Effect of health literacy on quality of life amongst patients with ischaemic heart disease in Australian General Practice

Gonzalez-Chica, David Alejandro, Mnisi, Zandile, Avery, Jodie, Duszynski, Katherine, Doust, Jenny, Tideman, Philip, Murphy, Andrew, Burgess, Jacquii, Beilby, Justin and Stocks, Nigel (2016) Effect of health literacy on quality of life amongst patients with ischaemic heart disease in Australian General Practice. PLoS ONE, 11 3: . doi:10.1371/journal.pone.0151079

Author Gonzalez-Chica, David Alejandro
Mnisi, Zandile
Avery, Jodie
Duszynski, Katherine
Doust, Jenny
Tideman, Philip
Murphy, Andrew
Burgess, Jacquii
Beilby, Justin
Stocks, Nigel
Title Effect of health literacy on quality of life amongst patients with ischaemic heart disease in Australian General Practice
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2016-03-04
Sub-type Article (original research)
DOI 10.1371/journal.pone.0151079
Open Access Status DOI
Volume 11
Issue 3
Total pages 15
Place of publication San Francisco, United States
Publisher Public Library of Science
Collection year 2017
Language eng
Formatted abstract
Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life.

To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders.

Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia) between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12) questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors) using multiple linear regression.

A total sample of 587 patients with IHD (mean age 72.0±8.4 years) was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8–17.3) classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1–42.1), 42.1 (95%CI 40.8–43.3) and 44.8 (95%CI 43.3–46.2) for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001). This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482). Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL.

Inadequate health literacy is a contributing factor to poor physical functioning in patients with IHD. Increasing health literacy may improve HRQoL and reduce the impact of IHD among patients with this chronic CVD.
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Sub-type: Article (original research)
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