Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Respiratory System, Surgery, Transplantation, Cardiovascular System & Cardiology, health behaviors, health literacy, heart transplantation, physical activity, survey, multicenter, KIDNEY-TRANSPLANT, PHYSICAL-ACTIVITY, VALIDATION, KNOWLEDGE, FAILURE, DISEASE, ACCESS, SKILLS, CARE, Adult, Age Factors, Aged, Confidence Intervals, Cross-Sectional Studies, Female, Graft Rejection, Health Behavior, Health Literacy, Heart Transplantation, Humans, Immunosuppressive Agents, Internationality, Life Style, Logistic Models, Male, Middle Aged, Needs Assessment, Patient Compliance, Prevalence, Prognosis, Sex Factors, Survival Rate, Transplantation Immunology, BRIGHT study team, 1102 Cardiorespiratory Medicine and Haematology, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences

Abstract:

BACKGROUND: Health literacy (HL) is a major determinant of health outcomes; however, there are few studies exploring the role of HL among heart transplant recipients. The objectives of this study were to: (1) explore and compare the prevalence of inadequate HL among heart transplant recipients internationally; (2) determine the correlates of HL; and (3) assess the relationship between HL and health-related behaviors. METHODS: A secondary analysis was conducted using data of the 1,365 adult patients from the BRIGHT study, an international multicenter, cross-sectional study that surveyed heart transplant recipients across 11 countries and 4 continents. Using the Subjective Health Literacy Screener, inadequate HL was operationalized as being confident in filling out medical forms none/a little/some of the time (HL score of 0 to 2). Correlates of HL were determined using backward stepwise logistic regression. The relationship between HL and the health-related behaviors were examined using hierarchical logistic regression. RESULTS: Overall, 33.1% of the heart transplant recipients had inadequate HL. Lower education level (adjusted odds ratio [AOR] 0.24, p < 0.001), unemployment (AOR 0.69, p = 0.012) and country (residing in Brazil, AOR 0.25, p < 0.001) were shown to be associated with inadequate HL. Heart transplant recipients with adequate HL had higher odds of engaging in sufficient physical activity (AOR 1.6, p = 0.016). HL was not significantly associated with the other health behaviors. CONCLUSIONS: Clinicians should recognize that almost one third of heart transplant participants have inadequate health literacy. Furthermore, they should adopt communication strategies that could mitigate the potential negative impact of inadequate HL.