Abstract 19227: Impact of Health Literacy on the Length of Delay in Seeking Care After Worsening of Symptoms in Patients With Heart Failure
Background: Repeated admissions in patients with heart failure (HF) are related to a delay in responding to HF symptoms. In order to adequately react to HF symptoms, HF knowledge and taking decisions to seek care are essential. Although previous studies have reported that health literacy (HL) was associated with decision making in chronic conditions, little is known on the impact of HL on their behavior for seeking treatment. We analyzed the hypothesis that HL is associated with a delay in seeking care in patients with HF.
Methods: This cross-sectional study analyzed the data of 112 hospitalized patients with HF (mean age, 69.6 ± 11 years; 68% males; mean left ventricular ejection fraction 49.6 ± 21%). During index hospitalization, a structured interview was conducted to assess the type of worsening HF symptoms and length of delay in seeking care.
Patients completed questionnaires on depressive symptoms and HL (functional, communicative, and critical HL). Clinical and demographic data were also collected. Linear regression analysis was performed to examine whether HL was independently associated with time to seeking care.
Results: Median patient delay time was 32 h, with 38 patients reporting short delay (<12 h) and 40 patients reporting long delay (>96 h). Patients having a long delay were more likely to be females and have no history of myocardial infarction or HF. Loss of appetite, fatigue, weight gain, and dyspnea on exertion were related to long delay. Levels of communicative and critical HL were associated with long delay (communicative HL short delay, 12.9 vs. long delay, 8.9, P = 0.024; critical HL short delay, 10.2 vs. long delay, 8.0, P = 0.043). After adjusting for confounding factors, communicative and critical HL were shown to be independent predictors of the length of delay in seeking care (communicative HL β = –0.176, P =
0.031; critical HL β = –0.314, P = 0.033).
Conclusions: Communicative and critical HL were factors associated with higher risks for delay in seeking care in patients with HF. In order to reduce the delay time, patients with low HL require enhanced education regarding recognition of HF symptoms and the appropriate actions that need to be taken to avoid worsening of symptoms.
- © 2013 by American Heart Association, Inc.