Abstract
OBJECTIVE: This study was conducted to evaluate the relationship between health literacy, awareness of rational drug use, and sleep hygiene among home-dwelling older adults in Istanbul. METHODS: This cross-sectional survey was conducted between May 2024 and August 2024 among 174 older adults living in Istanbul. Participants completed a Personal Information Form, the Health Literacy Scale, the Rational Drug Use Awareness Scale, and the Sleep Hygiene Index. Exclusion criteria included psychiatric diseases, cognitive problems, refusal to participate, and receiving institutional care. Data were analyzed using IBM SPSS Statistics version 28. Descriptive statistics (means, standard deviations, frequencies, and percentages) were calculated as appropriate. Group comparisons were performed using one-way ANOVA or Kruskal–Wallis tests depending on distributional assumptions, with appropriate post hoc analyses (Tukey HSD or Mann–Whitney U tests). Correlations between continuous variables were assessed using Spearman’s rho. Multiple linear regression analyses were conducted to examine variables associated with health literacy, rational drug use awareness, and sleep hygiene. In addition, an exploratory mediation analysis was performed using a regression-based approach with bootstrap resampling (5,000 samples) to assess the indirect association of rational drug use awareness in the relationship between health literacy and sleep hygiene. Statistical significance was set at p < 0.05. RESULTS: Education level and income perception were significant predictors of health literacy (p < 0.001 and p = 0.007, respectively). Rational drug use awareness was significantly associated with sleep hygiene (p < 0.001) and income perception (p < 0.01). In multiple linear regression analysis, rational drug use awareness emerged as the only significant predictor of sleep hygiene (R² = 0.189, p < 0.001). No significant associations were observed for gender, marital status, or having children (all p > 0.05). CONCLUSION: Health literacy was shaped by education level and income perception, whereas rational drug use awareness was associated with sleep hygiene. These findings suggest that targeted health education and medication awareness initiatives may be particularly relevant for older adults from lower socioeconomic backgrounds.