Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity

Abstract

Following a diagnosis of cardiovascular disease there is a need for patients to self-manage. Health literacy has been shown to be lower in patients with cardiovascular disease, yet research into health literacy in this population is limited. This study used the Health Literacy Questionnaire (HLQ) to examine the health literacy and associated health, health behaviours and psychological profiles of cardiac rehabilitation patients from a remote and rural regional programme in the Scottish Highlands. Consecutive patients referred to the service in a calendar year were sent a cross-sectional questionnaire by post. Hierarchical cluster analysis grouped respondents based on their health literacy profile, and nonparametric methods were used to analyse differences between clusters on the other measures. A total of 282 participants responded (45.7%). Respondents were older (median: 71 years) and more likely to be from more affluent areas. Five health literacy clusters emerged with different profiles of health, physical activity, self-efficacy, motivation and illness perceptions. There was no difference in relation to cardiac rehabilitation attendance by health literacy cluster, but those with lower health literacy were less likely to be aware of the referral. Patterns of health literacy are associated with health, health behaviours and some psychological constructs. Knowledge of distinct cluster characteristics may help services better target interventions.

Health Literacy and Its Sociodemographic Predictors: A Cross-Sectional Study of a Population in Madrid (Spain)

“…These results suggest that the population is passive in the health environment and that it may not be self-sufficient in seeking and critically analyzing information or in making any related decisions. These results are consistent with those of the above Spanish study that used the HLQ [ 25 ] and with those of another study performed in the United Kingdom [ 30 ].…”

“…In agreement with the current literature, educational level and health literacy appeared positively related [ 5 , 10 , 25 , 26 , 30 , 34 , 35 , 36 ]. In all these studies, those who had completed secondary education returned significantly higher scores for dimensions 5 “appraisal of health information”, 8 “ability to find good health information”, and 9 “understands health information well enough to know what to do” compared to those who had not finished it.…”

Health Literacy and Risk Factors for Coronary Artery Disease (From the CONCARDPCI Study)

“…9 Similarly, a Scottish study that examined 5 distinct health literacy profiles in a cardiac rehabilitation setting reported that people with a range of lower health literacy profiles tended to be physically inactive. 10 Moreover, although the degree of association between health literacy and BMI and smoking differ in previous studies, our study found that patients with lower health literacy were more likely to have a higher BMI and to be smokers. These results are in line with the AHA scientific statement, which states that health literacy is associated with a healthier lifestyle and favorable behaviors.…”

Illness perception, self-efficacy, health literacy, adherence, and quality of life in patients with intermittent claudication – a longitudinal cohort study

“…This concurred with previous studies on patients with COPD and cardiovascular disease, which showed that those with insu cient health literacy also experienced more emotional representations. 58,59 The current study also showed higher self-e cacy and higher QoL among patients with su cient health literacy compared to those with insu cient health literacy, which is in line with previous research. 60,61 These ndings suggest that improving patients' health literacy may improve their self-e cacy, which in turn may positively in uence their QoL.…”