Correlates of Health Literacy in Patients With Chronic Heart Failure (original) (raw)
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Cognitive function and health literacy are independently associated with heart failure knowledge
Heart & lung : the journal of critical care
Determine the relationship between cognitive function and health literacy in heart failure (HF) knowledge in patients with HF. HF requires extensive, complex treatment; thus, cognition and health literacy may contribute to understanding and self-management of HF. Participants were 330 HF outpatients. Health literacy was assessed using the Medical Term Recognition Test and the Rapid Estimate of Adult Literacy in Medicine. Global cognitive function was screened with the Modified Mini-Mental Status Examination. HF knowledge was assessed with the Dutch Heart Failure Knowledge Scale (DHFKS). Health literacy (β = .26, p < .001) and cognition (β = .36, p < .001) were related to DHFKS. Both scores were independently associated with DHFKS (health literacy: β = .13, p = .044 and cognition: β = .30, p < .001). Impairments in health literacy and cognition were independently associated with reduced HF knowledge. Interventions should address both factors to be maximally effective.
Health Literacy and Heart Failure
Journal of Cardiovascular Nursing, 2016
Background-Low health literacy affects millions of Americans, putting those who are affected at a disadvantage and at risk for poorer health outcomes. Low health literacy can act as a barrier to effective disease self-management; this is especially true for chronic diseases such as heart failure (HF) that require complicated self-care regimens. Purpose-This systematic review examined quantitative research literature published between 1999 and 2014 to explore the role of health literacy among HF patients. The specific aims of the systematic review are to (1) describe the prevalence of low health literacy among HF patients, (2) explore the predictors of low health literacy among HF patients, and (3) discuss the relationship between health literacy and HF self-care and common HF outcomes. Methods-A systematic search of the following databases was conducted, PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus, using relevant keywords and clear inclusion and exclusion criteria. Conclusions-An average of 39% of HF patients have low health literacy. Age, race/ethnicity, years of education, and cognitive function are predictors of health literacy. In addition, adequate health literacy is consistently correlated with higher HF knowledge and higher salt knowledge. Clinical Implications-Considering the prevalence of low health literacy among in the HF population, nurses and healthcare professionals need to recognize the consequences of low health literacy and adopt strategies that could minimize its detrimental effect on the patient's health outcomes.
How can health literacy influence outcomes in heart failure patients? Mechanisms and interventions
Current heart failure reports, 2013
Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the home, access care in the community, promote provider-patient interactions, structure self-care, and navigate health care programs both locally and nationally. Further, health literacy is a key determinant of health and a critical dimension for assessing individuals' needs, and, importantly, their capacity for self-care. Poorer health knowledge/status, more medication errors, costs, and higher rates of morbidity, readmissions, emergency room visits, and mortality among patients with health illiteracy have been demonstrated. Individuals at high risk for low health literacy include the elderly, disabled, Blacks, those with a poverty-level in...
Journal of Cardiac Failure, 2010
Background: Low health literacy compromises patient safety, quality health care, and desired health outcomes. Specifically, low health literacy is associated with decreased knowledge of one's medical condition, poor medication recall, nonadherence to treatment plans, poor self-care behaviors, compromised physical and mental health, greater risk of hospitalization, and increased mortality. Methods: The health literacy literature was reviewed for: definitions, scope, risk factors, assessment, impact on health outcomes (cardiovascular disease and heart failure), and interventions. Implications for future research and for clinical practice to address health literacy in heart failure patients were summarized. Results: General health literacy principles should be applied to patients with heart failure, similar to others with chronic conditions. Clinicians treating patients with heart failure should address health literacy using five steps: recognize the consequences of low health literacy, screen patients at risk, document literacy levels and learning preferences, and integrate effective strategies to enhance patients' understanding into practice. Conclusion: Although the literature specifically addressing low health literacy in patients with heart failure is limited, it is consistent with the larger body of health literacy evidence. Timely recognition of low health literacy combined with tailored interventions should be integrated into clinical practice. (J Cardiac Fail 2010;16:9e16)
The Relationship Between Health Literacy Level and Quality of Life in Heart Failure Patients
2021
Background and Objective: Heart failure is one of the most common cardiovascular disorders and also it is one of the main problems of general health in the current society. Considering the role of health literacy in improving the quality of life of patients, the present study was conducted to determine the health literacy status of patients with heart failure hospitalized in Shahid Mohammadi Hospital in Bandar Abbas and its relationship with quality of life in these patients. Materials and Methods: This cross-sectional study was performed on 200 patients with heart failure hospitalized in Shahid Mohammadi Hospital in Bandar Abbas in 2019. Sampling was random sampling in even days of week. Data was collected by two questionnaires including standard questionnaire of health literacy and the Minnesota Quality of Life Questionnaire (MLHF). The reliability of each scale was tested by Cronbach alpha. Data were analyzed by descriptive statistics and Pearson correlation test using SPSS 21 so...
