prevalence rates of the inadequate, marginal, and adequate health literacy of the respondents were 70%, 14.7%, and 15.3%, respectively. Two items of treatment regimen adherence (medication adherence and diet and exercise adherence) had a partial mediating role between health literacy and quality of life in elderly diabetes patients. The result of Baron and Kenny’s procedure and Sobel’s test showed a significant mediation role in medication adherence (p = 0.00, Sobel’s Z = 2.77) and diet and exercise adherence (p = 0.00, Sobel’s Z = 6.26) between health literacy and HRQoL. Conclusion: Medication adherence, diet adherence, and exercise adherence are mediating factors in relationship between health literacy and HRQoL that increase the health literacy and quality of life in older adults with T2DM.

Introduction: Hospital triage scale in emergency departments needs to be valid and reliable. Lack of sufficient data exists on triage scale rigor in emergency departments of Iran. This study aimed to determine the impact of the emergency severity index (ESI) triage scale in the emergency department. Materials and Methods: A single-center study was conducted. Proportion of triage categories allocated to high-risk patients admitted to high-acuity departments was examined in observational period in June 2012 and May 2013. True triage score was reported based on patients` paper- based scenario questionnaire. Interrater reliability was assessed using unweighted kappa. Concordance among experts, nurses and physicians was examined. The Chi-square test and Kappa statistics was used for statistical analysis. Results: Triage decisions regarding high-risk patients before and after implementation period are independent from each other (χ2 = 22.254; df=1; p

This cross-sectional and correlational survey examines the association between different types of living arrangements and life satisfaction in older Malaysians, while taking into account the mediating effects of social support function.A total of 1880 of older adults were selected by multistage stratified sampling. Life satisfaction and social support were measured with the Philadelphia Geriatric Center Morale Scale and Medical Outcomes Study Social Support Survey. The result shows living with children as the commonest type of living arrangement for older adults in peninsular Malaysia. Compared to living alone, living only with a spouse especially and then co-residency with children were both associated with better life satisfaction (p