Health Literacy Predicts Morbidity and Mortality in Rural Patients With Heart Failure

JOURNAL OF CARDIAC FAILURE

卷:21

Article

Moser, Debra K.¹  Robinson, Susan²  Biddle, Martha J.¹  Pelter, Michele M.³  Nesbitt, Thomas S.⁴  Southard, Jeffery⁴  Cooper, Lawton⁵  Dracup, Kathleen² 

[1] Univ Kentucky, Coll Nursing, Lexington, KY 40536 USA

[2] Univ Calif San Francisco, San Francisco, CA 94143 USA

[3] Univ Reno, Reno, NV USA

[4] Univ Calif Davis, Davis, CA 95616 USA

[5] NHLBI, NIH, Bethesda, MD 20892 USA

关键词: Health literacy;    heart failure;    rural;   

DOI  :  10.1016/j.cardfail.2015.04.004

来源: Elsevier

【 摘 要 】

Background: Patients hospitalized with heart failure are often readmitted. Health literacy may play a substantial role in the high rate of readmissions. The purpose of this study was to examine the association of health literacy with the composite end point of heart failure readmission rates and all-cause mortality in patients with heart failure living in rural areas. Methods and Results: Rural adults (n = 575), hospitalized for heart failure within the past 6 months, completed the Short Test of Functional Health Literacy in Adults (STOMA) to measure health literacy and were followed for >= 2 years. The percentage of patients with the end point of heart failure readmission or all-cause death was different (P = .001) among the 3 STOFHLA score levels. Unadjusted analysis revealed that patients with inadequate and marginal health literacy were 1.94 (95% confidence interval [CI] 1.43-2.63; P < .001) times, and 1.91 (95% CI 1.36-2.67; P < .001) times, respectively, more likely to experience the outcome. After adjustment for covariates, health literacy remained a predictor of outcomes. Of the other covariates, worse functional class, higher comorbidity burden, and higher depression score predicted worse outcomes. Conclusions: Inadequate or marginal health literacy is a risk factor for heart failure rehospitalization or all-cause mortality among rural patients with heart failure.

【 授权许可】

Free