Study On The Effect Of Health Literacy Education On Self-Management Of Patients With Chronic Heart Failure

Objective(1)To understand the status quo of health literacy,self-efficacy,hope level and self-management of patients with chronic heart failure,analyze the factors affecting self-management of patients with chronic heart failure,and further construct health literacy education programs for CHF patients.(2)To explore the influence of health literacy education on health literacy,self-efficacy,hope level and self-management of patients with chronic heart failure.Methods(1)The general data questionnaire,Heart Failure-Specific Health literacy Scale,self-efficacy for managing chronic disease 6-item scale,Herth Hope Index,self-management scale of heart disease patients were used to investigate the CHF patients,and the SPSS22.0statistical analysis software was used to analyze the data to explore the factors influencing the self-management of CHF patients.(2)Effect of health literacy education on self-management of patients with chronic heart failure:a study of 86 CHF patients hospitalized in the department of cardiology of a third-tier first-class hospital in tianjin from July 2019 to October 2019.The control group received regular education,while the intervention group received the researcher himself implemented health literacy education program.The intervention was divided into two parts:in-hospital intervention and out-of-hospital follow-up intervention.The two groups were evaluated before intervention,on the day the intervention ended,and 1 month after intervention.The outcome measures were general information questionnaire,heart failure specific health literacy scale,chronic disease self-efficacy scale,hope level scale and heart failure self-management scale.Repeated measures variance analysis,two independent samples t test,paired samples t test,chi-square test and non-parametric test were used for statistical analysis.Results(1)Analysis of self-management level and influencing factors of patients with chronic heart failure showed that the self-management score of patients with chronic heart failure was(47.91±12.55),and the highest score was drug management,followed by diet management,psychological/social adaptation management and symptom management.The results of single factor analysis showed that residence,marital status,per capita monthly family income,education level,residence status,medical expenses,heart function classification and self-care ability had significant influence on self-management of patients with chronic heart failure.The results of multivariate analysis showed that health literacy,level of hope,self-efficacy,per capita monthly family income,and self-care ability were the factors that affected self-management in patients with chronic heart failure,and the coefficient R~2 of self-management was 62.4%.(2)At the end of the intervention,a total of 81 caregivers completed the intervention during hospitalization and after follow-up and all data collection.There were 40 cases in the intervention group and 41 cases in the control group.The results of intervention showed:(1)After intervention,the total score of self-management,diet management,psychological/social adaptation management,symptom management dimension score of the two groups of patients with chronic heart failure intervention main effect,the difference was statistically significant(P<0.05).The results of the inter-group comparison showed that the inter-group comparison results at each time point after the intervention showed statistically significant differences in the total score of self-management and scores of each dimension on the day after the intervention and one month after the intervention(P<0.05).The results of the intra-group comparison before and after showed that the total score of self-management and scores of each dimension of chronic heart failure patients in the two groups showed an increasing trend with the passage of time,and the difference between the two groups was statistically significant(P<0.017).(2)After the intervention,the total score of health literacy,the score of functional health literacy and the score of critical health literacy were significantly different between the two groups(P<0.05).The results of the inter-group comparison showed that there were statistically significant differences in the total score of health literacy and scores of each dimension on the day of intervention and one month after intervention(P<0.05).The results of the intra-group comparison before and after the intervention showed that the total score of health literacy and scores of each dimension of chronic heart failure patients in the two groups showed an increasing trend with the passage of time,and the difference between the two groups was statistically significant(P<0.017).(3)After the intervention,the main effect of the intervention on the dimension score of maintaining close relationship between chronic heart failure patients and others in the two groups was statistically significant(P<0.05).The results of the inter-group comparison showed that on the end of the intervention day,there was a statistically significant difference in the score of maintaining a close relationship between the two groups of patients with chronic heart failure(P<0.05).The results of the intra-group comparison before and after showed that the expected level total score of patients with chronic heart failure in the two groups showed an increasing trend over time,and the difference between the two groups was statistically significant(P<0.017).(4)After intervention,the two groups of chronic heart failure patients self-efficacy and disease management self-efficacy dimension score intervention main effect,the difference is statistically significant(P<0.05).The results of inter-group comparison at each time point after intervention showed that the differences in self-efficacy and scores of each dimension were statistically significant on the day after intervention and 1 month after intervention(P<0.05).The results of the intra-group comparison before and after the intervention showed that the self-efficacy and scores of each dimension of chronic heart failure patients in the two groups showed an increasing trend with the passage of time,and there were statistically significant differences between the two groups on the day of intervention and before the intervention,1 month after the intervention,and 1 month after the intervention and before the intervention(P<0.017).Conclusion(1)Differences exist in self-management of CHF patients in different places of residence,marital status,per capita monthly income of families,education level,living conditions,medical expenses,classification of cardiac function and self-care ability;(2)The factors influencing the self-management of CHF patients were the family's per capita monthly income,self-care ability,health literacy,hope level and self-efficacy;(3)Health literacy intervention can improve the self-management level of patients with chronic heart failure;(4)Health literacy intervention can improve the health literacy level of patients with chronic heart failure;(5)Health literacy interventions have not yet raised the level of hope for patients with chronic heart failure;(6)Health literacy intervention can improve the self-efficacy level of patients with chronic heart failure.