Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedure
2.3. Measuring Instruments
2.3.1. European Health Literacy Questionnaire (HLS-EU-Q47)
2.3.2. Quality of Life Survey Generic Questionnaire (SF-36)
2.3.3. Quality of Life Survey Specific Questionnaire (MLWHF)
2.3.4. Patients’ Characteristics and Sociodemographic Questionnaire
2.4. Statistical Analysis
3. Results
3.1. Sociodemographic Characteristics of the Participants in the Study
3.2. Respondent Health Literacy Level
3.3. Quality of Life of Respondent
3.4. Factors Associated with Health Literacy Level
3.5. Association between Health Literacy and Quality of Life
4. Discussion
Limitations
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Sociodemographic Characteristic | No. | % | |
---|---|---|---|
Total sample size | 200 | 100 | |
Gender | Male | 119 | 59.5 |
Female | 81 | 40.5 | |
Age | ≤50 | 5 | 2.5 |
51–64 | 48 | 24 | |
≥65 | 147 | 73.5 | |
Marital status | Married | 122 | 61 |
Unmarried | 78 | 39 | |
Education | Low ≤ 8 | 47 | 23.5 |
Medium 8–12 | 88 | 44 | |
High > 12 | 65 | 32.5 | |
Employment | Employed | 18 | 9 |
Unemployed | 182 | 91 | |
Financial status perception | Poor | 51 | 25.5 |
Average | 96 | 48 | |
Good | 53 | 26.5 | |
Self-perceived health | Poor | 115 | 57 |
Average | 44 | 22 | |
Good | 41 | 20.5 | |
Number of visits to the doctor | 1–4 | 173 | 86.5 |
3 months ago | 18 | 9 | |
Have not seen | 9 | 4.5 | |
Cigarettes | Yes | 36 | 18 |
No | 164 | 82 | |
Alcohol | Yes | 18 | 9 |
No | 182 | 91 | |
BMI | Kg/m2 | 28.17 ± 5.18 | |
Blood pressure | Systolic | 126.83 ± 22.47 | |
Diastolic | 78.46 ± 14.20 |
Question Number from HLS-EU-Q47 | Dimensions from HLS-EU-Q47 | Mean, SD a | Categorized Level of Health Literacy | Value of Health Literacy Score (%) |
---|---|---|---|---|
Q1–47 | GENERAL HEALTH LITERACY INDEX | 29.23 ± 9.12 | ||
1. Excellent > 42–50 | 16 (8%) | |||
2. Sufficient > 33–42 | 56 (28%) | |||
3. Problematic > 25–33 | 55 (27.5%) | |||
4. Inadequate 0–25 | 73 (36.5%) | |||
5. Limited (3 + 4) 0–33 | 128 (64%) | |||
Q1–16 | HEALTH CARE | 33.03 ± 8.52 | ||
1. Excellent > 42–50 | 31 (15.5%) | |||
2. Sufficient > 33–42 | 74 (37%) | |||
3. Problematic > 25–33 | 54 (27%) | |||
4. Inadequate 0–25 | 41 (20.5%) | |||
5. Limited (3 + 4) 0–33 | 95 (47.5%) | |||
Q17–31 | PREVENTION OF DISEASE | 28.01 ± 9.34 | ||
1. Excellent > 42–50 | 17 (8.5%) | |||
2. Sufficient > 33–42 | 43 (21.5%) | |||
3. Problematic > 25–33 | 66 (33%) | |||
4. Inadequate 0–25 | 74 (37%) | |||
5. Limited (3 + 4) 0–33 | 140 (70%) | |||
Q32–47 | HEALTH PROMOTION | 30.46 ± 9.69 | ||
1. Excellent > 42–50 | 24 (12) | |||
