Health literacy and self-care of patients with heart failure: A longitudinal study
Abstract
Background. Inadequate health literacy, or difficulty in obtaining and understanding health information, may be a barrier in educating patients about their heart failure. Objectives. The first objective of this study was to model the relationship between health literacy, health locus of control, years of formal education, knowledge, self-efficacy, and self-care in patients with heart failure. The second objective of this study was to examine if baseline health literacy is associated with different trajectories of self-care, self-efficacy, and knowledge in patients with heart failure over time. Methods. New patient referrals (N=81, age 62.68 ± 13.55 years) to three heart failure clinics completed questionnaires to assess health literacy (Short-Form Test of Functional Health Literacy in Adults), knowledge (Heart Failure Knowledge Questionnaire), self-care and self-efficacy (Self-Care of Heart Failure Index v.6), and years of formal education at baseline. This assessment occurred prior to receiving traditional clinic-based education. Knowledge, self-efficacy, and self-care also were assessed at two months (after completion of traditional clinic-based education) and four months. Health locus of control (Multidimensional Health Locus of Control-Form C) was assessed at four months. Structural equation modeling was used to test relationships among the variables. Repeated Measures Analysis of Variance was used to test the influence of health literacy on knowledge, self-efficacy, and self-care over time. Results. A total of 63 participants with complete data were analyzed. The model demonstrated good fit with a comparative fit index of 1.000. Although health literacy was associated with more years of formal education, there was an independent effect of health literacy on heart failure knowledge. Health literacy was not related to self-care. Self-efficacy independently affected self-care. Nearly 34% of the variance in knowledge and 28% of the variance in self-care were explained by the model. There were significant effects of health literacy on knowledge longitudinally (p<0.001). No other effects of health literacy were statistically significant. Conclusions. Results of this study suggest that health literacy may influence knowledge attainment in heart failure. However, health literacy, knowledge, and self-efficacy may not fully explain why patients perform self-care.
Degree
Ph.D.
Advisors
Plake, Purdue University.
Subject Area
Health sciences
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