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Literacy critical to heart failure management: a scoping review

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Abstract

Heart failure is a complex clinical syndrome most commonly encountered among older adults. This complex clinical syndrome is associated with poor health outcomes such as frequent admissions and mortality. These adverse outcomes are commonly associated with poor self-care and lower health literacy. Literacy is a combination of knowledge and skills and often reflected by appropriate interaction with the community, while health literacy is the cognitive and social skills reflected by accessing and comprehending health information and making appropriate health decisions. These decisions are common and challenging to patients with heart failure. Poor outcomes are said to be reduced by adequate self-care, which is associated with health literacy among heart failure patients. Better self-care was also shown to be associated with self-efficacy and self-confidence that were in turn associated with health literacy. Hence, enhancing health literacy among patient with heart failure is critical to enable them to increase control over their disease by better understanding and participating in health care, while being empowered to take part in designing health care services and even tailoring research to serve their needs and consequently improve outcome at the individual and community level. In clinical practice, assessing health literacy, measuring health literacy, and identifying patients at risk of low nutrition literacy is important to enhance health literacy and health outcomes. Hence, developing reliable and valid methods and tools for assessment and developing tailored and targeted interventions is of critical importance.

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References

  1. Al Sayah F, Majumdar SR, Williams B, Robertson S, Johnson JA (2013) Health literacy and health outcomes in diabetes: a systematic review. J Gen Intern Med 28(3):444–452

    Article  Google Scholar 

  2. Alspach JG (2015) Heart failure and low health literacy: mitigating this lethal combination: AACN

  3. Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene, SJ, Vaduganathan M, . . . Shah AN (2014). The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol 63(12):1123–1133

  4. Azzolin K d O, Lemos DM, Lucena A d F, Rabelo-Silva ER (2015) Home-based nursing interventions improve knowledge of disease and management in patients with heart failure. Rev Latino Am Enfermagem 23(1):44–50. https://doi.org/10.1590/0104-1169.0144.2523

    Article  Google Scholar 

  5. Berkman ND, DeWalt DA, Pignone MP, Sheridan SL, Lohr KN, Lux L, . . . Bonito AJ (2004) Literacy and health outcomes: summary AHRQ evidence report summaries. Agency for Healthcare Research and Quality (US)

  6. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155(2):97–107

    Article  Google Scholar 

  7. Bidwell JT, Higgins MK, Reilly CM, Clark PC, Dunbar SB (2018) Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads. Heart & Lung 47(1):32–39. https://doi.org/10.1016/j.hrtlng.2017.11.001

    Article  Google Scholar 

  8. Boyde M, Peters R, Hwang R, Korczyk D, Ha T, New N (2017) The self-care educational intervention for patients with heart failure. J Cardiovasc Nurs 32(2):165–170. https://doi.org/10.1097/JCN.0000000000000318

    Article  PubMed  Google Scholar 

  9. Boyne JJJ, Vrijhoef HJM, Spreeuwenberg M, De Weerd G, Kragten J, Gorgels APM (2014) Effects of tailored telemonitoring on heart failure patients’ knowledge, self-care, self-efficacy and adherence: a randomized controlled trial. Eur J Cardiovasc Nurs 13(3):243–252. https://doi.org/10.1177/1474515113487464

    Article  PubMed  Google Scholar 

  10. Brabers AE, Rademakers JJ, Groenewegen PP, Van Dijk L, De Jong JD (2017) What role does health literacy play in patients’ involvement in medical decision-making? PLoS One 12(3):e0173316

    Article  Google Scholar 

  11. Cajita MI, Cajita TR, Han H-R (2016) Health literacy and heart failure: a systematic review. The Journal Of Cardiovascular Nursing 31(2):121–130

    Article  Google Scholar 

  12. Callender T, Woodward M, Roth G, Farzadfar F, Lemarie J-C, Gicquel S, . . . Shaikh M (2014) Heart failure care in low-and middle-income countries: a systematic review and meta-analysis. PLoS Med 11(8):e1001699

  13. Callister LC (2007) Improving literacy in women and girls globally. MCN Am J Matern Child Nurs 32(3):194

    Article  Google Scholar 

  14. Chen AMH, Yehle KS, Albert NM, Ferraro KF, Mason HL, Murawski MM, Plake KS (2013) Health literacy influences heart failure knowledge attainment but not self-efficacy for self-care or adherence to self-care over time. Nurs Res Pract 2013:1–8. https://doi.org/10.1155/2013/353290

