Turkoglu, NihanTurkmen, Necmi2026-03-012026-03-0120251471-231810.1186/s12877-025-06845-12-s2.0-105029595624https://doi.org/10.1186/s12877-025-06845-1https://hdl.handle.net/20.500.14720/29812Türkmen, Necmi/0000-0002-1525-4690Background: This study investigates the impact of health literacy on the quality of life among geriatric patients in Turkey, focusing on the mediating role of self-efficacy. The main objective is to understand how health literacy and self-efficacy contribute to the quality of life of older adults, and how self-efficacy shapes this relationship and influences health management in the elderly. Methods: This cross-sectional study included 493 geriatric diabetic patients treated at Van Y & uuml;z & uuml;nc & uuml; Y & imath;l University Dursun Odaba & scedil; Medical Center in Turkey. Data were collected in March-April 2024 using self-reported questionnaires: the Personal Information Form, Health Literacy Scale, Diabetes Self-Efficacy Scale, and Quality of Life in the Elderly Scale (CASP-19). Descriptive statistics and Pearson correlation analyses were analyzed with SPSS 27. Mediation analysis, which examines whether the effect of one variable on another occurs through a third variable, was performed using PROCESS Macro v4.3. Results: The mean Diabetes Self-Efficacy Scale score was 66.47 +/- 13.13, the mean CASP-19 score was 17.17 +/- 7.81, and the mean Health Literacy Scale score was 43.51 +/- 8.38. These values indicate moderate-to-good levels of diabetes self-efficacy, low-to-moderate quality of life, and moderate health literacy among participants. There were positive, moderate, and significant correlations between health literacy, self-efficacy, and quality of life. Health literacy showed a positive association with diabetes self-efficacy (B = 0.45, 95% CI [0.322, 0.569]) and with quality of life (total effect B = 0.37, 95% CI [0.291, 0.447]). An indirect association via self-efficacy was observed (indirect B = 0.11, 95% bootstrap CI [0.071, 0.159]. All results were statistically significant (p < 0.001). Conclusion: Health literacy is a key determinant of quality of life in elderly diabetic patients, with self-efficacy partially mediating this relationship. These findings suggest that structured health literacy and self-efficacy training-delivered by multidisciplinary teams such as diabetes nurse educators and community health workers, through regular group sessions and individualized coaching-may improve quality of life and diabetes management among older adults. Interventions should be tailored to the digital and cognitive capabilities of the elderly population to maximize accessibility and effectiveness.eninfo:eu-repo/semantics/openAccessDiabetes Self-EfficacyHealth LiteracyMediationQuality of LifeType 2 DiabetesArticle