title: Health Literacy Influences Heart Failure Knowledge Attainment but Not Self-Efficacy for Self-Care or Adherence to Self-Care over Time.
abstract: Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time. Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally. Methods. Prior to education, newly referred patients at three HF clinics (N = 51, age: 64.7 ± 13.0 years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes. Results. Health literacy was associated with HF knowledge longitudinally (P < 0.001) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate (P < 0.001) but not marginal (P = 0.073) health literacy. Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patients' health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined.
authors: Assistant Professor of Pharmacy Practice, School of Pharmacy, Cedarville University, 251 N. Main Street, Cedarville, OH 45314, USA.
authors: Aleda M H
authors: AM
authors: Chen
authors: Karen S
authors: KS
authors: Yehle
authors: Nancy M
authors: NM
authors: Albert
authors: Kenneth F
authors: KF
authors: Ferraro
authors: Holly L
authors: HL
authors: Mason
authors: Matthew M
authors: MM
authors: Murawski
authors: Kimberly S
authors: KS
authors: Plake
references: Patient Educ Couns. 2003 Nov;51(3):267-75
references: 14630383
references: J Card Fail. 2004 Aug;10(4):350-60
references: 15309704
references: J Cardiovasc Nurs. 2010 May-Jun;25(3):175-88
references: 20386241
references: Am Heart J. 2005 Nov;150(5):983
references: 16290977
references: Heart Lung. 2002 May-Jun;31(3):161-72
references: 12011807
references: Gerontologist. 2006 Oct;46(5):669-76
references: 17050758
references: Crit Care Nurs Q. 2011 Jul-Sep;34(3):235-45
references: 21670623
references: J Card Fail. 2010 Jun;16(6):e1-194
references: 20610207
references: J Cardiovasc Nurs. 2008 May-Jun;23(3):250-7
references: 18437067
references: J Cardiovasc Nurs. 2009 Nov-Dec;24(6):485-97
references: 19786884
references: Circulation. 2009 Sep 22;120(12):1141-63
references: 19720935
references: JAMA. 2011 Apr 27;305(16):1695-701
references: 21521851
references: J Am Coll Cardiol. 2004 Aug 18;44(4):810-9
references: 15312864
references: Patient Educ Couns. 2009 Jun;75(3):321-7
references: 19395223
references: Pharmacotherapy. 2012 Sep;32(9):819-26
references: 22744746
references: Psychol Rev. 1977 Mar;84(2):191-215
references: 847061
references: Ann Intern Med. 2007 May 15;146(10):714-25
references: 17502632
references: Evid Rep Technol Assess (Full Rep). 2011 Mar;(199):1-941
references: 23126607
references: Patient Educ Couns. 1999 Sep;38(1):33-42
references: 14528569
references: Int J Cardiol. 2011 May 19;149(1):39-45
references: 20060181
references: Circulation. 2011 Mar 1;123(8):933-44
references: 21262990
references: Circulation. 2013 Jan 1;127(1):e6-e245
references: 23239837
references: J Cardiovasc Nurs. 2011 Nov-Dec;26(6):446-51
references: 21263340
references: J Gen Intern Med. 2011 Sep;26(9):979-86
references: 21369770
references: J Cardiovasc Nurs. 2011 Sep-Oct;26(5):359-67
references: 21099698
references: J Cardiovasc Nurs. 2008 May-Jun;23(3):277-84
references: 18437070
references: J Card Fail. 2011 Oct;17(10):789-96
references: 21962415
references: BMC Health Serv Res. 2006 Mar 13;6:30
references: 16533388
references: Eur Heart J. 2006 Feb;27(4):434-40
references: 16230302