Health Information Literacy of Cardiac Patients: A Systematic Literature Review

Document Type : Systematic Review

Authors

1 Senior Librarian, Shalamar Medical and Dental College, Lahore, Pakistan.

2 PhD Scholar, Institute of Information Management, University of the Punjab, Pakistan.

3 Pro Vice Chancellor, University of the Punjab, Pakistan.

4 Dental Surgeon, Lahore Medical and Dental College, Lahore, Pakistan.

5 Medical Officer, Lahore Medical and Dental College, Lahore, Pakistan.

6 Librarian, Higher Education Department, Punjab, Pakistan.

Abstract

Background and Objectives: Health information literacy (HIL) is gaining global attention due to complex information ecosystem and exponential health issues. This systematic review investigates the low functioning of HIL among cardiac patients and the key factors associated with HIL and cardiac patients. In this study, we investigate the poor performance of HIL in cardiac patients (CP) and the important factors associated with HIL and CP.

Materials and Methods: This review examined Exploring the Gaps and Associations in Health Information Literacy among Cardiac Patients: A Systematic Review while evaluating research in English that appeared within the time period of 2006 to December 2024. The research eliminated studies which utilized Exploring the Gaps and Associations in Health Information Literacy Among Cardiac Patients: The flowchart stated in the PRISMA diagram shows how researchers selected 521 relevant studies for inclusion. A material extraction structure was applied to analyze the selected studies. Final selection of studies took place after conducting title reviews and abstract and full text evaluations. This review implementation conformed to the PRISMA standards for systematic reviews with meta-analyses.

Results: A total of 21 studies were included in this review, revealing four key reasons for low Health Information Literacy (HIL) among cardiac patients: (1) gender disparities, with older female patients showing lower HIL; (2) lower educational attainment, limiting patients' ability to understand and act on health information; (3) socio-economic status and race, as patients from disadvantaged backgrounds faced systemic barriers; and (4) the presence of cardiovascular and comorbid conditions, which complicated health information processing. The study results demonstrate that cardiac patients require specific intervention approaches to enhance HIL and health outcome performance.

Conclusion: The systematic review of 21 studies found that demographic and clinical factors, such as gender, age, education, and disease knowledge, positively impact health information literacy (HIL) among cardiac patients. Conversely, factors like older age, lower education, African American ethnicity, depression, hypertension, and longer disease duration negatively affect HIL. The study suggests tailored interventions and patient-centered care approaches.

Keywords

Acknowledgement: I would like to thanks my PhD Supervisors for their guidance and motivation. 


Availability of data and materials: All data generated or analysed during this study are included in this published article.


Conflicts of interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this study. 


Consent for publication: All authors have approved the final manuscript, confirm it's not published or under consideration, and consent to its publication in Journal of Health Literacy, requiring copyright holder's written consent.


Ethics approval and consent to participate: Not applicable.


Funding: The study was conducted without any external funding or financial support from any organization or institution.


Authors’ contribution: Ghulam Farid: Conceptualization, Manuscript writing, Khalid Mahmood: Proofreading and supervision. Sobia Khalid: Method, Data extraction, Resources. Fatima Khalid: Data analysis, Resources. Sadaf Iftikhar: Literature search, Data extraction.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

