Health literacy and coronary artery disease: A systematic review

Ghisi, Gabriela Lima de Melo; Chaves, Gabriela; Britto, Raquel Rodrigues; Oh, Paul

doi:10.1016/j.pec.2017.09.002

Cited by 69 publications

(38 citation statements)

References 41 publications

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“…More than 20 years of studies in nonsurgical fields have shown that low health literacy is associated with poorer health outcomes, including increased hospitalizations and emergency care, decreased use of preventive services such as mammography, poorer global health, and higher mortality among the elderly (Berkman et al, 2011;Dewalt, Berkman, Sheridan, Lohr, & Pignone, 2004). Many of these studies have focused on chronic medical conditions such as heart disease (Ghisi, Chaves, Britto, & Oh, 2018), diabetes mellitus (Schillinger et al, 2002), and cancer (Oldach & Katz, 2014). The relationship between health literacy and surgical outcomes is much less defined but has been identified by the National Institutes of Health and Ameri-can College of Surgeons as a research priority (Haider et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Health Literacy in Surgery

Chang¹,

Baker²,

Marques³

et al. 2020

HLRP: Health Literacy Research and Practice

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Background: Low health literacy is associated with poor health outcomes in many chronic diseases and may have an important role in determining surgical outcomes. This study aims to comprehensively review the current state of science on adult health literacy in surgery and to identify knowledge gaps for future research. Methods: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search was conducted to identify all studies from January 2002 through May 2018 that used validated instruments to assess health literacy among adult patients undergoing surgery. Studies were assessed for quality using the Newcastle-Ottawa scale and evaluated on findings by their focus on identifying health literacy levels, understanding associations with surgical outcomes, and/or developing interventions to address low health literacy. Key Results: There were 51 studies on health literacy with data from 22,139 patients included in this review. Low health literacy was present in more than one-third of surgical patients (34%, interquartile range 16%-50%). The most commonly used validated instrument for assessment of health literacy in the surgical population was the Newest Vital Sign. Most studies were focused on identifying the prevalence of low health literacy within a surgery population (84%, n = 43). Few studies focused on understanding the association of health literacy to surgical outcomes (12%, n = 6) and even fewer studies developed interventions to address health literacy (4%, n = 2). Discussion: Low health literacy is common among surgical patients. Important opportunities exist to better understand the role of health literacy in determining surgical outcomes and to develop more health literacy-sensitive models of surgical care. [HLRP: Health Literacy Research and Practice. 2020;4(1):e45-e65.] Plain Language Summary: Health literacy has not been well-studied in surgery but likely plays an important role. In this article, we reviewed all current research on health literacy in surgery to help us understand where we are at and where we need to go. We found that low health literacy is common and we need more ways to address it in surgery. METHODS Systematic Search Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Liberati et al., 2009), a comprehensive search of the National Library of Medicine's PubMed database, Embase, Scopus database, Proquest, PsychInfo, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was performed through May 31, 2018. Through partnerships with Library Services at the University of Alabama Birmingham, keywords and medical subject heading (MESH) terms used in the search included "health literacy, " "surgical, " "post-operative, " and "surgery. " The entire search string for each database along with the number of screened abstracts can be found in Table A. Two authors (S.J.B. and I.C.D.S M.) who are experienced researchers independently evaluated abstracts of the 673 articles obt...

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Section: Discussionmentioning

confidence: 99%

Health Literacy in Surgery

Chang¹,

Baker²,

Marques³

et al. 2020

HLRP: Health Literacy Research and Practice

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“…Health literacy has been identified as a mediator between social health determinants and health outcomes [8][9][10][11]. In relation to cardiac conditions, low health literacy has been associated with higher prevalence [12], poorer cardio-protective health behaviors [13,14], less disease knowledge and poorer self-management [14,15], higher hospital readmission rates [16][17][18], and higher mortality [17,18]. In addition, low health literacy has been associated with low health-related quality of life (HRQoL) [13,16,[19][20][21], particularly in relation to the physical components of HLQoL [19,20].…”

Section: Introductionmentioning

confidence: 99%

Health Literacy among People in Cardiac Rehabilitation: Associations with Participation and Health-Related Quality of Life in the Heart Skills Study in Denmark

Aaby

Friis

Christensen

et al. 2020

IJERPH

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Health literacy (HL) is a dynamic determinant of health and a promising target of health equity interventions in noncommunicable disease prevention. Among people referred to a cardiac rehabilitation program, we examined the associations between (1) HL and participation in cardiac rehabilitation and (2) HL and health-related quality of life (HRQoL). Using a cross-sectional design, we invited 193 people referred to cardiac rehabilitation in Randers Municipal Rehabilitation Unit, Denmark, to respond to a questionnaire in 2017. Of these, 150 people responded (77.7%). HL was measured using the nine scales of the Health Literacy Questionnaire (HLQ), while HRQoL was measured using the Short Form Health Survey 12 (version 2) (SF-12). The mean age of respondents was 67.0 years; 71.3% of the sample were men. Nonrespondents had significantly lower educational attainment and more often lived alone than respondents. Using multiple regression analyses, we found no significant associations between HL and participation in cardiac rehabilitation. There were significant positive associations between several aspects of HL and physical and mental HRQoL. HL could be a factor of interest in initiatives aimed at improving participation and outcomes of cardiac rehabilitation.

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“…a large Danish study has shown that people with cardiac conditions have significantly lower health literacy than the general population [15]. Among people with cardiac conditions, low health literacy is associated with adverse health behaviors [16,17] and poor quality of life [17][18][19]. CR programs are designed to sustain or improve self-care, health behavior, and quality of life, but participation and adherence is dependent on social health determinants such as education, cohabitation, and income [20].…”

Section: Introductionmentioning

confidence: 99%

Improving Organizational Health Literacy Responsiveness in Cardiac Rehabilitation Using A Co-Design Methodology: Results from The Heart Skills Study

Aaby

Simonsen

Ryom

et al. 2020

IJERPH

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For health services, improving organizational health literacy responsiveness is a promising approach to enhance health and counter health inequity. A number of frameworks and tools are available to help organizations boost their health literacy responsiveness. These include the Ophelia (OPtimising HEalth LIteracy and Access) approach centered on local needs assessments, co-design methodologies, and pragmatic intervention testing. Within a municipal cardiac rehabilitation (CR) setting, the Heart Skills Study aimed to: (1) Develop and test an organizational health literacy intervention using an extended version of the Ophelia approach, and (2) evaluate the organizational impact of the application of the Ophelia approach. We found the approach successful in producing feasible organizational quality improvement interventions that responded to local health literacy needs such as enhanced social support and individualized care. Furthermore, applying the Ophelia approach had a substantial organizational impact. The co-design process in the unit helped develop and integrate a new and holistic understanding of CR user needs and vulnerabilities based on health literacy. It also generated motivation and ownership among CR users, staff, and leaders, paving the way for sustainable future implementation. The findings can be used to inform the development and evaluation of sustainable co-designed health literacy initiatives in other settings.

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Health literacy and coronary artery disease: A systematic review

Cited by 69 publications

References 41 publications

Health Literacy in Surgery

Health Literacy in Surgery

Health Literacy among People in Cardiac Rehabilitation: Associations with Participation and Health-Related Quality of Life in the Heart Skills Study in Denmark

Improving Organizational Health Literacy Responsiveness in Cardiac Rehabilitation Using A Co-Design Methodology: Results from The Heart Skills Study

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