    Article  Google Scholar 

  15. Chen AMH, Yehle KS, Albert NM, Ferraro KF, Mason HL, Murawski MM, Plake KS (2014) Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence. Res Social Adm Pharm 10(2):378–386. https://doi.org/10.1016/j.sapharm.2013.07.001

    Article  PubMed  Google Scholar 

  16. Claeson M, Folger P (2008) Health issues of the UN millennium development goals

  17. Cox SR, Liebl MG, McComb MN, Chau JQ, Wilson AA, Achi M, Garey KW, Wallace D (2017) Association between health literacy and 30-day healthcare use after hospital discharge in the heart failure population. Research in Social & Administrative Pharmacy 13(4):754–758. https://doi.org/10.1016/j.sapharm.2016.09.003

    Article  Google Scholar 

  18. Deane P (2004) Adult literacy in America: a first look at the findings of the National Adult Literacy Survey (book). Libr J 129(14):50–50

    Google Scholar 

  19. Delgado JM, Ruppar TM (2017) Health literacy in older Latinos with heart failure. J Cardiovasc Nurs 32(2):125–134. https://doi.org/10.1097/JCN.0000000000000314

    Article  PubMed  Google Scholar 

  20. Dennison CR, McEntee ML, Samuel L, Johnson BJ, Rotman S, Kielty A, Russell SD (2011) Adequate health literacy is associated with higher heart failure knowledge and self care confidence in hospitalized patients. J Cardiovasc Nurs 26(5):359–367

    Article  Google Scholar 

  21. DeWalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP (2004) Literacy and health outcomes. J Gen Intern Med 19(12):1228–1239

    Article  Google Scholar 

  22. Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, . . . Yusoff K (2017). Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Health 5(7):e665–e672

  23. Fabbri M, Yost K, Finney Rutten LJ, Manemann SM, Boyd CM, Jensen D, Weston SA, Jiang R, Roger VL (2018) Health literacy and outcomes in patients with heart failure: a prospective community study. Mayo Clin Proc 93(1):9–15. https://doi.org/10.1016/j.mayocp.2017.09.018

    Article  PubMed  Google Scholar 

  24. Fredrickson D, Washington R, Pham N, Jackson T, Wiltshire J, Jecha L (1995) Reading grade levels and health behaviors of parents at child clinics. Kansas medicine: the journal of the Kansas Medical Society 96(3):127–129

    CAS  Google Scholar 

  25. Friel CJ (2016) Improving health outcomes for low health literacy heart failure patients. Home Healthcare Now 34(8):434–439. https://doi.org/10.1097/NHH.0000000000000433

    Article  PubMed  Google Scholar 

  26. Grif Alspach J (2015) Heart failure and low health literacy: mitigating this lethal combination. Crit Care Nurse 35(5):10–14. https://doi.org/10.4037/ccn2015734

    Article  PubMed  Google Scholar 

  27. Groleau D (2011) Embodying ‘Health Citizenship’ in health knowledge to fight health inequalities. Revista Brasileira de Enfermagem 64(5):811–816

    Article  Google Scholar 

  28. Hawkins MAW, Dolansky MA, Levin JB, Schaefer JT, Gunstad J, Redle JD, Josephson R, Hughes JW (2016) Cognitive function and health literacy are independently associated with heart failure knowledge. Heart & Lung 45(5):386–391. https://doi.org/10.1016/j.hrtlng.2016.07.004

    Article  Google Scholar 

  29. Ishikawa H, Yano E (2008) Patient health literacy and participation in the health-care process. Health Expect 11(2):113–122

    Article  Google Scholar 

  30. Jaarsma T, Cameron J, Riegel B, Stromberg A (2017) Factors related to self-care in heart failure patients according to the middle-range theory of self-care of chronic illness: a literature update. Current Heart Failure Reports 14(2):71–77

    Article  Google Scholar 

  31. Jacobson AF, Sumodi V, Albert NM, Butler RS, DeJohn L, Walker D, Dion K, Tai HLL, Ross DM (2018) Patient activation, knowledge, and health literacy association with self-management behaviors in persons with heart failure. Heart & Lung 47(5):447–451. https://doi.org/10.1016/j.hrtlng.2018.05.021

    Article  Google Scholar 

  32. Jovanić M, Zdravković M, Stanisavljević D, Jović Vraneš A (2018) Exploring the importance of health literacy for the quality of life in patients with heart failure. Int J Environ Res Public Health 15(8). https://doi.org/10.3390/ijerph15081761

