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      The roles of health literacy and social support in improving adherence to self‐care behaviours among older adults with heart failure

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          Abstract

          Aim

          To describe the associations between health literacy, social support and self‐care behaviours in older adults with heart failure.

          Design

          A cross‐sectional descriptive study.

          Methods

          A total of 252 older adults were recruited from a tertiary care hospital from September 2018–February 2019. Structured questionnaires and medical record reviews were used for data collection. Two steps of hierarchical regression analysis were employed to determine the predictors of self‐care behaviours.

          Results

          Health literacy ( β = 0.27, p < .001) and social support ( β = 0.32, p < .001) were significant determinants of self‐care behaviours in older adults with heart failure. Together, they explained 22% of the variance in self‐care behaviours.

          Conclusion

          Health literacy and perceived social support were positively associated with self‐care behaviours among older heart failure patients. Our findings can help health professionals develop heart failure self‐care interventions to enhance health literacy skills and social support for older adults.

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          Most cited references43

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          Validation of screening questions for limited health literacy in a large VA outpatient population.

          Lisa Chew, Joan Griffin, Melissa R Partin … (2008)
          Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population. We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of "inadequate or marginal" health literacy based on the S-TOFHLA and 2) inadequate and the combination of "inadequate or marginal" health literacy based on the REALM. Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, "How confident are you filling out medical forms by yourself?" had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69-0.79) and 0.84 (95% CI: 0.79-0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting "inadequate or marginal" health literacy than for detecting inadequate health literacy for each of the 3 questions. A single question may be useful for detecting patients with inadequate health literacy in a VA population.
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            Environmental Determinants of Cardiovascular Disease.

            Aruni Bhatnagar (2017)
            Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment because of migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex, and their natural, social, and personal domains are highly variable because of diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such as altitude, latitude, and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke.
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              Self‐Care for the Prevention and Management of Cardiovascular Disease and Stroke

              Barbara Riegel, Debra Moser, Harleah Buck … (2017)
              Abstract Self‐care is defined as a naturalistic decision‐making process addressing both the prevention and management of chronic illness, with core elements of self‐care maintenance, self‐care monitoring, and self‐care management. In this scientific statement, we describe the importance of self‐care in the American Heart Association mission and vision of building healthier lives, free of cardiovascular diseases and stroke. The evidence supporting specific self‐care behaviors such as diet and exercise, barriers to self‐care, and the effectiveness of self‐care in improving outcomes is reviewed, as is the evidence supporting various individual, family‐based, and community‐based approaches to improving self‐care. Although there are many nuances to the relationships between self‐care and outcomes, there is strong evidence that self‐care is effective in achieving the goals of the treatment plan and cannot be ignored. As such, greater emphasis should be placed on self‐care in evidence‐based guidelines.
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                Author and article information

                Contributors
                Youn‐Jung Son:
                ORCID: https://orcid.org/0000-0002-0961-9606
                yjson@cau.ac.kr
                Journal
                Journal ID (nlm-ta): Nurs Open
                Journal ID (iso-abbrev): Nurs Open
                Journal ID (doi): 10.1002/(ISSN)2054-1058
                Journal ID (publisher-id): NOP2
                Title: Nursing Open
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2054-1058
                Publication date (Electronic): 18 August 2020
                Publication date Collection: November 2020
                Volume: 7
                Issue: 6 ( doiID: 10.1002/nop2.v7.6 )
                Pages: 2039-2046
                Affiliations
                [ 1 ] Red‐Cross college of Nursing Chung‐Ang University Seoul Korea
                [ 2 ] College of Nursing and Institution of Nursing Science Ajou University Suwon Korea
                Author notes
                [*] [* ] Correspondence

                Youn‐Jung Son, Red Cross College of Nursing, Chung‐Ang University, Seoul, Korea.

                Email: yjson@ 123456cau.ac.kr

                Author information
                https://orcid.org/0000-0002-0961-9606
                Article
                Publisher ID: NOP2599
                DOI: 10.1002/nop2.599
                PMC ID: 7544858
                SO-VID: 9f78407f-5013-4620-b9b2-ff89bd487490
                Copyright © © 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                Date received : 22 May 2020
                Date revision received : 04 July 2020
                Date accepted : 29 July 2020
                Page count
                Figures: 0, Tables: 3, Pages: 8, Words: 6179
                Funding
                Funded by: the Basic Science Research Program through the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT)
                Award ID: 2018R1A2B6003972
                Categories
                Subject: Research Article
                Subject: Research Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date November 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.2 mode:remove_FC converted:08.10.2020

                Keywords: health literacy,heart failure,nursing,self‐care,social support
                Data availability:
                Keywords: health literacy, heart failure, nursing, self‐care, social support

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