You are accessing a medical content website
Are you a health professional?

 
Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:178-84 - Vol. 71 Num.03 DOI: 10.1016/j.rec.2017.06.010

Health Literacy and Health Outcomes in Very Old Patients With Heart Failure

Rocío León-González a, Esther García-Esquinas a, Emilio Paredes-Galán b, Ana Isabel Ferrero-Martínez c, José Luis González-Guerrero d, Mercedes Hornillos-Calvo e, Rocío Menéndez-Colino f, Ivett Torres-Torres g, María Concepción Galán h, Marta Torrente-Carballido c, Mayte Olcoz-Chiva i, Carlos Rodríguez-Pascual c,j, Fernando Rodríguez-Artalejo a,

a Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/Idipaz, CIBERESP and IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
b Servicio de Cardiología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
c Servicio de Geriatría, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
d Servicio de Geriatría, Complejo Hospitalario de Cáceres, Cáceres, Spain
e Servicio de Geriatría, Hospital Universitario de Guadalajara, Universidad de Alcalá de Henares, Guadalajara, Spain
f Servicio de Geriatría, Hospital Universitario La Paz, IdiPaz, Universidad Autónoma de Madrid, Madrid, Spain
g Servicio de Geriatría, Complejo Hospitalario de Albacete, Albacete, Spain
h Servicio de Geriatría, Complejo Hospitalario de Oviedo, Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
i Department of Care of the Elderly, Lincoln County Hospital, Lincoln, Lincolnshire, United Kingdom
j University of Lincoln, Lincoln County Hospital, Lincoln, Lincolnshire, United Kingdom

Keywords

Health literacy. Educational level. Self-care. Mortality. Heart failure.

Abstract

Introduction and objectives

Health literacy (HL) has been associated with lower mortality in heart failure (HF). However, the results of previous studies may not be generalizable because the research was conducted in relatively young and highly-educated patients in United States settings. This study assessed the association of HL with disease knowledge, self-care, and all-cause mortality among very old patients, with a very low educational level.

Methods

This prospective study was performed in 556 patients (mean age, 85 years), with high comorbidity, admitted for HF to the geriatric acute-care unit of 6 hospitals in Spain. About 74% of patients had less than primary education and 71% had preserved systolic function. Health literacy was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults questionnaire, knowledge of HF with the DeWalt questionnaire, and HF self-care with the European Heart Failure Self-Care Behaviour Scale.

Results

Disease knowledge progressively increased with HL; compared with being in the lowest (worse) tertile of HL, the multivariable beta coefficient (95%CI) of the HF knowledge score was 0.60 (0.01-1.19) in the second tertile and 0.87 (0.24-1.50) in the highest tertile, P-trend = .008. However, no association was found between HL and HF self-care. During the 12 months of follow-up, there were 189 deaths. Compared with being in the lowest tertile of HL, the multivariable HR (95%CI) of mortality was 0.84 (0.56-1.27) in the second tertile and 0.99 (0.65-1.51) in the highest tertile, P-trend = .969.

Conclusions

No association was found between HL and 12-month mortality. This could be partly due to the lack of a link between HL and self-care.

Article

You can access the full text of this article:

Members of the Spanish Society of Cardiology


Subscribers of Revista Española de Cardiología

You may purchase this article for 30.00 €

Buy Now
Subscribers of ScienceDirect

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved