Aleda M H Chen1, Karen S Yehle2, Nancy M Albert3, Kenneth F Ferraro4, Holly L Mason5, Matthew M Murawski5, Kimberly S Plake6. 1. Department of Pharmacy Practice, School of Pharmacy, Cedarville University, 251 N. Main St., Cedarville, OH 45314, USA. Electronic address: amchen@cedarville.edu. 2. School of Nursing, Purdue University, West Lafayette, IN, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA. 3. Cleveland Clinic, Nursing Research and Innovation, Cleveland, OH, USA. 4. Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA; Department of Sociology, Purdue University, West Lafayette, IN, USA. 5. College of Pharmacy, Purdue University, West Lafayette, IN, USA. 6. Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA; College of Pharmacy, Purdue University, West Lafayette, IN, USA.
Abstract
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.
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.
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