Como June M
Author Affiliation: Assistant Professor of Nursing, Graduate and Clinical Doctorate in Nursing Practice Programs Coordinator, and Fellow of the New York Academy of Medicine, College of Staten Island, City University of New York.
Clin Nurse Spec. 2018 Jan/Feb;32(1):29-42. doi: 10.1097/NUR.0000000000000346.
PURPOSE/AIM: The aim of this study was to investigate whether health literacy, self-efficacy, and medication adherence can explain or predict the variance in health outcomes (measured as perceived physical or mental health status [HS]) in persons with chronic heart failure (HF).
A nonexperimental cross-sectional survey study used data gathered from 175 patients with chronic HF from urban cardiology practices in the northeast United States.
The Paasche-Orlow and Wolf Causal Pathways conceptual model and Bandura's self-efficacy theory were used to select and test variables in the study. A demographic questionnaire, the Short Test of Functional Health Literacy, the Self-Efficacy for Appropriate Medication Use Scale, the Morisky Medication Adherence Scale, and the Short Form-12 version 2 assessing perceived physical and mental HS were completed. Multiple hierarchical regression analyses were used to analyze relationships among the variables.
Significant associations between health literacy and self-efficacy and between health literacy and perceived mental HS were found (P < .05). High self-efficacy was the strongest predictor of physical HS (P < .01). The strongest predictor of mental HS was medication adherence (P < .01).
Support of self-efficacy and medication adherence may improve HS. Including health literacy strategies in clinical practice may support improvements in HS in people with chronic HF.
目的/目标：本研究旨在调查健康素养、自我效能感和药物依从性是否能够解释或预测慢性心力衰竭（HF）患者健康结局（以感知到的身体或心理健康状况[HS]衡量）的差异。
一项非实验性横断面调查研究，使用了从美国东北部城市心脏病科诊所的175例慢性HF患者收集的数据。
采用帕施-奥洛和沃尔夫因果路径概念模型以及班杜拉的自我效能感理论来选择和测试研究中的变量。完成了一份人口统计学调查问卷、功能健康素养简短测试、合理用药自我效能量表、莫利斯基药物依从性量表以及评估感知到的身体和心理健康状况的简明健康调查简表第2版。使用多元分层回归分析来分析变量之间的关系。
发现健康素养与自我效能感之间以及健康素养与感知到的心理健康状况之间存在显著关联（P < .05）。高自我效能感是身体HS的最强预测因素（P < .01）。心理健康状况的最强预测因素是药物依从性（P < .01）。
支持自我效能感和药物依从性可能会改善HS。在临床实践中纳入健康素养策略可能有助于改善慢性HF患者的HS。
