Pathway analysis of the impact of health literacy, social support, and self-management on frailty in patients with chronic heart failure: A cross-sectional study

Oct 29, 2024Medicine

How health knowledge, social support, and self-care relate to frailty in chronic heart failure patients

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Abstract

47.9% of chronic heart failure patients in the study were found to suffer from .

Frailty is negatively correlated with , social support, and .
Health literacy, social support, and self-management may influence frailty in chronic heart failure patients.
Social support is positively associated with both health literacy and self-management.
Higher health literacy is associated with improved self-management.
Effective strategies to enhance health literacy and social support may help reduce frailty.

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Chronic heart failure (CHF) is a significant global health challenge, and is common among CHF patients. Although abundant evidence has revealed significant intercorrelations among , social support, , and frailty, no study has explored their associations into 1 model based on a theoretical framework. The study aimed to test the Information-Motivation-Behavioral Skills Model in a sample of Chinese CHF patients and explore the potential relationships among social support, health literacy, self-management, and frailty. A cross-sectional study was conducted on CHF patients (n = 219) at a tertiary hospital in China. The Tilburg Frailty Indicator, Heart Failure Specific Health Literacy Scale, Social Support Rating Scale, and Self-management Scale of Heart Failure Patients were used to assess frailty, health literacy, social support, and self-management, respectively. Structural equation modeling with the bootstrapping method was used to test the hypothesized relationships among the variables. The results showed that 47.9% of the CHF patients suffered from frailty. Frailty was negatively correlated with health literacy (r = -0.268, P < .01) with a moderate effect size, social support (r = -0.537, P < .01) with a large effect size, and self-management (r = -0.416, P < .01) with a moderate effect size. The structural equation modeling model showed that social support was positively associated with health literacy (β = 0.419, P < .01) and self-management (β = 0.167, P < .01) while negatively associated with frailty (β = -0.494, P < .01). Health literacy was positively associated with self-management (β = 0.565, P < .01), and self-management was negatively associated with frailty (β = -0.272, P < .01). Our study suggests the potential positive impacts of health literacy, social support, and self-management on improving frailty in CHF patients. Healthcare providers should strengthen patient health education, improve their health literacy, enhance their social support, and promote their self-management so as to reverse frailty and reduce the risk of adverse outcomes.

Key numbers

47.9%

Prevalence

Percentage of CHF patients identified as frail.

−0.537

Social Support Correlation

Correlation coefficient between social support and .

−0.268

Correlation

Correlation coefficient between and .

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Pathway analysis of the impact of health literacy, social support, and self-management on frailty in patients with chronic heart failure: A cross-sectional study

Abstract

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