2018
O ne of the core concepts of the Patient Centered Medical Home (PCMH) is to facilitate a partnership between patients and practitioners to help ensure patients have the knowledge and feel empowered to actively participate in setting goals for their own health care.1 An integral component to success of this partnership is understanding the barriers that prevent a patient from reaching specific treatment goals. One such barrier may include poor health literacy, which is defined by the Institute of Medicine as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”2 Health literacy is not regularly assessed by health care practitioners, even though low health literacy, including its effect on medication adherence, has a potential negative effect on health outcomes. For example, patients who have poorer understanding about disease processes and medications used to treat them...
Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure
International Journal of Environmental Research and Public Health, 2018
As with all other chronic noncommunicable diseases, adequate health literacy plays a key role in making the right decisions in the treatment of heart failure. Patients with heart failure and a lower health literacy have a reduced quality of life. A cross-sectional study among 200 patients with heart failure was conducted at a state university hospital in Belgrade, Serbia. The European Health Literacy Questionnaire, HLS-EU-Q47, was used to assess health literacy. Quality of life was measured with the generic SF-36 and the Minnesota Living with Heart Failure Questionnaire. Descriptive and analytical statistical analysis was applied. More than half of the respondents (64%) had limited health literacy. The lowest mean health literacy index (28.01 ± 9.34) was within the disease prevention dimension, where the largest number of respondents showed limited health literacy (70%). Our patients had a poorer quality of life in the physical dimension, and the best scores were identified in the e...
Journal of General Internal Medicine, 2011
BACKGROUND: We sought to examine the relationship between literacy and heart failure-related quality of life (HFQOL), and to explore whether literacy-related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. METHODS: We recruited patients with symptomatic heart failure (HF) from four academic medical centers. Patients completed the short version of the Test of Functional Health Literacy in Adults (TOFHLA) and questions on HF-related knowledge, HF-related selfefficacy, and self-care behaviors. We assessed HFQOL with the Heart Failure Symptom Scale (HFSS) (range 0-100), with higher scores denoting better quality of life. We used bivariate (t-tests and chi-square) and multivariate linear regression analyses to estimate the associations between literacy and HF knowledge, self-efficacy, self-care behaviors, and HFQOL, controlling for demographic characteristics. Structural equation modeling was conducted to assess whether general HF knowledge, salt knowledge, self-care behaviors, and self-efficacy mediated the relationship between literacy and HFQOL. RESULTS: We enrolled 605 patients with mean age of 60.7 years; 52% were male; 38% were African-American and 16% Latino; 26% had less than a high school education; and 67% had annual incomes under $25,000. Overall, 37% had low literacy (marginal or inadequate on TOFHLA). Patients with adequate literacy had higher general HF knowledge than those with low literacy (mean 6.6 vs. 5.5, adjusted difference 0.63, p< 0.01), higher self-efficacy (5.0 vs. 4.1 ,adjusted difference 0.99, p<0.01), and higher prevalence of key self-care behaviors (p<0.001). Those with adequate literacy had better HFQOL scores compared to those with low literacy (63.9 vs. 55.4, adjusted difference 7.20, p<0.01), but differences in knowledge, self-efficacy, and self-care did not mediate this difference in HFQOL. CONCLUSION: Low literacy was associated with worse HFQOL and lower HF-related knowledge, self-efficacy, and self-care behaviors, but differences in knowledge, self-efficacy and self-care did not explain the relationship between low literacy and worse HFQOL. KEY WORDS: literacy; self-care; quality of life; heart failure. J Gen Intern Med 26(9):979-86
Health literacy and adherence to treatment of patients with heart failure
Revista da Escola de Enfermagem da USP, 2019
Objective: To relate the level of functional health literacy with adherence and barriers to non-adherence, rehospitalization, readmission and death in patients with heart failure. Method: A cross-sectional, analytical study with patients admitted to the emergency room with a diagnosis of heart failure. Literacy was assessed by the Newest Vital Sign. Patient adherence to medication treatment and barriers to non-compliance were assessed 90 days after discharge by the Morisky-Green test and the Brief Medical Questionnaire, respectively. Results: 100 patients participated in the study. The mean age was 63.3 years (± 15.2), with a predominance of white women. Medication adherence was low in 41.1% of participants, of which 55.9% presented inadequate literacy. Re-hospitalization and death were present in patients with inadequate literacy (p<0.001). Conclusion: The low level of literacy was directly related to lower adherence and the presence of barriers to medication adherence, as well ...
Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure
Journal of the American Heart Association, 2015
More than 30% of patients hospitalized for heart failure are rehospitalized or die within 90 days of discharge. Lower health literacy is associated with mortality among outpatients with chronic heart failure; little is known about this relationship after hospitalization for acute heart failure. Patients hospitalized for acute heart failure and discharged home between November 2010 and June 2013 were followed through December 31, 2013. Nurses administered the Brief Health Literacy Screen at admission; low health literacy was defined as Brief Health Literacy Screen ≤9. The primary outcome was all-cause mortality. Secondary outcomes were time to first rehospitalization and, separately, time to first emergency department visit within 90 days of discharge. Cox proportional hazards models determined their relationships with health literacy, adjusting for age, gender, race, insurance, education, comorbidity, and hospital length of stay. For the 1379 patients, average age was 63.1 years, 56...