Health literacy in persons at risk of and patients with coronary heart disease: A systematic review

2020
Background: Health literacy (HL) plays a crucial role in the maintenance and improvement of individual health. Empirical findings highlight the relation between a person's HL-level and clinical outcomes. However, the role of HL in persons at risk for coronary heart disease (CHD) and patients with CHD has not been researched conclusively. Objective: The aim of this study was to review systematically the current evidence on HL, its dimensions (access to, understanding, appraisal and apply of health-related information), and its important influencing factors, with regard to CHD risk. Method: We used a mixed-methods approach. Eligible articles needed to employ a validated tool for HL or mention the concept and at least one of its dimensions. After the screening process, 14 quantitative and 27 qualitative studies were included and referred to one or more dimensions of HL. Six observational studies measured HL with a validated tool. Results: Findings suggest that patients with lower HL feel less capable to perform lifestyle changes, exhibit fewer proactive coping behaviors, are more likely to deny CHD, are generally older, are less often employed, have lower educational levels and lower socioeconomic status, experience faster physical decline, and use the healthcare system less, compared to patients with higher HL. Barriers to HL include inadequate provision of information by health providers, lack of awareness of the risk factors for CHD, perceived impairment of quality of life due to lifestyle changes, and negative experiences with the healthcare system. Facilitators include a good patient-physician relationship based on good communicative competences of health providers. Conclusions: The concept of HL yields a promising potential to understand the process from obtaining information to actual health behavior change, and the results clearly indicate the need for more systematic research on HL in CHD patients and persons at risk.
SOCIAL SCIENCE & MEDICINE
卷号:245
ISSN:0277-9536
收录类型
SSCI
发表日期
2020
学科领域
循证公共卫生
国家
德国
语种
英语
DOI
10.1016/j.socscimed.2019.112711
EISSN
1873-5347
资助机构
Robert Bosch Foundation [11.5, A402.0002.0]
资助信息
The authors thank the Robert Bosch Foundation for funding the study (funding number: 11.5.A402.0002.0). The sponsors had no influence on study initiation, conduct, or reporting.
被引频次(WOS)
6
被引更新日期
2022-01
来源机构
University of Cologne University of Cologne
关键词
Coronary heart disease Health literacy Prevention Health behavior Disease risk Risk perception Health-related decision-making Health information