Associazione Nazionale Medici Cardiologi Ospedalieri



Association between health literacy and nursing dependency in heart failure patients: a retrospective study

Cesare Manuele Roma (RM) – Centro di Eccellenza per la Cultura e la Ricerca Infermieristica | Cristofori Elena Roma (RM) – Università Cattolica del Sacro Cuore | Magliozzi Erasmo Roma (RM) – Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata

Background: Approximately 6.7 million Americans over 20 years of age have heart failure (HF) and 33% of the US adult population without known symptomatic HF is at-risk for HF. To understand self-care protocols, patients should understand and use health information and literature suggests a positive relation between health literacy (HL) and self-care. Health literacy (HL) is a potential risk factor for health outcomes and can be defined as “personal knowledge and competencies obtained through daily activities, social interactions and across generations”. However, even though HL has gained international relevance, it remains underestimated in most world countries. Moreover, HL is poorly measured in hospitalized HF patients and its relationship with nursing dependency is still poorly studied. We aimed to describe HL levels by analyzing the relationship between HL and nursing dependency.

Methods: A retrospective design was used by selecting 608 adult patients with HF consecutively admitted in cardiovascular and internal medicine units of an Italian university hospital across 1 year. Single Item Literacy Screener (SILS) was used to measure HL and was systematically reported on electronic health records; nursing diagnoses were collected from the clinical nursing information system to measure nursing dependency.

Results: The mean age of the sample was 75.50 ± 13.06. HL levels were low (SILS >2) in approximately 26% of the hospitalized patients (n=159; 26.2%). A mean of 4.1 ± 3.4 nursing diagnosis per patient was identified. A significant difference was observed between patients with adequate HL (n=449) and low HL (n=159) in terms of nursing diagnoses (mean 2.76 ± 20.3 VS mean 8.69 ± 2.79; .001, respectively). A statistically significant linear association (Spearman’s correlation coefficient) was observed between the HL score and the number of NDs.

Conclusion: HL was associated with the number of NDs in HF patients. Understanding the relationship between HL and nursing dependency can allow the planning of targeted interventions to improve the patient’s health outcomes, representing a key element for public health.