Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure.
Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure.
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DOI：
10.1007/s11606-011-1668-y
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发表时间：
2011-09
影响因子：
5.7
通讯作者：
Pignone, Michael
中科院分区：
文献类型：
--
作者：
Macabasco-O'Connell, Aurelia;DeWalt, Darren A.;Broucksou, Kimberly A.;Hawk, Victoria;Baker, David W.;Schillinger, Dean;Ruo, Bernice;Bibbins-Domingo, Kirsten;Holmes, George M.;Erman, Brian;Weinberger, Morris;Pignone, Michael
我们试图考察识字与心力衰竭相关生活质量(HFQOL)之间的关系，并探索识字相关知识、自我效能和/或自我照顾行为的差异是否解释了这种关系。我们从四个学术医学中心招募了有症状性心力衰竭(HF)的患者。患者完成了简明版的成人功能性健康素养测试(TOFHL A)，以及关于心力衰竭相关知识、心力衰竭相关自我效能和自我护理行为的问题。我们用心力衰竭症状量表(HFSS)(范围0-100)评估HFQOL，得分越高表示生活质量越好。我们使用双变量(t检验和卡方)和多元线性回归分析来估计识字与HF知识、自我效能、自我照顾行为和HFQOL之间的关系，并控制人口统计学特征。结构方程模型被用来评估一般知识、盐知识、自我照顾行为和自我效能感是否在识字和生活质量之间起中介作用。我们招募了605名患者，平均年龄60.7岁；52%是男性；38%是非洲裔美国人，16%是拉丁裔；26%没有高中学历；67%的人年收入低于25,000美元。总体而言，37%的人识字率较低(TOFHL考试成绩较差或不足)。文化程度高的患者一般心力衰竭知识高于文化程度低的患者(平均6.6vs.5.5，校正差值0.63p <； 0.01)，高自我效能感(5.0vs.4.1，调整差值0.99，p <； 0.01)，关键自我照顾行为的患病率高(p <； 0.001)。文化程度较高的儿童生活质量得分高于文化程度较低的儿童(63.9vs.55.4vs.55.4，调整后差异7.20，p <； 0.01)，但知识、自我效能感和自我照顾方面的差异并不能影响生活质量的差异。低文化程度与较差的HFQOL和较低的HF相关知识、自我效能和自我照顾行为有关，但知识、自我效能和自我照顾方面的差异不能解释低文化程度与较差的HFQOL之间的关系。
We sought to examine the relationship between literacy and heart failure-related quality of life (HFQOL), and to explore whether literacy-related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. We recruited patients with symptomatic heart failure (HF) from four academic medical centers. Patients completed the short version of the Test of Functional Health Literacy in Adults (TOFHLA) and questions on HF-related knowledge, HF-related self-efficacy, and self-care behaviors. We assessed HFQOL with the Heart Failure Symptom Scale (HFSS) (range 0–100), with higher scores denoting better quality of life. We used bivariate (t-tests and chi-square) and multivariate linear regression analyses to estimate the associations between literacy and HF knowledge, self-efficacy, self-care behaviors, and HFQOL, controlling for demographic characteristics. Structural equation modeling was conducted to assess whether general HF knowledge, salt knowledge, self-care behaviors, and self-efficacy mediated the relationship between literacy and HFQOL. We enrolled 605 patients with mean age of 60.7 years; 52% were male; 38% were African-American and 16% Latino; 26% had less than a high school education; and 67% had annual incomes under $25,000. Overall, 37% had low literacy (marginal or inadequate on TOFHLA). Patients with adequate literacy had higher general HF knowledge than those with low literacy (mean 6.6 vs. 5.5, adjusted difference 0.63, p < 0.01), higher self-efficacy (5.0 vs. 4.1 ,adjusted difference 0.99, p < 0.01), and higher prevalence of key self-care behaviors (p < 0.001). Those with adequate literacy had better HFQOL scores compared to those with low literacy (63.9 vs. 55.4, adjusted difference 7.20, p < 0.01), but differences in knowledge, self-efficacy, and self-care did not mediate this difference in HFQOL. Low literacy was associated with worse HFQOL and lower HF-related knowledge, self-efficacy, and self-care behaviors, but differences in knowledge, self-efficacy and self-care did not explain the relationship between low literacy and worse HFQOL.
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影响因子：
4.8
作者：
Goldberg, LR;Piette, JD;Loh, E
通讯作者：
Loh, E
影响因子：
2.8
作者：
DeWalt DA;Broucksou KA;Hawk V;Baker DW;Schillinger D;Ruo B;Bibbins-Domingo K;Holmes M;Weinberger M;Macabasco-O'Connell A;Pignone M
通讯作者：
Pignone M
影响因子：
5.7
作者：
Baker, DW;Parker, RM;Clark, WS
通讯作者：
Clark, WS
影响因子：
24
作者：
Klersy, Catherine;De Silvestri, Annalisa;Auricchio, Angelo
通讯作者：
Auricchio, Angelo
影响因子：
3.5
作者：
Gazmararian, JA;Williams, MV;Baker, DW
通讯作者：
Baker, DW