  1. Bonin CD, Santos RZ, Ghisi GL, Vieira AM, Amboni R, Benetti M. Construction and validation of a questionnaire about heart failure patients' knowledge of their disease. Arquivos Brasileiros de Cardiologia. 2014 Feb 17;102:364-73. https://doi.org/10.5935/abc.20140032 PMid:24652054 PMCid:PMC4028939
  2. Jovanić M, Zdravković M, Stanisavljević D, Jović Vraneš A. Exploring the importance of health literacy for the quality of life in patients with heart failure. International journal of environmental research and public health. 2018 Aug;15(8):1761. https://doi.org/10.3390/ijerph15081761 PMid:30115831 PMCid:PMC6121278
  3. Jafari A, Naddafi, F, Gholian‑Aval M, Tehrani H. Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: a path analysis study. Diabetology & Metabolic Syndrome. 2024;16(1):150.
  4. Borkowski P, Borkowska N, Mangeshkar S, Adal BH, Singh N. Racial and Socioeconomic Determinants of Cardiovascular Health: A Comprehensive Review. Cureus. 2024 May;16(5). https://doi.org/10.7759/cureus.59497
  5. Aktaa, S., Gale, C.P., Brida, M., Giannakoulas, G., Kovacs, G., Adir, Y., Benza, R.L., Böhm, M., Coats, A., d'Alto, M. and Escribano‐Subias, P., 2023. European Society of Cardiology quality indicators for the care and outcomes of adults with pulmonary arterial hypertension. Developed in collaboration with the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure, 25(4), pp.469-477. https://doi.org/10.1002/ejhf.2830 PMid:36924171
  6. Heidenreich, P.A., Fonarow, G.C., Breathett, K., Jurgens, C.Y., Pisani, B.A., Pozehl, B.J., Spertus, J.A., Taylor, K.G., Thibodeau, J.T., Yancy, C.W. and Ziaeian, B., 2020. 2020 ACC/AHA clinical performance and quality measures for adults with heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circulation: Cardiovascular Quality and Outcomes, 13(11), p.e000099. https://doi.org/10.1161/HCQ.0000000000000099 PMid:33136435 PMCid:PMC8388013
  7. Reveilhac M, Blanchard A. The framing of health technologies on social media by major actors: Prominent health issues and COVID-related public concerns. International Journal of Information Management Data Insights. 2022 Apr 1;2(1):100068. https://doi.org/10.1016/j.jjimei.2022.100068
  8. Graven LJ, Grant JS. Social support and self-care behaviors in individuals with heart failure: an integrative review. International journal of nursing studies. 2014 Feb 1;51(2):320-33. https://doi.org/10.1016/j.ijnurstu.2013.06.013 PMid:23850389
  9. Paz LF, Medeiros CD, Martins SM, Bezerra SM, Oliveira WD, Silva MB. Quality of life related to health for heart failure patients. Revista brasileira de enfermagem. 2019 Dec 5;72(suppl 2):140-6. https://doi.org/10.1590/0034-7167-2018-0368 PMid:31826203
  10. Hallyburton A. A conceptual approach to practitioners' health information literacy. Reference Services Review. 2016 Jun 13;44(2):178-90. https://doi.org/10.1108/RSR-02-2016-0006
  11. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Kardiologia Polska (Polish Heart Journal). 2016;74(10):1037-147. https://doi.org/10.5603/KP.2016.0141 PMid:27748494
  12. Buck HG, Lee CS, Moser DK, Albert NM, Lennie T, Bentley B, Worrall-Carter L, Riegel B. Relationship between self-care and health-related quality of life in older adults with moderate to advanced heart failure. Journal of Cardiovascular Nursing. 2012 Jan 1;27(1):8-15. https://doi.org/10.1097/JCN.0b013e3182106299 PMid:21558868
  13. Rudd RE. The evolving concept of health literacy: new directions for health literacy studies. Journal of Communication in Healthcare. 2015 Mar 1;8(1):7-9. https://doi.org/10.1179/1753806815Z.000000000105
  14. Waltz MJ, Moberly HK, Carrigan EE. Identifying information literacy skills and behaviors in the curricular competencies of health professions. Journal of the Medical Library Association: JMLA. 2020 Jul 7;108(3):463. https://doi.org/10.5195/jmla.2020.833 PMid:32843877 PMCid:PMC7441914
