健康素养与心力衰竭知识、自我效能感和自我护理依从性之间的关系。
Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence.
作者信息
Chen Aleda M H, Yehle Karen S, Albert Nancy M, Ferraro Kenneth F, Mason Holly L, Murawski Matthew M, Plake Kimberly S
机构信息
Department of Pharmacy Practice, School of Pharmacy, Cedarville University, 251 N. Main St., Cedarville, OH 45314, USA.
School of Nursing, Purdue University, West Lafayette, IN, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA.
出版信息
Res Social Adm Pharm. 2014 Mar-Apr;10(2):378-86. doi: 10.1016/j.sapharm.2013.07.001. Epub 2013 Aug 13.
BACKGROUND
It has been argued that only 12% of adults have the necessary health literacy to manage their health care effectively, which can lead to difficulties in self-care activities, such as medication adherence. Prior research suggests that health literacy may influence knowledge, self-efficacy and self-care, but this has not been fully examined.
OBJECTIVE
To test a model to explain the relationships between health literacy, heart failure knowledge, self-efficacy, and self-care.
METHODS
Prior to receiving clinic-based education, newly referred patients to 3 heart failure clinics completed assessments of health literacy, heart failure knowledge, self-efficacy, self-care, and demographics. Structural equation modeling was completed to examine the strength of the inter-variable relationships.
RESULTS
Of 81 participants recruited, data from 63 patients were complete. Health literacy was independently associated with knowledge (P < 0.001). Health literacy was not related to self-care. Self-efficacy was independently-associated with self-care adherence (P = 0.016). No other relationships were statistically significant. The model had good fit (comparative fit index = 1.000) and explained 33.6% of the variance in knowledge and 27.6% in self-care.
CONCLUSIONS
Health literacy influences knowledge about heart failure but not self-care adherence. Instead, self-efficacy influenced self-care adherence. Future research should incorporate additional factors that may better model the relationships between health literacy, knowledge, self-efficacy, and self-care.
背景
有人认为，只有12%的成年人具备有效管理自身医疗保健所需的健康素养，这可能导致自我护理活动出现困难，如药物依从性方面。先前的研究表明，健康素养可能会影响知识、自我效能感和自我护理，但这一点尚未得到充分研究。
目的
检验一个模型，以解释健康素养、心力衰竭知识、自我效能感和自我护理之间的关系。
方法
在接受基于诊所的教育之前，新转诊至3家心力衰竭诊所的患者完成了健康素养、心力衰竭知识、自我效能感、自我护理和人口统计学评估。采用结构方程模型来检验变量间关系的强度。
结果
在招募的81名参与者中，63名患者的数据完整。健康素养与知识独立相关（P < 0.001）。健康素养与自我护理无关。自我效能感与自我护理依从性独立相关（P = 0.016）。其他关系均无统计学意义。该模型拟合良好（比较拟合指数 = 1.000），解释了33.6%的知识方差和27.6%的自我护理方差。
结论
健康素养影响关于心力衰竭方面的知识，但不影响自我护理依从性。相反，自我效能感影响自我护理依从性。未来的研究应纳入其他因素，以便更好地构建健康素养、知识、自我效能感和自我护理之间关系的模型。
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