2. Sufficient > 33–42 | 62 (31%) | |||
3. Problematic > 25–33 | 44 (22%) | |||
4. Inadequate 0–25 | 70 (35%) | |||
5. Limited (3 + 4) 0–33 | 114 (57%) |
Quality of Life Questionnaire | Dimensions of Quality of Life | Mean (SD) | Minimum Score | Maximum Score | Median (Range) |
---|---|---|---|---|---|
SF-36 * | Physical functioning | 38.77 (30.64) | 0 | 100 | 32.50 (58.75) |
Physical role | 33.12 (41.63) | 0 | 100 | 0 (75.00) | |
Body pain | 61.99 (35.54) | 0 | 100 | 62.00 (69.00) | |
General health | 49.57 (24.45) | 0 | 100 | 45.00 (40.00) | |
Vitality | 42.37 (28.27) | 0 | 90 | 35.00 (53.75) | |
Social functioning | 50.26 (30.44) | 0 | 100 | 50.00 (50.00) | |
Emotional role | 50.50 (46.80) | 0 | 100 | 67.00 (100.00) | |
Mental health | 59.04 (25.25) | 4 | 100 | 60.00 (40.00) | |
Total physical dimensions | 45.01 (24.77) | 0 | 97 | 40.00 (39.50) | |
Total mental dimensions | 50.35 (25.82) | 1 | 97 | 49.00 (47.50) | |
Minnesota ** | Physical dimension | 24.73 (10.87) | 1 | 40 | 26.00 (19.50) |
Emotional dimension | 7.34 (6.42) | 0 | 25 | 6.00 (25.00) | |
Total quality of life | 51.67 (24.10) | 4 | 98 | 50.00 (40.00) |
Sociodemographic Characteristics | Level of Health Literacy | p * | Mean (SD) General Health Literacy Index | p ** | ||||
---|---|---|---|---|---|---|---|---|
Limited (0–33), % | Sufficient (> 33–42), % | Excellent (> 42), % | ||||||
Gender | Male | 74 (62.2%) | 37 (31.1%) | 8 (6.7%) | 0.416 | 29.60 (8.97) | 0.485 | |
Female | 54 (66.7%) | 19 (23.5%) | 8 (9.9%) | 28.68 (9.37) | ||||
Age (years) | ≤50 | 2 (40%) | 2 (40%) | 1 (20%) | 0.361 | 34.76 (9.45) | 0.382 | |
51–64 | 32 (66.7%) | 15 (31.3%) | 1 (2.1%) | 29.34 (8.28) | ||||
≥65 | 94 (63.9%) | 39 (26.5%) | 14 (9.5%) | 29.00 (9.37) | ||||
Marital status | Married | 73 (59.8%) | 39 (32%) | 10 (8.2%) | 0.270 | 29.93 (9.14) | 0.174 | |
Unmarried | 55 (70.5%) | 17 (21.8%) | 6 (7.7%) | 28.13 (9.04) | ||||
Education | Low ≤8 | 45 (95.7%) | 1 (2.1%) | 1 (2.1%) | <0.001 | 21.59 (7.06) | <0.001 | |
Medium 8–12 | 74 (84.1%) | 14 (15.9%) | 0 (0%) | 26.68 (6.48) | ||||
High >12 | 9 (13.8%) | 41 (63.1%) | 15 (23.1%) | 38.19 (5.69) | ||||
Employment | Employed | 7 (38.9%) | 10 (55.6%) | 1 (5.6%) | 0.024 | 34.43 (7.84) | 0.011 | |
Unemployed | 121 (64%) | 46 (25.3%) | 15 (8.2%) | 28.71 (9.10) | ||||
Financial status perception | Poor | 40 (78.4%) | 10 (19.6%) | 1 (2%) | 0.002 | 29.99 (9.07) | <0.001 | |
Average | 65 (67.7%) | 25 (26%) | 6 (6.3%) | 28.69 (8.72) | ||||
Good | 23 (43.4%) | 21 (39.6%) | 9 (17%) | 34.27 (7.50) | ||||
Self-perceived health | Poor | 90 (78.3%) | 20 (17.4%) | 5 (4.3%) | < 0.001 | 25.84 (8.92) | < 0.001 | |