  33. Kickbusch I, Pelikan J, Apfel F, Tsouros AD (2013) Health literacy: the solid facts

  34. Kollipara UK, Jaffer O, Amin A, Toto KH, Nelson LL, Schneider R, Markham D, Drazner MH (2008) Relation of lack of knowledge about dietary sodium to hospital readmission in patients with heart failure. Am J Cardiol 102(9):1212–1215. https://doi.org/10.1016/j.amjcard.2008.06.047

    Article  CAS  PubMed  Google Scholar 

  35. Lee C, Park Y-H (2017) Health literacy and participation among older adult patients with heart failure in Korean culture. J Transcult Nurs 29(5):429–440. https://doi.org/10.1177/1043659617745136

    Article  PubMed  Google Scholar 

  36. León-González R, García-Esquinas E, Paredes-Galán E, Ferrero-Martínez AI, González-Guerrero JL, Hornillos-Calvo M, Menéndez-Colino R, Torres-Torres I, Galán MC, Torrente-Carballido M, Olcoz-Chiva M, Rodríguez-Pascual C, Rodríguez-Artalejo F (2018) Health literacy and health outcomes in very old patients with heart failure. Revista Espanola De Cardiologia (English Ed) 71(3):178–184. https://doi.org/10.1016/j.rec.2017.06.010

    Article  Google Scholar 

  37. Longtin Y, Sax H, Leape LL, Sheridan SE, Donaldson, L., & Pittet D (2010) Patient participation: current knowledge and applicability to patient safety. Paper presented at the Mayo Clinic Proceedings

  38. Magnani JW, Mujahid MS, Aronow HD, Cené CW, Dickson VV, Havranek E, . . . Willey JZ (2018) Health literacy and cardiovascular disease: fundamental relevance to primary and secondary prevention: a scientific statement from the american heart association. Circulation 138(2):e48–e74

  39. Matsuoka S, Kato N, Kayane T, Yamada M, Koizumi M, Ikegame T, Tsuchihashi-Makaya M (2016a) Development and validation of a heart failure-specific health literacy scale. The Journal Of Cardiovascular Nursing 31(2):131–139. https://doi.org/10.1097/JCN.0000000000000226

    Article  PubMed  Google Scholar 

  40. Matsuoka S, Tsuchihashi-Makaya M, Kayane T, Yamada M, Wakabayashi R, Kato NP, Yazawa M (2016b) Health literacy is independently associated with self-care behavior in patients with heart failure. Patient Educ Couns 99(6):1026–1032. https://doi.org/10.1016/j.pec.2016.01.003

    Article  PubMed  Google Scholar 

  41. McNaughton CD, Cawthon C, Kripalani S, Liu D, Storrow AB, Roumie CL (2015) Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure. J Am Heart Assoc 4(5):e001799

    Article  Google Scholar 

  42. Moran AE, Tzong KY, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, Murray CJL, Naghavi M (2014) Variations in ischemic heart disease burden by age, country, and income: the global burden of diseases, injuries, and risk factors 2010 study. Glob Heart 9(1):91–99

    Article  Google Scholar 

  43. Morrow D, Clark D, Tu W, Wu J, Weiner M, Steinley D, Murray MD (2006) Correlates of health literacy in patients with chronic heart failure. Gerontologist 46(5):669–676

    Article  Google Scholar 

  44. Moser DK, Robinson S, Biddle MJ, Pelter MM, Nesbitt TS, Southard J, Cooper L, Dracup K (2015) Health literacy predicts morbidity and mortality in rural patients with heart failure. J Card Fail 21(8):612–618

    Article  Google Scholar 

  45. Nutbeam D (1998) Health promotion glossary. Health Promot Int 13(4):349–364

    Article  Google Scholar 

  46. Peterson PN, Shetterly SM, Clarke CL, Bekelman DB, Chan PS, Allen LA, . . . Masoudi FA (2011) Health literacy and outcomes among patients with heart failure. JAMA 305(16):1695–1701. https://doi.org/10.1001/jama.2011.512

  47. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, . . . Jankowska EA (2016) 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail 18(8):891–975

  48. Protheroe J, Nutbeam D, Rowlands G (2009) Health literacy: a necessity for increasing participation in health care. Br J Gen Pract 59(567):721–723. https://doi.org/10.3399/bjgp09X472584

    Article  PubMed  PubMed Central  Google Scholar 

  49. Rabelo ER, Mantovani VM, Aliti GB, Domingues FB (2011) Cross-cultural adaptation and validation of a disease knowledge and self-care questionnaire for a brazilian sample of heart failure patients. Revista Latino-Americana De Enfermagem 19(2):277–284

