Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice

Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life. To assess the relationship between health literacy and health-related quality of li...

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Published in:	PloS one Vol. 11; no. 3; p. e0151079
Main Authors:	González-Chica, David Alejandro, Mnisi, Zandile, Avery, Jodie, Duszynski, Katherine, Doust, Jenny, Tideman, Philip, Murphy, Andrew, Burgess, Jacquii, Beilby, Justin, Stocks, Nigel
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 04-03-2016 Public Library of Science (PLoS)
Subjects:	Aged Aged, 80 and over Cardiovascular disease Cardiovascular diseases Care and treatment Chronic illnesses Coronary artery disease Cross-Sectional Studies Demographic aspects Demography Discipline Disease control Education Female General Practice - statistics & numerical data Health Health education Health literacy Health Literacy - statistics & numerical data Health risks Heart diseases Heart failure Humans Inequality Literacy Male Males Medicine Medicine and Health Sciences Morbidity Mortality Myocardial ischemia Myocardial Ischemia - epidemiology Myocardial Ischemia - psychology Patient outcomes Patients Quality of Life Queensland - epidemiology Regression analysis Research and Analysis Methods Risk analysis Risk factors Risk management Social Sciences Socio-economic aspects South Australia - epidemiology Studies Queensland South Australia Australia South Australia Australia
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Summary:	Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life. To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders. Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia) between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12) questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors) using multiple linear regression. A total sample of 587 patients with IHD (mean age 72.0±8.4 years) was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8-17.3) classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1-42.1), 42.1 (95%CI 40.8-43.3) and 44.8 (95%CI 43.3-46.2) for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001). This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482). Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL. Inadequate health literacy is a contributing factor to poor physical functioning in patients with IHD. Increasing health literacy may improve HRQoL and reduce the impact of IHD among patients with this chronic CVD.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceived and designed the experiments: KD JD PT AM J. Burgess J. Beilby NS. Performed the experiments: KD JD PT AM J. Burgess J. Beilby NS. Analyzed the data: DAGC ZM JA NS. Contributed reagents/materials/analysis tools: DAGC ZM JA NS. Wrote the paper: DAGC ZM JA KD JD AM NS. Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0151079