Relationship Between Health Literacy, Quality of Life, and Treatment Adherence in Patients with Acute Coronary Syndrome.

BACKGROUND: Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes. OBJECTIVE: This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome. METHODS: This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis. RESULTS: Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = -0.167, p < .01), and quality of life (r = -0.153, p < .01), and a positive association between treatment adherence and quality of life (r = 0.169, p < .01). CONCLUSION: The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [HLRP: Health Literacy Research and Practice. 2023;7(2):e71-e79.].

Psychometric Evaluation of Chronic Patients Using the Persian Version of Patient Activation Measure (PAM).

The Patient Activation Measure (PAM) is a 13-item questionnaire that assesses patients' knowledge, skills, and confidence in self-management. The current study aimed to translate the American version of the PAM-13 into Persian and test the psychometric properties of the Persian version among chronic patients. This cross-sectional study was conducted on 438 chronically ill patients in Rafsanjan, Iran from May to November 2019. The American version of the PAM-13 was translated into Persian using a standardized forward-backward translation method. Internal consistency, test-retest reliability, face and content validity, as well as construct validity (structural and convergent validity) were all assessed. The content validity index of the Patient Activation Measure-13 Persian (PAM-13-P) was 0.91. Exploratory and confirmatory factor analyses showed that the PAM-13-P had a meaningful structural validity. The PAM-13-P scores were negatively correlated with the Partner in Health Measure (PIH) (r = -0.29, p < 0.001). In addition, the PAM13-P scores were positively correlated with the Satisfaction with Life Scale (SWLS) (r = 0.31, p < 0.001). The internal consistency was 0.88, and the repeatability was excellent [Intraclass Correlation Coefficient (ICC):0.96 and confidence interval (CI): 0.94-0.98]. This study demonstrates that the PAM-13-P is a reliable and valid measure for assessing activation among chronically ill patients. The PAM-13-P scale assesses the level of self-management of chronic patients and identifies appropriate care strategies to meet their needs.

Patients' knowledge and concerns about using the implantable cardioverter defibrillator for the primary prevention of sudden cardiac death and its correlates: A cross-sectional study.

Background and Aims: Sudden cardiac death (SCD) is one of the most common causes of mortality in heart failure (HF) patients with reduced ejection fraction. Patients have concerns about the disease and use the implantable cardioverter defibrillator (ICD) to reduce the effects of HF disease. The current study aims to evaluate the barriers and factors affecting the implantation of the ICD for primary prevention. Methods: One hundred-forty-seven patients with HF were studied in public hospitals in southern Iran by using a cross-sectional design from April 2018 to June 2019. Demographic, researcher-made questionnaire, World Health Organization Quality of life-BREF (WHOQOL-BREF), general self-efficacy questionnaires, and Multidimensional Scale of Perceived Social Support (MSPSS) were measured for investigating the barriers and impact factors in patent HF. Results: Most participants were male (56.5%), married (88.4%), illiterate (54.1%), and unemployed (72.6%). 62.6% (n = 92) of the participants did not know about HF and ICD. The total score of patients' concerns about using ICD was 47.11 ± 11.26, which showed a moderate level. The scores of knowledge about HF and ICD had a significant positive poor correlation with self-efficacy, perceived social support and QoL. Also, the score of concerns about the ICD had a significant negative poor correlation with perceived social support. Conclusion: Understanding HF patients' issues and obstacles can help us prevent sudden death. Doctors' advice has a significant impact on patients' acceptance. Poor knowledge is the most important reason for nonparticipation. Intervention is necessary to inform patients to understand the advantages and disadvantages.