Abstract
Objective: To examine sex differences in psychosocial predictors of health literacy (HL) among inpatients with chronic diseases in Thailand.
Methodology: This cross-sectional study was conducted from March to April 2021 among 250 hospitalized patients with chronic diseases-including diabetes, cardiovascular diseases, cancer, chronic obstructive pulmonary disease, and hypertension, at a tertiary care hospital in Thailand. Self-reported data were collected using validated questionnaires: Health Literacy Questionnaire, Perceived Benefits Scale, Perceived Self-Efficacy Scale, Perceived Barriers Scale, and Social Support Scale. Descriptive statistics, independent t-tests, and hierarchical multiple regression analyses were conducted, stratified by sex.
Results: Most participants were women (58%), with a mean age of 48.92±8.90 years. Overall HL was at a moderate level (43.78±2.30), with no significant difference between men and women (p=0.144). Regression analysis revealed that for men, perceived barriers were the only significant predictor of HL (β = 0.270, p = 0.006). For women, both perceived barriers (β = 0.298, p<0.001) and social support (β = 0.293, p<0.001) were significant predictors. The explained variance was 16.0% for men and 19.0% for women.
Conclusion: HL interventions should be sex-sensitive. For men, reducing perceived barriers may be critical, while for women, enhancing social support in addition to minimizing barriers can improve HL. Tailored hospital-based education and family-centered programs are recommended to strengthen HL in both groups.

Key words: Health literacy, health behavior, sex difference, chronic diseases, inpatients.