%0 Journal Article
%T Health Literacy Influences Heart Failure Knowledge Attainment but Not Self-Efficacy for Self-Care or Adherence to Self-Care over Time
%A Aleda M. H. Chen
%A Karen S. Yehle
%A Nancy M. Albert
%A Kenneth F. Ferraro
%A Holly L. Mason
%A Matthew M. Murawski
%A Kimberly S. Plake
%J Nursing Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/353290
%X Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time. Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally. Methods. Prior to education, newly referred patients at three HF clinics ( , age: years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes. Results. Health literacy was associated with HF knowledge longitudinally ( ) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate ( ) but not marginal ( ) health literacy. Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patientsĄŻ health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined. 1. Introduction Heart failure is identified as a leading cause of hospitalizations [1], morbidity, mortality, and rising healthcare costs for nearly six million Americans [2, 3]. After a diagnosis of heart failure, patients must perform self-care behaviors to reduce negative clinical outcomes [4, 5]. Self-care is a decision-making process, where patients perform activities to prevent symptoms (maintenance) and respond to symptoms as they occur (management) [4]. Self-care maintenance activities for heart failure patients include exercising daily, eating a low sodium diet, monitoring fluid intake, and monitoring weight. Patients may respond to symptoms by engaging in the following self-care management activities: consulting their healthcare provider, reducing fluid and sodium intake, and increasing the dose of a diuretic. However, patientsĄŻ adherence to recommended self-care behaviors varies greatly and is generally poor [5¨C7]. Multiple factors may affect patientsĄŻ adherence to heart failure self-care including heart failure knowledge. Patients may not have received recommended heart failure education [8, 9] if the heart failure diagnosis was secondary
%U http://www.hindawi.com/journals/nrp/2013/353290/