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18-10-2019

Effect of health literacy on quality of life among patients with chronic heart failure in China

Auteurs: Junhua Zhang, Stuart Gilmour, Yancun Liu, Erika Ota

Gepubliceerd in: Quality of Life Research | Uitgave 2/2020

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Abstract

Purpose

Despite advances in treatment and management, Chronic heart failure (CHF) is still associated with poor prognosis, a high rate of hospitalization and readmission, and reduced quality of life (QOL). However, the relationship between QOL and health literacy in patients with CHF remains unclear. This study aimed to examine the association between health literacy and QOL, among Chinese patients with CHF.

Method

This is a cross-sectional study of a convenience sample from a cardiovascular hospital in Henan Province in China. Subjects completed a self-administered questionnaire that assessed the heart failure-specific health literacy score. QOL was measured using the Minnesota Living with heart failure scale. Unadjusted and adjusted multiple linear regression were used to explore the association between health literacy and QOL.

Results

This study sampled 299 patients, with a mean age of 61.9 ± 14.9 years old. The association between health literacy and QOL was significant only in the unadjusted model (P < 0.001) and was no longer statistically significant after controlling for covariates. The final best-fitted model identified 9 significant predictors, accounting for 38.6% of the variance in quality of life.

Conclusions

This study suggests that there is no relationship between health literacy and QOL in Chinese CHF patients after adjusting for covariates. Residence, monthly income, self-care management, self-efficacy and social support are significantly associated with QOL. Compared patients with high health literacy, patients with low health literacy may have problems comprehending healthcare information and following disease management instructions, which might contribute to diminished QOL. Therefore, in clinical practice, effective interventions such as creating appropriate materials for low-literacy patients and performing education to raise self-care management, self-efficacy, might improve the QOL of patients with CHF.
Literatuur
1.
go back to reference Ambrosy, A. P., Fonarow, G. C., Butler, J., Chioncel, O., Greene, S. J., Vaduganathan, M., et al. (2014). The global health and economic burden of hospitalizations for heart failure: Lessons learned from hospitalized heart failure registries. Journal of the American College of Cardiology,63(12), 1123–1133.CrossRef Ambrosy, A. P., Fonarow, G. C., Butler, J., Chioncel, O., Greene, S. J., Vaduganathan, M., et al. (2014). The global health and economic burden of hospitalizations for heart failure: Lessons learned from hospitalized heart failure registries. Journal of the American College of Cardiology,63(12), 1123–1133.CrossRef
2.
go back to reference Ponikowski, P., Anker, S. D., AlHabib, K. F., Cowie, M. R., Force, T. L., Hu, S., et al. (2014). Heart failure: Preventing disease and death worldwide. ESC Heart Fail,1(1), 4–25.CrossRef Ponikowski, P., Anker, S. D., AlHabib, K. F., Cowie, M. R., Force, T. L., Hu, S., et al. (2014). Heart failure: Preventing disease and death worldwide. ESC Heart Fail,1(1), 4–25.CrossRef
3.
go back to reference Gardner, R. S., & McDonagh, T. A. (2014). Chronic heart failure: Epidemiology, investigation and management. Medicine,42(10), 562–567.CrossRef Gardner, R. S., & McDonagh, T. A. (2014). Chronic heart failure: Epidemiology, investigation and management. Medicine,42(10), 562–567.CrossRef
4.
go back to reference Cajita, M. I., Cajita, T. R., & Han, H. R. (2016). Health literacy and heart failure: A systematic review. Journal of Cardiovascular Nursing,31(2), 121–130.CrossRef Cajita, M. I., Cajita, T. R., & Han, H. R. (2016). Health literacy and heart failure: A systematic review. Journal of Cardiovascular Nursing,31(2), 121–130.CrossRef
5.
go back to reference Nesbitt, T., Doctorvaladan, S., Southard, J. A., Singh, S., Fekete, A., Marie, K., et al. (2014). Correlates of quality of life in rural patients with heart failure. Circulation Heart Failure,7(6), 882–887.CrossRef Nesbitt, T., Doctorvaladan, S., Southard, J. A., Singh, S., Fekete, A., Marie, K., et al. (2014). Correlates of quality of life in rural patients with heart failure. Circulation Heart Failure,7(6), 882–887.CrossRef
6.
