A Proposed Model of the Relationships Between Health Literacy, Self-Care, Self-Efficacy, and Knowledge in Heart Failure

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±13.0years) 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.

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Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2013.07.001 ◽

2014 ◽

Vol 10 (2) ◽

pp. 378-386 ◽

Cited By ~ 59

Author(s):

Aleda M.H. Chen ◽

Karen S. Yehle ◽

Nancy M. Albert ◽

Kenneth F. Ferraro ◽

Holly L. Mason ◽

...

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Self Efficacy ◽

Self Care

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17. Health literacy influences knowledge attainment but not self-care or self-efficacy longitudinally in patients with heart failure

Heart & Lung ◽

10.1016/j.hrtlng.2012.04.030 ◽

2012 ◽

Vol 41 (4) ◽

pp. 419-420

Author(s):

K.S. Yehle ◽

A.M. Chen ◽

N.M. Albert ◽

K.F. Ferraro ◽

H.L. Mason ◽

...

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Self Efficacy ◽

Self Care ◽

Patients With Heart Failure

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Abstract 58: Health Literacy Influences Knowledge Attainment but not Self-Care or Self-Efficacy Longitudinally in Heart Failure Patients

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.5.suppl_1.a58 ◽

2012 ◽

Vol 5 (suppl_1) ◽

Author(s):

Aleda M Chen ◽

Karen S Yehle ◽

Nancy M Albert ◽

Kenneth F Ferraro ◽

Holly L Mason ◽

...

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Self Efficacy ◽

Short Form ◽

Self Care ◽

Functional Health ◽

Health Literacy Level ◽

Literacy Level ◽

Post Hoc ◽

Inadequate Health Literacy

Introduction: Inadequate health literacy may be a barrier during traditional clinic-based heart failure (HF) education. The influence of health literacy on gains over time in knowledge, self-efficacy and self-care is unknown. The purpose of this study was to examine health literacy, knowledge, self-efficacy, and self-care longitudinally in HF. Hypotheses: Patient health literacy level will be associated with differential gains in knowledge, self-efficacy, and self-care after completion of traditional clinic-based education. Methods: First-time patients at 3 HF clinics (N=51, age: 64.7±13.04 years) completed assessments of health literacy (Short-Form Test of Functional Health Literacy in Adults), knowledge (HF Knowledge Questionnaire), and self-care/self-efficacy (Self-Care of HF Index v.6) prior to HF education (baseline), 2 months (education completion), and 4 months post-baseline. Repeated measures Analysis of Variance was used to analyze longitudinal associations, and post-hoc tests with Bonferroni-adjusted alpha-levels were used for comparison. Results: Higher health literacy was associated with greater HF knowledge at 2 and 4 months (p<0.001), but there were no associations between health literacy and self-care or self-efficacy. In post-hoc analyses (Figure 1), patients with inadequate health literacy had less knowledge than those with marginal (p=0.024) or adequate (p<0.001) health literacy at 2 months. At 4 months, patients with inadequate health literacy continued to have less knowledge compared to adequate (p<0.001). Conclusions: Health literacy level is associated with attaining and retaining HF knowledge; however, it is not associated with self-care confidence or adherence. Tailoring HF education to health literacy level may aid in grasping concepts taught. It is unknown if a better grasp of concepts would enhance self-care adherence and promote improved health. Future research is needed to more fully understand the consequences of inadequate health literacy on self-care.

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IMPACT OF HEALTH LITERACY ON KNOWLEDGE, SELF-CARE AND CLINICAL OUTCOMES IN HEART FAILURE PATIENTS

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2018.07.263 ◽

2018 ◽

Vol 34 (10) ◽

pp. S93

Author(s):

J. McConnery ◽

F. Foroutan ◽

A. Alba ◽

H. Ross ◽

J. MacIver

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Clinical Outcomes ◽

Self Care ◽

Heart Failure Patients

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THE ROLE OF HEALTH LITERACY ON PROCESS AND OUTCOMES OF A DIABETES SELF-HELP INTERVENTION WITH KOREAN AMERICANS

