Psychosocial Correlates of Health Literacy Among Older Patients With Coronary Heart Disease

Abstract

This study examined psychosocial correlates of health literacy (HL) scores among older patients with coronary heart disease (CHD). A cross-sectional survey assessed psychosocial factors relating to the following: self-efficacy (i.e., perception of ability to perform a specified behavior) for diet, exercise, medication, and for a future attempt to quit smoking; social support; social stigma; appointment attendance; knowledge of heart problems; and understanding of health information. Health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM). Of 321 patients, 70 had a REALM score in the low HL range (<60). When adjusting for demographics, a lower REALM score was significantly associated with reports of increased difficulty understanding health information (p < .001), less knowledge of heart problems (p = .002), increased discomfort about asking for explanations of health information (p = .014), less support with discussing health problems (p = .020). Patients with CHD and low HL are likely to face psychosocial challenges when managing their health problems. In order to encourage these individuals to seek help, health professionals need to be aware of the psychosocial characteristics of patients with low HL. These individuals may need behavioral support to increase both their self-efficacy and their understanding of their medical condition.

We thank Oliver Dennis for help with preparation of this article. The study was funded by STaRNet London, which is funded by the U.K. Department of Health.

Notes

CHD = coronary heart disease; BMI = body mass index (kg/m²).

^a Two patients refused to declare their marital status.

^b For 67 patients, weight and height were not measured at admission.

FTE = full-time education, CHD = coronary heart disease, BMI = body mass index (kg/m²).

^a Two patients refused to give their age.

^b Two patients refused to give their years of education.

^c For 67 patients, weight and height were not measured at admission.

^d Time with CHD was not available for 12 patients.

^a One person missing in denominator.

^b two missing in denominator.

^c five missing in denominator.

REALM = Rapid Estimate of Adult Literacy in Medicine score.

*significant at p < .05.

^a Adjusted for ethnicity.

^b Adjusted for ethnicity, gender, age, and education.

REALM = Rapid Estimate of Adult Literacy in Medicine score.

*significant at p < .05.