THE RELATIONSHIP BETWEEN HEALTH LITERACY, SELF-EFFICACY, AND QUALITY OF LIFE AMONG HEART FAILURE PATIENTS

A Clinical Paper Submitted In Partial Fulfillment of the Requirements For the Degree of Master of Science in Nursing Family Nurse PractitionerHeart failure (HF) is a growing healthcare concern nearing epidemic numbers. The prevalence of HF was 5.8 million in 2006, with an annual incidence rate of 10 per 1000 after age 65. Mortality rates are high, as HF accounts for 282,754 deaths annually. In 2005, annual healthcare costs associated with HF were approximately $35 billion. These costs are estimated to increase to over $39.2 billion in 2010. Quality of life (QOL) has been found to be a predictor of hospital readmissions and mortality in persons with HF. Inadequate health literacy and low self-efficacy have both been found to be related to poorer health outcomes, including lower QOL, yet few studies have examined these concepts together among HF patients. The purpose of this pilot study is to examine the possible relationships between health literacy, self-efficacy, and QOL among patients with HF. Bandura's (1986) Social Cognitive Theory is utilized as the guiding theoretical framework for this study. A non-experimental, cross-sectional, correlational design was utilized. A convenience sample of 5 inpatients with a primary diagnosis of HF was obtained from a hospital located in Northeast Wisconsin. The Newest Vital Sign instrument was used to measure health literacy; Self Efficacy for Managing Chronic Disease 6-Item Scale measured perceived self-efficacy; and QOL was measured using the Minnesota Living with Heart Failure Questionnaire Data were analyzed using Pearson's r and descriptive statistics. The study demonstrated a highly significant relationship between self-efficacy and QOL (r = -0.965, p = 0.01). The relationships between health literacy and self efficacy, as well as health literacy and QOL, were not found to be significant. All patients were found to have a high likelihood of having inadequate health literacy, had a moderately high level of self-efficacy and moderately low QOL. The results demonstrate the need to be aware of the prevalence of inadequate health literacy in patients with HF and to seek interventions aimed at improving patients' self-efficacy and QOL. The use of Bandura's (1986) social cognitive theory may help advanced nurse practitioners discover interventions that will improve the overall QOL among HF patients. Replication of this study with a larger sample size in multiple locations is warranted to improve the statistical power, as well as the generalizability, of the results. An experimental design would allow for causal inferences