go back to reference Jackson, J. D., Cotton, S. E., Bruce Wirta, S., Proenca, C. C., Zhang, M., Lahoz, R., et al. (2018). Burden of heart failure on patients from China: Results from a cross-sectional survey. Drug Design, Development and Therapy,12, 1659–1668.CrossRef Jackson, J. D., Cotton, S. E., Bruce Wirta, S., Proenca, C. C., Zhang, M., Lahoz, R., et al. (2018). Burden of heart failure on patients from China: Results from a cross-sectional survey. Drug Design, Development and Therapy,12, 1659–1668.CrossRef
7.
go back to reference Moser, D. K., Yamokoski, L., Sun, J. L., Conway, G. A., Hartman, K. A., Graziano, J. A., et al. (2009). Improvement in health-related quality of life after hospitalization predicts event-free survival in patients with advanced heart failure. Journal of Cardiac Failure,15(9), 763–769.CrossRef Moser, D. K., Yamokoski, L., Sun, J. L., Conway, G. A., Hartman, K. A., Graziano, J. A., et al. (2009). Improvement in health-related quality of life after hospitalization predicts event-free survival in patients with advanced heart failure. Journal of Cardiac Failure,15(9), 763–769.CrossRef
8.
go back to reference Ho, C. C., Clochesy, J. M., Madigan, E., & Liu, C. C. (2007). Psychometric evaluation of the Chinese version of the minnesota living with heart failure questionnaire. Nursing Research,56(6), 441–448.CrossRef Ho, C. C., Clochesy, J. M., Madigan, E., & Liu, C. C. (2007). Psychometric evaluation of the Chinese version of the minnesota living with heart failure questionnaire. Nursing Research,56(6), 441–448.CrossRef
9.
go back to reference Middel, B., Bouma, J., de Jongste, M., van Sonderen, E., Niemeijer, M. G., Crijns, H., et al. (2001). Psychometric properties of the Minnesota living with heart failure questionnaire (MLHF-Q). Clinical Rehabilitation,15(5), 489–500.CrossRef Middel, B., Bouma, J., de Jongste, M., van Sonderen, E., Niemeijer, M. G., Crijns, H., et al. (2001). Psychometric properties of the Minnesota living with heart failure questionnaire (MLHF-Q). Clinical Rehabilitation,15(5), 489–500.CrossRef
10.
go back to reference Sk, S. (1974). Health education as social policy. Health Education Monograph,2, 1–25. Sk, S. (1974). Health education as social policy. Health Education Monograph,2, 1–25.
11.
go back to reference Sorensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., et al. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health,12, 80.CrossRef Sorensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., et al. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health,12, 80.CrossRef
12.
go back to reference Halverson, J. L., Martinez-Donate, A. P., Palta, M., Leal, T., Lubner, S., Walsh, M. C., et al. (2015). Health literacy and health-related quality of life among a population-based sample of cancer patients. Journal of Health Communication,20(11), 1320–1329.CrossRef Halverson, J. L., Martinez-Donate, A. P., Palta, M., Leal, T., Lubner, S., Walsh, M. C., et al. (2015). Health literacy and health-related quality of life among a population-based sample of cancer patients. Journal of Health Communication,20(11), 1320–1329.CrossRef
13.
go back to reference Lee, E. H., Lee, Y. W., & Moon, S. H. (2016). A structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life in patients with type 2 diabetes. Asian Nursing Research,10(1), 82–87.CrossRef Lee, E. H., Lee, Y. W., & Moon, S. H. (2016). A structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life in patients with type 2 diabetes. Asian Nursing Research,10(1), 82–87.CrossRef
14.
go back to reference Omachi, T. A., Sarkar, U., Yelin, E. H., Blanc, P. D., & Katz, P. P. (2013). Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. Journal of General Internal Medicine,28(1), 74–81.CrossRef Omachi, T. A., Sarkar, U., Yelin, E. H., Blanc, P. D., & Katz, P. P. (2013). Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. Journal of General Internal Medicine,28(1), 74–81.CrossRef
15.
go back to reference Valerio, M. A., Peterson, E. L., Wittich, A. R., & Joseph, C. L. (2016). Examining health literacy among urban African-American adolescents with asthma. Journal of Asthma,53(10), 1041–1047.CrossRef Valerio, M. A., Peterson, E. L., Wittich, A. R., & Joseph, C. L. (2016). Examining health literacy among urban African-American adolescents with asthma. Journal of Asthma,53(10), 1041–1047.CrossRef
17.
go back to reference Macabasco-O’Connell, A., DeWalt, D. A., Broucksou, K. A., Hawk, V., Baker, D. W., Schillinger, D., et al. (2011). Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. Journal of General Internal Medicine,26(9), 979–986.CrossRef Macabasco-O’Connell, A., DeWalt, D. A., Broucksou, K. A., Hawk, V., Baker, D. W., Schillinger, D., et al. (2011). Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. Journal of General Internal Medicine,26(9), 979–986.CrossRef