  15. Jaarsma T, Hill L, Bayes‐Genis A, La Rocca HP, Castiello T, Čelutkienė J, Marques‐Sule E, Plymen CM, Piper SE, Riegel B, Rutten FH. Self‐care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology. European journal of heart failure. 2021 Jan;23(1):157-74. https://doi.org/10.1002/ejhf.2008 PMid:32945600 PMCid:PMC8048442
  16. Hu J, Gonsahn MD, Nerenz DR. Socioeconomic status and readmissions: evidence from an urban teaching hospital. Health Affairs. 2014 May 1;33(5):778-85. https://doi.org/10.1377/hlthaff.2013.0816 PMid:24799574
  17. Tung HH, Lu TM, Chen LK, Liang SY, Wu SF, Chu KH. Health literacy impact on elderly patients with heart failure in Taiwan. Journal of Clinical Gerontology and Geriatrics. 2014 Sep 1;5(3):72-6. https://doi.org/10.1016/j.jcgg.2014.01.005
  18. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. Bmj. 2015 Jan 2;349. https://doi.org/10.1136/bmj.g7647 PMid:25555855
  19. Greenhalgh T, Wong G, Westhorp G, Pawson R. Protocol-realist and meta-narrative evidence synthesis: evolving standards (RAMESES). BMC medical research methodology. 2011 Dec;11:1-0. https://doi.org/10.1186/1471-2288-11-115 PMid:21843376 PMCid:PMC3173389
  20. Turan GB, Çiftçi B. Examination of Health Fatalism And Health Literacy In Patients With Heart Failure. Eastern Journal of Medicine. 2023 Apr 1;28(2). https://doi.org/10.5505/ejm.2022.91298
  21. Chaudhry SI, Herrin J, Phillips C, Butler J, Mukerjhee S, Murillo J, Onwuanyi A, Seto TB, Spertus J, Krumholz HM. Racial disparities in health literacy and access to care among patients with heart failure. Journal of cardiac failure. 2011 Feb 1;17(2):122-7. https://doi.org/10.1016/j.cardfail.2010.09.016 PMid:21300301 PMCid:PMC3053061
  22. Chen AM, Yehle KS, Plake KS, Murawski MM, Mason HL. Health literacy and self-care of patients with heart failure. Journal of Cardiovascular Nursing. 2011 Nov 1;26(6):446-51. https://doi.org/10.1097/JCN.0b013e31820598d4 PMid:21263340 PMCid:PMC3134625
  23. Chen AM, Yehle KS, Albert NM, Ferraro KF, Mason HL, Murawski MM, Plake KS. Health literacy influences heart failure knowledge attainment but not self‐efficacy for self‐care or adherence to self‐care over time. Nursing research and practice. 2013;2013(1):353290. https://doi.org/10.1155/2013/353290 PMid:23984058 PMCid:PMC3741959
  24. Dennison CR, McEntee ML, Samuel L, Johnson BJ, Rotman S, Kielty A, Russell SD. Adequate health literacy is associated with higher heart failure knowledge and self-care confidence in hospitalized patients. Journal of Cardiovascular Nursing. 2011 Sep 1;26(5):359-67. https://doi.org/10.1097/JCN.0b013e3181f16f88 PMid:21099698 PMCid:PMC3116982
  25. Fabbri M, Yost K, Rutten LJ, Manemann SM, Boyd CM, Jensen D, Weston SA, Jiang R, Roger VL. Health literacy and outcomes in patients with heart failure: a prospective community study. InMayo Clinic Proceedings 2018 Jan 1 (Vol. 93, No. 1, pp. 9-15). Elsevier. https://doi.org/10.1016/j.mayocp.2017.09.018 PMid:29217337 PMCid:PMC5756510
  26. Gomez R, Andrey JL, Puerto JL, Romero SP, Pedrosa MJ, Rosety-Rodriguez M, Gomez F. Health literacy and prognosis of heart failure: a prospective propensity-matched study in the community. European Journal of Cardiovascular Nursing. 2023 Mar 1;22(3):282-90. https://doi.org/10.1093/eurjcn/zvac045 PMid:35849049
  27. McNaughton CD, Cawthon C, Kripalani S, Liu D, Storrow AB, Roumie CL. Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure. Journal of the American Heart Association. 2015 Apr 29;4(5):e001799. https://doi.org/10.1161/JAHA.115.001799 PMid:25926328 PMCid:PMC4599411
  28. Meraz R, Caldwell EP, McGee JS. The Relationships Among Health Literacy, Patient Activation, and Self-Care Behaviors in Adults With Heart Failure: A Cross Sectional Study. SAGE Open. 2023 Mar;13(1):21582440231163779. https://doi.org/10.1177/21582440231163779
