The Impact of Resilience, Health Literacy, and Social Support on Medication Adherence and Self-care Among Adults With Heart Failure

Abstract

Background: Personal and psychological factors, such as depression, have a considerable influence on nonadherence to medications and self-care in those with heart failure. More evidence is needed about positive personal factors that motivate adherence to medications and self-care in those with heart failure. Objective: The purpose of this study was to investigate whether there was a relationship between the personal resources of resilience, hope, health literacy, social support, and self-care activation and adherence to HF self-care and medications and whether race impacts adherence. Methods: This study used a cross-sectional, correlational design. Stepwise regression was used to test whether resilience, hope, health literacy, self-care activation, and race significantly predicted medication adherence and self-care. A diverse sample was recruited for this study. Results: Of the 174 participants, 51% were female, 51.7% were White, and the mean age was 62 years. After adjustment for differences in age and depressive symptoms, a predictive relationship remained between resilience, health literacy, and medication adherence. Hope, activation, and race were not selected in the final regression model. A high level of perceived social support was the only predictor of better HF self-care. Conclusion: Persons with heart failure may have better medication adherence and overall self-care if sufficiently resilient, health literate, and supported regardless of their degree of hope or activation. Race and age may be important factors to consider. More research is needed to understand the connection between resilience and medication adherence.

The Relationships Among Health Literacy, Patient Activation, and Self-Care Behaviors in Adults With Heart Failure: A Cross Sectional Study

“…Health literacy ( t = 4.367, p < .001) was significantly lower among persons of color compared to White participants. Persons of color in this study were more likely to be under the age of 65 ( M = 56.64; X 2 = 19.160; df = 1; p < .001; Cramer’s phi = −.332), unmarried ( X 2 = 4.305; df = 1; p = .038; Cramer’s phi = .157) and have an annual household income < $50,000 ( X 2 = 5.735; df = 1; p = .017; Cramer’s phi = −.182) compared to White participants (Meraz et al, 2022).…”

“…A correlational, cross-sectional, survey design was used to study a convenience sample of 174 adults with HF who were recruited in July 2020 (Meraz et al, 2022). Institutional Review Board (name of IRB blinded for review #1577400-1) approval was acquired prior to initiating study activities.…”

Educational status affects prognosis of patients with heart failure with reduced ejection fraction: A post‐hoc analysis from the WARCEF trial

“…[2][3][4] Several SDOH have been explored in HF patients, including employment, marital status, income and educational levels. [4][5][6][7] Particularly, some studies suggested that low educational level is associated with high risk of developing cardiovascular disease, as well as mortality from heart disease and stroke 8 ; moreover, educational status has also been linked with higher risk of HF-related hospital admission. 9 Nonetheless, the association between low educational status and poor prognosis may represent an epiphenomenon of inequal access to care for HF patients, [10][11][12] and may also be related to the clustering of other SDOH associated with low educational status, such as low income, unemployment and unpartnered status, which have been demonstrated to be associated to higher risk of death after discharge for HF hospitalization.…”

Resilience mediates the effects of self‐care activation and hope on medication adherence in heart failure patients

“…While studies have examined the adverse effects of person‐related factors on medication adherence (Gast & Mathes, 2019; Riegel et al, 2022), there is limited research examining person‐related factors that may positively influence decisions for medication adherence in people with HF (Celano et al, 2020; Meraz et al, 2023). The person‐related factors of self‐care activation and hope may positively influence medication adherence decisions, although research findings are inconsistent (Beckie et al, 2017; Meraz et al, 2022; Riegel et al, 2022; Saunders et al, 2010).…”

“…The person-related factors of self-care activation and hope may positively influence medication adherence decisions, although research findings are inconsistent (Beckie et al, 2017;Meraz et al, 2022;Riegel et al, 2022;Saunders et al, 2010).…”