title: Correlates of Health Literacy and Its Impact on Illness Beliefs for Emergency Department Patients With Acute Heart Failure.
abstract: To study the relationship between health literacy (HL) and socioeconomic, demographic factors and disease-specific illness beliefs among patients who present to the emergency department with heart failure (HF).
  
  
  
  Maintenance of well-being for patients with HF is partially dependent on appropriate self-care behaviors, which, in turn, are influenced by underlying illness beliefs. HL is a potential modifier of the interaction between behaviors and beliefs. There have been limited investigations studying this relationship among individuals with acute HF.
  
  
  
  A cross-sectional study of patients with hemodynamically stable acute HF was conducted. Demographic, education, and social support data were obtained from all patients along with self-reported responses to the 36-item STOFHLA survey, a 14 item HF-specific illness belief questionnaire, and a 5-item self-care adherence survey. General association was assessed using the χ or Fisher exact test, and comparisons were made using the Kruskal-Wallis test.
  
  
  
  A total of 100 patients (51 females and 49 males) were included, 94% of whom were African-American (mean age [SD]: 57.5 [13.2] years). Inadequate, marginal, and adequate health literacy were present in 35%, 17%, and 48%, respectively, with increasing adequacy among the higher educated (P < 0.001). Overall, HF illness beliefs were considered to be "inaccurate" (mean score [SD] on a 4-point Likert scale: 2.8 [0.3]) but did correlate positively with improved HL (r = 0.26; P = 0.008).
  
  
  
  In this cohort of relatively young, predominantly African-American patients with acute HF, HL was positively correlated with level of education and negatively associated with age and was an important determinant of disease-specific illness beliefs.
authors.affiliation: From the *Department of Emergency Medicine and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, MI; †Nursing Research and Innovation, Cleveland Clinic, Cleveland, OH; ‡Detroit Medical Centre, Detroit, MI; and §Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors.forename: Vijaya Arun
authors.initials: VA
authors.lastname: Kumar
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.forename: Patrick
authors.initials: P
authors.lastname: Medado
authors.forename: Lynn Marie
authors.initials: LM
authors.lastname: Mango
authors.forename: Benjamin
authors.initials: B
authors.lastname: Nutter
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Yang
authors.forename: Phillip
authors.initials: P
authors.lastname: Levy
mesh_terms: D000208:Acute Disease; D003430:Cross-Sectional Studies; D004522:Educational Status; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006333:Heart Failure / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012189:Retrospective Studies; D012648:Self Care / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires