Department of Pharmacy Practice, College of Pharmacy, Center on Aging and Life Course, Purdue University, West Lafayette, Indiana, USA.
J Cardiovasc Nurs. 2011 Nov-Dec;26(6):446-51. doi: 10.1097/JCN.0b013e31820598d4.
Today's complex healthcare system relies heavily on sophisticated self-care regimens. To navigate the system and follow self-care protocols, patients must be able to understand and use health information, which requires health literacy. However, nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Understanding how to effectively care for one's self is thought to improve heart failure symptoms and patient outcomes, but little is actually known about how health literacy influences self-care in patients with heart failure. The purpose of this pilot study was to examine the relationship between health literacy and self-care of patients with heart failure.
Patients with a diagnosis of heart failure were recruited from a variety of community settings. Participants completed the Short-Form Test of Functional Health Literacy (measured health literacy), the Self-care Index of Heart Failure (measured self-care maintenance, management, and confidence), and a demographic questionnaire. Spearman ρ correlations were used to assess the strength of the relationship between health literacy level and self-care scores.
Among the 49 participants recruited, health literacy was positively related to self-care maintenance (Rs = 0.357, P = .006). Health literacy had a negative relationship with self-care management (Rs = -0.573, P = .001). There was no association between health literacy and self-care confidence (Rs = 0.201, P = .083). This project provides preliminary data regarding the association between health literacy and self-care in heart failure, showing support for higher health-literate patients performing more self-care maintenance, which has been shown to improve patient outcomes in heart failure. Patients with higher health literacy trended toward having greater self-care confidence, which can increase the likelihood of performing self-care, but this finding was not statistically significant. It was unexpected to find that lower health-literate patients performed more self-care management.
当今复杂的医疗体系严重依赖于复杂的自我护理方案。为了在系统中进行导航并遵循自我护理方案，患者必须能够理解和使用健康信息，这就需要具备健康素养。然而，近 9000 万美国人缺乏在面对复杂的医疗体系和自我护理方案时充分照顾自己所需的必要健康素养技能。人们认为，了解如何有效地自我护理可以改善心力衰竭症状和患者预后，但实际上人们对健康素养如何影响心力衰竭患者的自我护理知之甚少。本初步研究旨在探讨健康素养与心力衰竭患者自我护理之间的关系。
从各种社区环境中招募了心力衰竭诊断患者。参与者完成了简短形式的功能性健康素养测试（衡量健康素养）、心力衰竭自我护理指数（衡量自我护理维持、管理和信心）和一份人口统计学问卷。使用斯皮尔曼 ρ 相关系数来评估健康素养水平与自我护理得分之间的关系强度。
在招募的 49 名参与者中，健康素养与自我护理维持呈正相关（Rs = 0.357，P =.006）。健康素养与自我护理管理呈负相关（Rs = -0.573，P =.001）。健康素养与自我护理信心之间没有关联（Rs = 0.201，P =.083）。该项目提供了心力衰竭患者健康素养与自我护理之间关联的初步数据，支持健康素养较高的患者进行更多的自我护理维持，这已被证明可以改善心力衰竭患者的预后。健康素养较高的患者自我护理信心更强，这可能会增加自我护理的可能性，但这一发现没有统计学意义。出乎意料的是，健康素养较低的患者进行了更多的自我护理管理。
