The Development and Validation of the Hypertension Evaluation of Lifestyle and Management Knowledge Scale

Abstract

Hypertension knowledge is an integral component of the chronic care model. A valid scale to assess hypertension knowledge and self-management skills is needed. The hypertension evaluation of lifestyle and management (HELM) scale was developed as part of a community-based study designed to improve self-management of hypertension. Participants included 404 veterans with hypertension. Literature review and an expert panel were used to identify required skills. Items were generated and pilot tested in the target population. Validity was assessed through comparisons of performance with education, health numeracy, print numeracy, patient activation and self-efficacy, and hypertension control. The HELM knowledge scale had 14 items across 3 domains: general hypertension knowledge, lifestyle and medication management, and measurement and treatment goals. Scores were positively associated with education (0.28, P<.0001), print health literacy (0.21, P<.001), health numeracy (0.17, P<.001), and patient activation (0.12, P=.015) but no association was found with diastolic or systolic blood pressure. The HELM knowledge scores increased following the educational intervention from baseline (mean, 8.7; standard deviation, 2.2) to 12-month follow-up (mean, 9.2, standard deviation, 2.2; P<.001). We conclude that the HELM provides a valid measure of the knowledge required for patients to take an active role in the chronic disease management of hypertension.

Health Literacy, Numeracy, and Graphical Literacy Among Veterans in Primary Care and Their Effect on Shared Decision Making and Trust in Physicians

“…Further, inadequate health literacy in primary care veterans was a predictor of worse satisfaction with health care after adjusting for patient sociodemographics (Shea et al, 2007). In contrast, another study conducted on veterans—96% of whom were White—showed higher levels of adequate literacy (Schapira et al, 2012). These studies, however, did not assess numeracy or graph literacy.…”

The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills

“…Health literacy is becoming a focal issue for health providers and policy makers in many countries around the world. Health literacy is defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" [1][2][3]. According to research, individuals with lower health literacy are more likely to have poor health outcomes, are less likely to understand their health problems and care management, and are at higher risk of hospitalizations and mortality rates [4,5].…”

Estudio de propiedades psicométricas de un cuestionario de afrontamiento, apoyo social y conducta alimentaria en personas con diabetes e hipertensión

“…En la actualidad, existen cuestionarios que evalúan aspectos psicosociales por separado, tales como el afrontamiento de la enfermedad crónica (Welch, 1994;González, 2008), el apoyo social percibido (Revilla, Luna del Castillo, Bailón, & Medina, 2005), el estrés asociado a la enfermedad (Ortiz, Ortiz, Gatica, & Gómez, 2011), la conducta alimentaria (Van Strien, Frijters, Bergers, & Defares, 1986;Cepeda-Benito, Gleaves, Fernández, Vila, Williams, & Reynoso, 2000;Castro, Bellido, & Pertega, 2010;Pino, Díaz, y López, 2011), la percepción de la enfermedad (Moss-Morris et al, 2002), el manejo de la enfermedad (Schapira et al, 2012;Schmitt et al, 2013) y la calidad de vida asociada a ésta (Robles, Cortázar, Sánchez-Sosa, Paez, & Nicolini, 2003). Sin embargo, estos cuestionarios son relativamente extensos o sólo evalúan un aspecto psicosocial, por lo que toma mucho tiempo realizar una evaluación integral.…”