Health literacy and heart failure-related knowledge in ambulatory patients with chronic heart failure: a cross-sectional study
K Rebernik Grah, M Lainscak, J FarkasAbstract
Background
Patients with Heart failure (HF) need to understand information related to symptoms, treatment, and long-term disease management. Health literacy (HL) has been associated with patients’ ability to access, understand, and use health information. The relationship between HL and HF–related knowledge may clarify how differences in HL are reflected in patients’ disease-related knowledge.
Purpose
We aimed to examine the association between HL and HF–related knowledge in ambulatory patients with HF.
Methods
Ambulatory patients with HF aged ≥18 years in NYHA functional class II–III were included. Those with dementia or other cognitive impairments were excluded. We collected data on socio-demographic characteristics, general and disease-specific HL, and HF–related knowledge using validated questionnaires (Brief Health Literacy Screen, Heart Failure-Specific Health Literacy Scale, and Dutch Heart Failure Knowledge Scale). Associations between general and disease-specific HL and HF–related knowledge were examined using multivariable linear regression analyses adjusted for age, gender, level of education, NYHA functional class and depressive symptoms.
Results
The analysis included 126 ambulatory patients with HF (mean age 69 ± 11 years, 71% male; 30% completed primary education, 71% married), receiving optimal pharmacological therapy. In multivariable linear regression analyses, disease-specific HL was not independently associated with HF–related knowledge (B = 0.013, 95% CI −0.060 to 0.085; p = 0.728). In contrast, higher general HL was independently associated with greater HF–related knowledge (B = 0.167, 95% CI 0.005 to 0.329; p = 0.043). In this model, younger age (B = −0.059, p = 0.005) and higher level of education (B = 0.516, p = 0.002) were consistently associated with higher knowledge levels, whereas gender, NYHA class and depressive symptoms were not.
Conclusions
These findings suggest that general HL may be particularly relevant for understanding patients’ disease-related knowledge in routine HF care.For image description, please refer to the figure legend and surrounding text.