Innovation in Aging ◽

10.1093/geroni/igz038.1511 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S406-S406

Author(s):

Miyong T Kim

Keyword(s):

Health Literacy ◽

Glucose Control ◽

Self Efficacy ◽

Diabetes Management ◽

Self Care ◽

Korean Americans ◽

Target Population ◽

Management Intervention ◽

Underlying Mechanisms

Abstract The purpose of this study was to explicate the underlying mechanisms of the role of health literacy (HL) in diabetes management process involving a group of Korean Americans with type 2 diabetes mellitus (DM). We used data from a randomized clinical trial of an HL-focused diabetes self-management intervention (n = 250). A series of path analyses identified the level of self-efficacy and self-care skills as a significant mediator between HL and glucose control (HbA1C) and quality of life for the target population. In addition, education and acculturation were revealed as the most significant correlates of HL for this new immigrant group. Despite inconsistent empirical findings regarding the statistically significant effect of HL on glucose control, this study confirmed the apriority hypothesis that HL indirectly influences health outcome through mediators such self-care skills as self-efficacy. This study highlighted the importance of HL in chronic disease management for people with limited HL.

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Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

Oman Medical Journal ◽

10.5001/omj.2016.10 ◽

2016 ◽

Vol 31 (1) ◽

pp. 52-59 ◽

Cited By ~ 34

Author(s):

Mahnoush Reisi ◽

Firoozeh Mostafavi ◽

Homamodin Javadzade ◽

Behzad Mahaki ◽

Elahe Tavassoli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Self Efficacy ◽

Self Care ◽

Outcome Expectations

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The relationship between health literacy and self-care in patients with heart failure

British Journal of Cardiac Nursing ◽

10.12968/bjca.2020.0128 ◽

2021 ◽

pp. 1-10

Author(s):

Katie Nesbitt ◽

Huiyun Du ◽

Paul Nolan ◽

Susie Cartledge ◽

Parichat Wonggom ◽

...

Keyword(s):

Heart Failure ◽

Health Literacy ◽

Patient Group ◽

Care Management ◽

Self Care ◽

Randomised Control Trial ◽

Adequate Health Literacy ◽

Patients With Heart Failure ◽

Literacy Knowledge ◽

The Relationship

Background/Aims Research has shown that health literacy can influence an individual's ability to practise self-care, particularly for patients with heart failure. This study aimed to assess health literacy and its relationship with heart failure knowledge and self-care practices in this patient group. Methods An observational sub-study was conducted with the data from a large randomised control trial that evaluated the relationship between patients' health literacy, general literacy, knowledge of heart failure and self-care. Results A total of 36 participants were recruited, of which 33 (89.9%) had adequate levels of health literacy. Health literacy was positively associated with heart failure knowledge. However, 67.7% of participants with adequate health literacy were found to have inadequate levels of self-care management. Conclusions Health literacy may facilitate better heart failure knowledge, but it does not necessarily lead to improved self-care management in patients with heart failure. This suggest that clinicians need to put more emphasis on translating knowledge into behavioural changes for self-care in this patient group.

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Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study

10.21203/rs.2.21066/v2 ◽

2020 ◽

Author(s):

Ming-Jye Wang ◽

Hung-Ming Lin ◽

Li-Chen Hung ◽

Yi-Ting Lo

Keyword(s):

Type 2 Diabetes ◽

Decision Making ◽

Health Literacy ◽

Self Efficacy ◽

Patient Empowerment ◽

Self Care ◽

Cross Sectional Study ◽

Medical Decision ◽

Cross Sectional

Abstract Background: The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making.Methods: A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via self-administered questionnaires. Partial least squares structural equation modeling was used for analysis.Results: Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making. Conclusions: Health literacy is a critical factor in improving self-care behaviors in patients with type 2 diabetes, and the effect of health literacy on self-efficacy was more significant in the shared decision-making than in the physician decision-making. Therefore, developing an effective health strategy to strengthen health literacy awareness and designing friendly, diverse health literacy materials, and application tools is the most important factor to facilitate self-care behaviors in this population.

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