    Article  Google Scholar 

  50. Reyes EB, Ha J-W, Firdaus I, Ghazi AM, Phrommintikul A, Sim D, Vu QN, Siu CW, Yin WH, Cowie MR (2016) Heart failure across Asia: same healthcare burden but differences in organization of care. Int J Cardiol 223:163–167

    Article  Google Scholar 

  51. Riegel B, Lee CS, Albert N, Lennie T, Chung M, Song EK, Bentley B, Heo S, Worrall-Carter L, Moser DK (2011) From novice to expert: confidence and activity status determine heart failure self-care performance. Nurs Res 60(2):132–138. https://doi.org/10.1097/NNR.0b013e31820978ec

    Article  PubMed  Google Scholar 

  52. Rigaud C (2019) Literacy is key to achiving the SDGs by 2030. from https://www.globalpartnership.org/blog/literacy-key-achieving-sdgs-2030

  53. Sak G, Rothenfluh F, Schulz PJ (2017) Assessing the predictive power of psychological empowerment and health literacy for older patients’ participation in health care: a cross-sectional population-based study. BMC Geriatr 17(1):59

    Article  Google Scholar 

  54. Savarese G, Lund LH (2017) Global public health burden of heart failure. Cardiac failure review 3(1):7

    Article  Google Scholar 

  55. Son Y-J, Shim DK, Seo EK, Seo EJ (2018) Health literacy but not frailty predict self-care behaviors in patients with heart failure. Int J Environ Res Public Health 15(11). https://doi.org/10.3390/ijerph15112474

  56. Tankumpuan T, Asano R, Koirala B, Dennison-Himmelfarb C, Sindhu S, Davidson PM (2019) Heart failure and social determinants of health in Thailand: an integrative review. Heliyon 5(5):e01658

    Article  Google Scholar 

  57. Tavakoly Sany SB, Peyman N, Zadehahmad Z, Ferns G, Doosti H (2019) Effect of educational interventions on health literacy in patients with heart failure. Int J Health Promot Educ 57(1):23–36. https://doi.org/10.1080/14635240.2018.1545597

    Article  Google Scholar 

  58. The Joint Commission (2007) “What did the doctor say?” Improving health literacy to protect patient safety Health Care at the Crossroads reports. The Joint Commission

  59. WHO (2017) Promoting health in the SDGs. Report on the 9th Global conference for health promotion, Shanghai, China, 21–24 November 2016: all for health, health for all WHO/NMH/PND/17.5). Licence: CC BY-NC-SA 3.0 IGO. Geneva

  60. Wickens CM, Sandlin JA (2007) Literacy for what? Literacy for whom? The politics of literacy education and neocolonialism in UNESCO-and World Bank–sponsored literacy programs. Adult Educ Q 57(4):275–292

    Article  Google Scholar 

  61. Wilsher SH, Brainard J, Loke Y, Salter C (2017) Patient and public involvement in health literacy interventions: a mapping review. Research involvement and engagement 3(1):31

    Article  Google Scholar 

  62. World Health organization (1986) The Ottawa charter for health promotion. Paper presented at the The First International COnference on health promotion, Ottowa

    Google Scholar 

  63. Wu J-R, Holmes GM, Dewalt DA, Macabasco-O'Connell A, Bibbins-Domingo K, Ruo B, . . . Pignone M (2013) Low literacy is associated with increased risk of hospitalization and death among individuals with heart failure. JGIM: J Gen Intern Med 28(9):1174–1180. https://doi.org/10.1007/s11606-013-2394-4

  64. Wu J-R, Moser DK, DeWalt DA, Rayens MK, Dracup K (2016) Health literacy mediates the relationship between age and health outcomes in patients with heart failure. Circ Heart Fail 9(1):e002250

    Article  Google Scholar 

  65. Wu J-R, Reilly CM, Holland J, Higgins M, Clark PC, Dunbar SB (2017) Relationship of health literacy of heart failure patients and their family members on heart failure knowledge and self-care. J Fam Nurs 23(1):116–137. https://doi.org/10.1177/1074840716684808

    Article  PubMed  Google Scholar 

  66. Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, . . . Liu T (2014) Cardiovascular risk and events in 17 low-, middle-, and high-income countries. N Engl J Med 371(9):818–827

  67. 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. J Psychosom Res 91:33–39. https://doi.org/10.1016/j.jpsychores.2016.10.006

    Article  PubMed  Google Scholar 

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Deek, H., Itani, L. & Davidson, P.M. Literacy critical to heart failure management: a scoping review. Heart Fail Rev 26, 1413–1419 (2021). https://doi.org/10.1007/s10741-020-09964-6

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