18.
go back to reference Tung, H.-H., Lu, T.-M., Chen, L.-K., Liang, S.-Y., Wu, S.-F., & Chu, K.-H. (2014). Health literacy impact on elderly patients with heart failure in Taiwan. Journal of Clinical Gerontology and Geriatrics,5(3), 72–76.CrossRef Tung, H.-H., Lu, T.-M., Chen, L.-K., Liang, S.-Y., Wu, S.-F., & Chu, K.-H. (2014). Health literacy impact on elderly patients with heart failure in Taiwan. Journal of Clinical Gerontology and Geriatrics,5(3), 72–76.CrossRef
19.
go back to reference Zou, H., Chen, Y., Fang, W., Zhang, Y., & Fan, X. (2016). The mediation effect of health literacy between subjective social status and depressive symptoms in patients with heart failure. Journal of Psychosomatic Research,91, 33–39.CrossRef Zou, H., Chen, Y., Fang, W., Zhang, Y., & Fan, X. (2016). The mediation effect of health literacy between subjective social status and depressive symptoms in patients with heart failure. Journal of Psychosomatic Research,91, 33–39.CrossRef
20.
go back to reference Zou, H., Chen, Y., Fang, W., Zhang, Y., & Fan, X. (2017). Identification of factors associated with self-care behaviors using the COM-B model in patients with chronic heart failure. European Journal of Cardiovascular Nursing,16(6), 530–538.CrossRef Zou, H., Chen, Y., Fang, W., Zhang, Y., & Fan, X. (2017). Identification of factors associated with self-care behaviors using the COM-B model in patients with chronic heart failure. European Journal of Cardiovascular Nursing,16(6), 530–538.CrossRef
21.
go back to reference Wang, C., Kane, R. L., Xu, D., & Meng, Q. (2015). Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC Womens Health,15, 34.CrossRef Wang, C., Kane, R. L., Xu, D., & Meng, Q. (2015). Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC Womens Health,15, 34.CrossRef
22.
go back to reference Matsuoka, S., Kato, N., Kayane, T., Yamada, M., Koizumi, M., Ikegame, T., et al. (2016). Development and validation of a heart failure-specific health literacy scale. Journal of Cardiovascular Nursing,31(2), 131–139.CrossRef Matsuoka, S., Kato, N., Kayane, T., Yamada, M., Koizumi, M., Ikegame, T., et al. (2016). Development and validation of a heart failure-specific health literacy scale. Journal of Cardiovascular Nursing,31(2), 131–139.CrossRef
23.
go back to reference Yue, M., Zhang, L., Lu, Y., & Jin, C. (2016). Translation and psychometric evaluation of the Chinese version of the heart failure-specific health literacy scale. International Journal of Nursing Sciences,3(4), 342–346.CrossRef Yue, M., Zhang, L., Lu, Y., & Jin, C. (2016). Translation and psychometric evaluation of the Chinese version of the heart failure-specific health literacy scale. International Journal of Nursing Sciences,3(4), 342–346.CrossRef
24.
go back to reference Barutcu, C. D., & Mert, H. (2013). The relationship between social support and quality of life in patients with heart failure. Journal of Pakistan Medical Association,63(4), 463–467. Barutcu, C. D., & Mert, H. (2013). The relationship between social support and quality of life in patients with heart failure. Journal of Pakistan Medical Association,63(4), 463–467.
25.
go back to reference Seto, E., Leonard, K. J., Cafazzo, J. A., Masino, C., Barnsley, J., & Ross, H. J. (2011). Self-care and quality of life of heart failure patients at a multidisciplinary heart function clinic. Journal of Cardiovascular Nursing,26(5), 377–385.CrossRef Seto, E., Leonard, K. J., Cafazzo, J. A., Masino, C., Barnsley, J., & Ross, H. J. (2011). Self-care and quality of life of heart failure patients at a multidisciplinary heart function clinic. Journal of Cardiovascular Nursing,26(5), 377–385.CrossRef
26.
go back to reference Wang, C., Lang, J., Xuan, L., Li, X., & Zhang, L. (2017). The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: A cross-sectional study. International Journal for Equity in Health,16(1), 58.CrossRef Wang, C., Lang, J., Xuan, L., Li, X., & Zhang, L. (2017). The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: A cross-sectional study. International Journal for Equity in Health,16(1), 58.CrossRef
27.
go back to reference Riegel, B., Lee, C. S., Dickson, V. V., & Carlson, B. (2009). An update on the self-care of heart failure index. Journal of Cardiovascular Nursing,24(6), 485–497.CrossRef Riegel, B., Lee, C. S., Dickson, V. V., & Carlson, B. (2009). An update on the self-care of heart failure index. Journal of Cardiovascular Nursing,24(6), 485–497.CrossRef
