title: Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence.
abstract: BACKGROUND
  It has been argued that only 12% of adults have the necessary health literacy to manage their health care effectively, which can lead to difficulties in self-care activities, such as medication adherence. Prior research suggests that health literacy may influence knowledge, self-efficacy and self-care, but this has not been fully examined.
  
  
  OBJECTIVE
  To test a model to explain the relationships between health literacy, heart failure knowledge, self-efficacy, and self-care.
  
  
  METHODS
  Prior to receiving clinic-based education, newly referred patients to 3 heart failure clinics completed assessments of health literacy, heart failure knowledge, self-efficacy, self-care, and demographics. Structural equation modeling was completed to examine the strength of the inter-variable relationships.
  
  
  RESULTS
  Of 81 participants recruited, data from 63 patients were complete. Health literacy was independently associated with knowledge (P < 0.001). Health literacy was not related to self-care. Self-efficacy was independently-associated with self-care adherence (P = 0.016). No other relationships were statistically significant. The model had good fit (comparative fit index = 1.000) and explained 33.6% of the variance in knowledge and 27.6% in self-care.
  
  
  CONCLUSIONS
  Health literacy influences knowledge about heart failure but not self-care adherence. Instead, self-efficacy influenced self-care adherence. Future research should incorporate additional factors that may better model the relationships between health literacy, knowledge, self-efficacy, and self-care.
authors: Department of Pharmacy Practice, School of Pharmacy, Cedarville University, 251 N. Main St., Cedarville, OH 45314, USA. Electronic address: amchen@cedarville.edu.
authors: Aleda M H
authors: AM
authors: Chen
authors: School of Nursing, Purdue University, West Lafayette, IN, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA.
authors: Karen S
authors: KS
authors: Yehle
authors: Cleveland Clinic, Nursing Research and Innovation, Cleveland, OH, USA.
authors: Nancy M
authors: NM
authors: Albert
authors: Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA; Department of Sociology, Purdue University, West Lafayette, IN, USA.
authors: Kenneth F
authors: KF
authors: Ferraro
authors: College of Pharmacy, Purdue University, West Lafayette, IN, USA.
authors: Holly L
authors: HL
authors: Mason
authors: College of Pharmacy, Purdue University, West Lafayette, IN, USA.
authors: Matthew M
authors: MM
authors: Murawski
authors: Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA; College of Pharmacy, Purdue University, West Lafayette, IN, USA.
authors: Kimberly S
authors: KS
authors: Plake
mesh_terms: D000368:Aged; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010349:Patient Compliance; D012648:Self Care; D020377:Self Efficacy
keywords: Health literacy; Heart failure; Heart failure knowledge; Self-care; Self-efficacy
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