| Title: | General and disease-specific health literacy in patients with heart failure : an outcome analysis |
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| Authors: | ID Rebernik Grah, Klara (Author)
ID Lainščak, Mitja (Author)
ID Farkaš-Lainščak, Jerneja (Author) |
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| Files: |  URL - Source URL, visit https://academic.oup.com/eschf/advance-article/doi/10.1093/eschf/xvag204/8740364
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  NIJZ - National Institute of Public Health
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| Abstract: | Abstract
Aims
To evaluate general and disease-specific health literacy in patients with heart failure (HF) and to examine their association with behavioural, patient-reported and clinical outcomes.
Methods and results
This prospective observational study included 126 outpatients with HF (mean age 69 ± 11 years; 71% male) who were followed for six months. General health literacy was assessed using the Brief Health Literacy Screen (BHLS), and disease-specific health literacy using the Heart Failure-Specific Health Literacy Scale (HFsHLS). The two measures were moderately positively correlated (Spearman's ρ = 0.49, p < 0.001), indicating partial overlap. Limited general health literacy (BHLS ≤ 9) was identified in 22% of patients and was associated with lower educational level, more depressive symptoms, higher NT-proBNP levels, and a greater number of prescribed medications (all p < 0.05). In univariable analyses, both health literacy measures were associated with better HF-related knowledge (p = 0.004 and 0.049), higher health-related quality of life (p < 0.001 and 0.007), and better self-rated health (p < 0.001 for both), which was not sustained after multivariable adjustment. Additionally, disease-specific health literacy was associated with self-care behaviours (p = 0.033), also after multivariable adjustment (p = 0.026). Neither measure was independently associated with clinical outcomes (death, HF hospitalization, emergency department visit); however, patients with limited general health literacy showed numerically higher event rates and a tendency towards increased risk of clinical outcomes.
Conclusion
In patients with HF, limited general health literacy was observed in 22% of patients. General and disease-specific health literacy measures were not interchangeable, and only disease-specific health literacy showed an independent association with self-care behaviours. A tendency towards less favourable clinical outcomes was observed among patients with limited general health literacy. |
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| Keywords: | heart failure, health literacy |
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| Publication status: | In print |
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| Publication version: | Author Accepted Manuscript |
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| Submitted for review: | 29.05.2026 |
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| Article acceptance date: | 20.07.2026 |
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| Publication date: | 23.07.2026 |
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| Year of publishing: | 2026 |
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| Number of pages: | str. 1-40 |
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| Numbering: | Vol. |
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| PID: | 20.500.12556/DiRROS-31300  |
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| UDC: | 61 |
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| ISSN on article: | 2055-5822 |
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| DOI: | 10.1093/eschf/xvag204 |
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| COBISS.SI-ID: | 286016515 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 24. 7. 2026;
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| Publication date in DiRROS: | 24.07.2026 |
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| Views: | 20 |
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| Downloads: | 16 |
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