28.
go back to reference Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment,55(3–4), 610–617.CrossRef Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment,55(3–4), 610–617.CrossRef
29.
go back to reference Peter Armitage, G. B., & Matthews, J. N. S. (2001). Statistical methods in medical research (4th ed.). Hoboken: Wiley. Peter Armitage, G. B., & Matthews, J. N. S. (2001). Statistical methods in medical research (4th ed.). Hoboken: Wiley.
30.
go back to reference Al Sayah, F., Majumdar, S. R., & Johnson, J. A. (2015). Association of inadequate health literacy with health outcomes in patients with type 2 diabetes and depression: Secondary analysis of a controlled trial. Canadian Journal of Diabetes,39(4), 259–265.CrossRef Al Sayah, F., Majumdar, S. R., & Johnson, J. A. (2015). Association of inadequate health literacy with health outcomes in patients with type 2 diabetes and depression: Secondary analysis of a controlled trial. Canadian Journal of Diabetes,39(4), 259–265.CrossRef
31.
go back to reference Couture, E. M., Chouinard, M. C., Fortin, M., & Hudon, C. (2018). The relationship between health literacy and patient activation among frequent users of healthcare services: A cross-sectional study. BMC Family Practice,19(1), 38.CrossRef Couture, E. M., Chouinard, M. C., Fortin, M., & Hudon, C. (2018). The relationship between health literacy and patient activation among frequent users of healthcare services: A cross-sectional study. BMC Family Practice,19(1), 38.CrossRef
32.
go back to reference Montbleau, K. E., King, D., Henault, L., & Magnani, J. W. (2017). Health literacy, health-related quality of life, and atrial fbrillation. Cogent Medicine,4, 1412121.CrossRef Montbleau, K. E., King, D., Henault, L., & Magnani, J. W. (2017). Health literacy, health-related quality of life, and atrial fbrillation. Cogent Medicine,4, 1412121.CrossRef
33.
go back to reference Zheng, M., Jin, H., Shi, N., Duan, C., Wang, D., Yu, X., et al. (2018). The relationship between health literacy and quality of life: A systematic review and meta-analysis. Health and Quality of Life Outcomes,16(1), 201.CrossRef Zheng, M., Jin, H., Shi, N., Duan, C., Wang, D., Yu, X., et al. (2018). The relationship between health literacy and quality of life: A systematic review and meta-analysis. Health and Quality of Life Outcomes,16(1), 201.CrossRef
34.
go back to reference Evangelista, L. S., Rasmusson, K. D., Laramee, A. S., Barr, J., Ammon, S. E., Dunbar, S., et al. (2010). Health literacy and the patient with heart failure–implications for patient care and research: A consensus statement of the Heart Failure Society of America. Journal of Cardiac Failure,16(1), 9–16.CrossRef Evangelista, L. S., Rasmusson, K. D., Laramee, A. S., Barr, J., Ammon, S. E., Dunbar, S., et al. (2010). Health literacy and the patient with heart failure–implications for patient care and research: A consensus statement of the Heart Failure Society of America. Journal of Cardiac Failure,16(1), 9–16.CrossRef
35.
go back to reference Xu, W. H., Rothman, R. L., Li, R., Chen, Y., Xia, Q., Fang, H., et al. (2014). Improved self-management skills in Chinese diabetes patients through a comprehensive health literacy strategy: Study protocol of a cluster randomized controlled trial. Trials,15, 498.CrossRef Xu, W. H., Rothman, R. L., Li, R., Chen, Y., Xia, Q., Fang, H., et al. (2014). Improved self-management skills in Chinese diabetes patients through a comprehensive health literacy strategy: Study protocol of a cluster randomized controlled trial. Trials,15, 498.CrossRef
36.
go back to reference Wang, W., Lau, Y., Chow, A., Thompson, D. R., & He, H. G. (2014). Health-related quality of life and social support among Chinese patients with coronary heart disease in mainland China. European Journal of Cardiovascular Nursing,13(1), 48–54.CrossRef Wang, W., Lau, Y., Chow, A., Thompson, D. R., & He, H. G. (2014). Health-related quality of life and social support among Chinese patients with coronary heart disease in mainland China. European Journal of Cardiovascular Nursing,13(1), 48–54.CrossRef
Metagegevens
Titel
Effect of health literacy on quality of life among patients with chronic heart failure in China
Auteurs
Junhua Zhang
Stuart Gilmour
Yancun Liu
Erika Ota
Publicatiedatum
18-10-2019
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 2/2020
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02332-4