  29. Meraz R, McGee J, Caldwell EP, Ke W, Osteen K. The impact of resilience, health literacy, and social support on medication adherence and self-care among adults with heart failure. Journal of Cardiovascular Nursing. 2023 Sep 1;38(5):415-24. https://doi.org/10.1097/JCN.0000000000000948 PMid:36103430
  30. Morrow D, Clark D, Tu W, Wu J, Weiner M, Steinley D, Murray MD. Correlates of health literacy in patients with chronic heart failure. The Gerontologist. 2006 Oct 1;46(5):669-76. https://doi.org/10.1093/geront/46.5.669 PMid:17050758
  31. Murray MD, Tu W, Wu J, Morrow D, Smith F, Brater DC. Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills. Clinical pharmacology & therapeutics. 2009 Jun;85(6):651-8. https://doi.org/10.1038/clpt.2009.7 PMid:19262464 PMCid:PMC2855238
  32. Peterson PN, Shetterly SM, Clarke CL, Bekelman DB, Chan PS, Allen LA, Matlock DD, Magid DJ, Masoudi FA. Health literacy and outcomes among patients with heart failure. Jama. 2011 Apr 27;305(16):1695-701. https://doi.org/10.1001/jama.2011.512 PMid:21521851 PMCid:PMC4540335
  33. Rezaei S, Vaezi F, Afzal G, Naderi N, Mehralian G. Medication adherence and health literacy in patients with heart failure: a cross-sectional survey in Iran. HLRP: Health Literacy Research and Practice. 2022 Jul 1;6(3):e191-9. https://doi.org/10.3928/24748307-20220718-02 PMid:35943838 PMCid:PMC9359808
  34. Son YJ, Lee SJ, Kim SH. The role of patient activation in self‐care behaviours of Korean older adults with heart failure. Nursing Open. 2023 Aug;10(8):5202-10. https://doi.org/10.1002/nop2.1756 PMid:37013816 PMCid:PMC10333907
  35. Tilahun D, Gezahegn A, Tegenu K, Fenta B. Functional health literacy in patients with cardiovascular diseases: cross-sectional study in Ethiopia. International Journal of General Medicine. 2021 May 19:1967-74. https://doi.org/10.2147/IJGM.S304007 PMid:34040428 PMCid:PMC8141385
  36. Lee, J. K., & Son, Y. J. (2018). Gender differences in the impact of cognitive function on health literacy among older adults with heart failure. International journal of environmental research and public health, 15(12), 2711. https://doi.org/10.3390/ijerph15122711 PMid:30513761 PMCid:PMC6313791
  37. Cajita MI, Cajita TR, Han HR. Health literacy and heart failure: a systematic review. Journal of Cardiovascular Nursing. 2016 Mar 1;31(2):121-30. https://doi.org/10.1097/JCN.0000000000000229 PMid:25569150 PMCid:PMC4577469
  38. Ahmadzadeh K, Farshidi H, Nikparvar M, Ezati-Rad R, Mahmoodi M. The relationship between health literacy level and quality of life in heart failure patients. Journal of Health Literacy. 2021 Sep 1;6(2):61-8.
  39. Magnani JW, Mujahid MS, Aronow HD, Cené CW, Dickson VV, Havranek E, Morgenstern LB, Paasche-Orlow MK, Pollak A, Willey JZ. Health literacy and cardiovascular disease: fundamental relevance to primary and secondary prevention: a scientific statement from the American Heart Association. Circulation. 2018 Jul 10;138(2):e48-74. https://doi.org/10.1161/CIR.0000000000000579 PMid:29866648 PMCid:PMC6380187
  40. Magnani JW, Mujahid MS, Aronow HD, Cené CW, Dickson VV, Havranek E, Morgenstern LB, Paasche-Orlow MK, Pollak A, Willey JZ. Health literacy and cardiovascular disease: fundamental relevance to primary and secondary prevention: a scientific statement from the American Heart Association. Circulation. 2018 Jul 10;138(2):e48-74. https://doi.org/10.1161/CIR.0000000000000579 PMid:29866648 PMCid:PMC6380187
  41. Walters R, Leslie SJ, Polson R, Cusack T, Gorely T. Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review. BMC public health. 2020 Dec;20:1-7. https://doi.org/10.1186/s12889-020-08991-0 PMid:32605608 PMCid:PMC7329558
  42. Stormacq C, Oulevey Bachmann A, Van den Broucke S, Bodenmann P. How socioeconomically disadvantaged people access, understand, appraise, and apply health information: A qualitative study exploring health literacy skills. Plos one. 2023 Aug 9;18(8):e0288381. https://doi.org/10.1371/journal.pone.0288381 PMid:37556436 PMCid:PMC10411818

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