Abstract
Objective
Coronary artery disease is more common in middle-aged and elderly individuals. Its treatment process may take a long time, and it is a condition that can impair quality of life while being associated with individuals’ health literacy (HL) levels. This study aims to assess the HL and quality of life levels of individuals with coronary artery disease, explore the relationship between these variables, and identify the factors influencing them.
Material and Methods
The study was conducted with 64 coronary artery disease patients who visited a university hospital between November 2018 and May 2019. It was designed as a cross-sectional study. Data were collected through face-to-face interviews using the “sociodemographic data form,” “European HL scale (HLS-EU),” and “Nottingham health profile (NHP)”. Statistical analyses included chi-square, Fisher’s exact test, Mann-Whitney U, Kruskal-Wallis, and Spearman’s correlation tests.
Results
The mean age of participants was 61.1±12.9 years, with 60.9% being male, 46.9% having primary or secondary school education, and 40.6% actively employed. Among the participants, 62.5% were found to have inadequate or problematic HL levels. A significant negative correlation was observed between HL levels and NHP scores (r=-0.450, p≤0.05). Subscale scores of HLS-EU for “treatment services,” “disease prevention,” and “health promotion” also showed significant negative correlations with the NHP total score (p≤0.05). As HL levels improved, NHP scores and subscale scores for energy, emotional reactions, and physical activity decreased significantly.
Conclusion
In conclusion, individuals with coronary artery disease generally have low HL levels, which negatively impact their quality of life. While gender and education did not significantly influence quality of life, improving HL was associated with better health-related quality of life. Therefore, enhancing HL be a priority for interventions targeting this patient group.
Keywords: Coronary artery disease, health literacy, quality of life, health promotion
References
National Institute for Literacy. The national literacy act of 1991. Public Law 102-73, 102nd Congress. 1991.
Institute of Medicine (US) Committee on Health Literacy. Health literacy: a prescription to end confusion. Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Washington (DC): National Academies Press (US); 2004.
Tokuda Y, Doba N, Butler JP, Paasche-Orlow MK. Health literacy and physical and psychological wellbeing in Japanese adults. Patient Educ Couns. 2009;75(3):411-417.
Mancuso JM. Health literacy: a concept/dimensional analysis. Nurs Health Sci. 2008;10(3):248-255.
Muldoon MF, Barger SD, Flory JD, Manuck SB. What are quality of life measurements measuring? BMJ. 1998;316(7130):542-545.
Okyay P, Abacıgil F. Türkiye sağlık okuryazarlığı ölçekleri güvenilirlik ve geçerlilik çalışması. T.C. Sağlık Bakanlığı. 2016;125:39-60.
Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000;23(1):31-38.
Aksakoğlu G. Sağlıkta araştırma teknikleri ve analiz yöntemleri. İzmir: Dokuz Eylül Üniversitesi Yayınları, 2001.
Demirli. P. Bireysel sağlık okuryazarlığı üzerine bir araştırma: Edirne ili örneği, Trakya Üniversitesi Sosyal Bilimler Enstitüsü, Yüksek Lisans Tezi. Edirne:2018.
Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, et al. Health literacy and use of outpatient physician services by Medicare managed care enrollees. J Gen Intern Med. 2004;19(3):215-220.
Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ. 2012;344:e1602.
Çiftci Kİ. Kronik hastalığı olan bireylerin sağlık okuryazarlığı ve sağlık bakım hizmetinin belirlenmesi. T.C. Atatürk Üniversitesi Sağlık Bilimleri Enstitüsü, Erzurum:2015:1-70.
Öztaş D, Güzeldemirci GB, Özhasanekler A, Yıldızbaşı E, Karahan S, Eray İK, et al. Sağlık okuryazarlığı perspektifinden mükerrer acil servis. Ankara Med J. 2016;(3):255‐262
Oksel E, Yorulmaz S, Kolcu Z, Pasaoglu S. Obez bireylerde yaşam kalitesi. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi, 2008;3(24):115-123.
Sezer A. Sağlık okuryazarlığının sağlıklı yaşam biçimi davranışları ile ilişkisi. Marmara Ünversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, İstanbul:2012.
Köppen PJ, Dorner TE, Stein KV, Simon J, Crevenna R. Health literacy, pain intensity and pain perception in patients with chronic pain. Wien Klin Wochenschr. 2018;130(1-2):23-30.
Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007;167(14):1503-1509.
Torun A, Topcu B, Buyukkilic BZ, Kilic S, Yilmaz I, Uzun M. The impact of education on patients eligible for cardiac rehabilitation and factors contributing to declining participation in turkish society: are patients aware of cardiac rehabilitation? Cureus. 2024;16(6):e62508.
