Effect of health literacy on health-related quality of life among Korean middle-aged men: mediating roles of anxiety and sleep duration

Background: This study investigated the mediating effects of anxiety and sleep duration on the relationship between health literacy and health-related quality of life (HRQoL) among middle-aged men. Methods: This descriptive study involved the secondary analysis of data obtained from the 2023 Korea National Health and Nutrition Examination Survey, an annual government-led survey examining health levels and behaviors. The participants in this study were 1171 middle-aged men aged 40–64 years. The main analysis involved the application of Hayes’s PROCESS Macro for SPSS v.4.0, and Model 6 was used to determine the mediating effects of anxiety and sleep duration on the relationship between health literacy and HRQoL. Results: In Stage 1, health literacy had a significant effect on anxiety (B = −0.017, p = 0.040), and in Stage 2, health literacy (B = −0.062, p < 0.001) and anxiety (B = −0.050, p = 0.009) had a significant effect on sleep duration. In Stage 3, health literacy (B = 0.001, p < 0.001), anxiety (B = −0.009, p < 0.001), and sleep duration (B = 0.001, p < 0.001) significantly affected HRQoL. In Stage 4, health literacy had a significant effect on HRQoL (B = 0.001, p < 0.001). The total effect of health literacy on HRQoL increased from 0.001 to 0.002 (p < 0.001) when anxiety and sleep duration were included. Conclusions: This study has important implications for the HRQoL of middle-aged men. Significantly, to improve HRQoL among this cohort, it is necessary to increase health literacy and develop interventions to reduce anxiety and maintain adequate sleep time.

Middle-aged men; Health literacy; Health-related quality of life; Anxiety; Sleep duration

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