Average | 23 (52.3%) | 17 (38.6%) | 4 (9.1) | 32.32 (7.16) | ||||
Good | 15 (36.6%) | 19 (46.3%) | 7 (17.1) | 35.40 (7.03) | ||||
Number of visits to the doctor | 1–4 | 109 (63%) | 51 (29.5%) | 13 (7.5%) | 0.454 | 29.43 (8.93) | 0.370 | |
3 months ago | 14 (77.8%) | 2 (11.1%) | 2 (11.1) | 26.49 (9.8) | ||||
Have not seen | 5 (55.6%) | 3 (33.3%) | 1 (11.1%) | 30.89 (11.41) | ||||
Cigarettes | Yes | 24 (66.7%) | 11 (30.6%) | 1 (2.8%) | 0.439 | 28.41 (9.34) | 0.555 | |
No | 104 (63.4%) | 45 (27.4%) | 15 (9.1%) | 29.41 (9.09) | ||||
Alcohol | Yes | 15 (83.3%) | 3 (16.7%) | 0 (0%) | 0.162 | 25.15 (8.29) | 0.046 | |
No | 113 (62.1%) | 53 (29.1%) | 16 (8.8%) | 29.63 (9.1) | ||||
BMI | < 18.5 Malnourished | 4 (100%) | 0 (0%) | 0 (0%) | 0.313 | 16.47 (4.54) | 0.008 | |
18.5–24.9 Normal weight | 26 (52%) | 18 (36%) | 6 (12%) | 30.90 (9.33) | ||||
> 25 Obese | 95 (66.9%) | 37 (26.1%) | 10 (7%) | 28.96 (8.89) | ||||
Blood pressure | Systolic | Low | 3 (75%) | 1 (25%) | 0 (0%) | 0.153 | 26.58 (7.44) | 0.027 |
Normal | 57 (57%) | 33 (33%) | 10 (10%) | 30.94 (8.97) | ||||
Elevated | 68 (70.8%) | 22 (22.9%) | 6 (6.3%) | 27.55 (9.08) | ||||
Diastolic | Low | 2 (66.7%) | 1 (33.3%) | 0 (0%) | 0.583 | 22.73 (13.89) | 0.127 | |
Normal | 53 (60.9%) | 25 (28.7%) | 9 (10.3%) | 30.50 (8.63) | ||||
Elevated | 73 (66.4%) | 30 (27.3%) | 7 (6.4%) | 28.40 (0.30) |
Quality of Life Questionnaires | Health Literacy | ||||||
---|---|---|---|---|---|---|---|
β Unadjusted | Coefficient (95% CI) | p | β Adjusted | Coefficient (95% CI) | p | ||
SF-36 | Physical dimension a | 0.534 | 1.13; 1.77 | <0.001 | 0.42 | 0.71; 1.57 | <0.001 |
Emotional dimension a | 0.513 | 1.11; 1.79 | <0.001 | 0.38 | 0.62; 1.55 | <0.001 | |
Minnesota | Total quality of life a | -0.417 | -1.44; -0.76 | <0.001 | -0.30 | -1.25; -0.33 | 0.001 |
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Jovanić, M.; Zdravković, M.; Stanisavljević, D.; Jović Vraneš, A. Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure. Int. J. Environ. Res. Public Health 2018, 15, 1761. https://doi.org/10.3390/ijerph15081761
Jovanić M, Zdravković M, Stanisavljević D, Jović Vraneš A. Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure. International Journal of Environmental Research and Public Health. 2018; 15(8):1761. https://doi.org/10.3390/ijerph15081761
Chicago/Turabian StyleJovanić, Marija, Marija Zdravković, Dejana Stanisavljević, and Aleksandra Jović Vraneš. 2018. "Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure" International Journal of Environmental Research and Public Health 15, no. 8: 1761. https://doi.org/10.3390/ijerph15081761