Health Literacy, Social Support, and Self-Management Outcomes in Cardiovascular Disease: A Cross-Sectional Analysis

Abstract

Social support and health literacy represent the key factors that can trigger positive self-care practices among new and existing cardiac patients. There is however a dearth of evidence that has been carried out with tertiary care facilities in Pakistan to study the combined impact of such factors on patient outcomes. To establish the association between health literacy and self-care practices as well as test the mediating effect of social support between health literacy and medication adherence in cardiac patients.

Methods

An analysis of 110 adult cardiac patients in Mayo hospital Lahore was done in a hospital based cross-sectional study. Consecutive sampling defined the participants applied in cardiology outpatient and inpatient units. The structured face-to-face interview that used validated measures assessing health literacy, perceived social support, self-care behaviours, and medication adherence was used to collect these data. Demographic and clinical characteristics were summarized with the help of descriptive statistics. The level of associations between variables was tested using Pearson correlation analysis and direct and indirect effects using regression-based mediation analysis. The p value was adjusted to statistical significance of p < 0.05.

Results

The average scores of health literacy relayed a moderate literacy level (72.45 ± 15.38) and social support level was also moderate (58.72 ± 10.41) as well as self-care behaviours (66.81 ± 12.26). It was found that health literacy and social support (r = 0.41, p < 0.01) and health literacy and self-care (r = 0.45, p < 0.01) as well as social support and medication adherence (r = 0.47, p < 0.01) showed significant positive correlation. A mediation analysis showed that social support mediated the correlation between health literacy and self-care outcomes (indirect effect 0.25) which showed both a direct and indirect effect on the behaviours of disease management.

Conclusion

Health literacy and social support are important predictors of self-care and adherence to medication among patients with cardiac conditions. Social support moderates the relationship between health literacy and health outcomes, which supports the need to incorporate educational and psychosocial interventions in cardiac care interventions.

Keywords: Health literacy; Social support, Self-care; Medication adherence; Cardiac patients; Cross-sectional study; Pakistan