The Research On The Relationship Between Health Literacy And Frailty In Elderly Patients With Coronary Heart Disease

Objectives1.To evaluate the health literacy of elderly patients with coronary heart disease,and to understand the status and influencing factors of the health literacy of elderly patients with coronary heart disease.2.To explore the correlation between frailty and health literacy in elderly patients with coronary heart disease.3.To explore the predictive value of frailty score on the low-grade health literacy status of elderly patients with coronary heart disease.Methods1.From April 2017 to June 2018,490 eligible elderly patients with coronary heart disease in the Department of Cardiology of a three-level hospital in Yangzhou City were interviewed according to inclusion criteria.2.The general condition,health literacy,sleep,nutrition and frailty of patients were assessed by self-designed general situation questionnaire,health literacy questionnaire of patients with coronary heart disease,Athens Insomnia Scale(AIS),Nutrition Risk Screening 2002(NRS2002),Tilburg Frailty Index Scale(TFI).3.SPSS21.0 was used for data statistics and analysis.Statistical methods included descriptive analysis,nonparametric test,contingency tabic analysis,logistic regression,spearman correlation analysis and receiver operating characteristic curve(ROC).Results1.Current status and influencing factors of health literacy of elderly patients with coronary heart diseaseThe lowest score of health literacy in elderly patients with coronary heart disease is 8,the highest score is 120,and the median score is 84.The median scores of health knowledge,health attitude,health behavior and health skill are 36,18,14 and 16 respectively.Among 490 elderly patients with coronary heart disease,53.88%had low-grade health literacy,32.04%had medium-grade health literacy,and only 14.08%had good-grade health literacy.The single factor analysis of influencing factors of health literacy in elderly patients with coronary heart disease showed that there were significant differences in gender,education level,occupation,monthly income,course of disease,family history and medication(P<0.05).Logistic regression analysis showed that education level,monthly income,course of disease and medication were independent influencing factors of health literacy of coronary heart disease.2.The correlation between frailty and health literacy in elderly patients with coronary heart disease.Of 490 elderly patients with coronary heart disease,47.35%were in a robust state and 52.65%were in a frailty state.Logistic regression analysis showed that age,marital status,monthly income,number of illnesses,medication and sleep disorders were independent influencing factors.There were significant differences in health literacy scores of elderly patients with coronary heart disease under different TFI grades(P<0.05).Under different TFI grades,there were statistical differences in health literacy grades(P<0.05).The score of health literacy and its four dimensions were negatively correlated with the total score of TFI and its three dimensions.3.Predictive value of TFI scores on low-grade health literacy of elderly patients with coronary heart diseaseThe ROC curve showed that the area under the ROC curve of the TFI score predicting the low-grade health literacy status of elderly patients with coronary heart disease was 0.611(P<0.05).When the score of TFI was greater than or equal to 6,the sensitivity and specificity of predicting the low-grade health literacy status of elderly patients with coronary heart disease were better(sensitivity was 50.38%,specificity was 69.47%).Conclusion1.The incidence of low-grade health literacy in elderly patients with coronary heart disease is at a high level.Education level,monthly income,course of disease and medication are the influencing factors.Nurses can take effective measures according to the above influencing factors.2.There is a correlation between health literacy and frailty.The higher the score of health literacy,the lower the score of frailty.This means that the high-grade health literacy status of patients with coronary heart disease,the lower the incidence of frailty.3.TFI score has predictive value for the low-grade health literacy status of elderly patients with coronary heart disease.In clinic,the low-grade health literacy status of patients with coronary heart disease can be judged by TFI score.