Cognitive impairment and limited health literacy are associated with poor health outcomes among patients with heart failure residing in rural areas

IF 3.1 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2025-01-23 DOI:10.1111/jrh.12919

Jia-Rong Wu PhD, RN, FAAN, FAHA, Chin-Yen Lin PhD, RN, JungHee Kang PhD, MPH, RN, Debra K. Moser PhD, RN, FAAN, FAHA

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引用次数: 0

Abstract

Background

Cognitive impairment and limited health literacy are prevalent among patients with heart failure, particularly those residing in rural areas, and are linked to poor health outcomes. Little is known about the intricate relationships among cognitive function, health literacy, and rehospitalization and death in rural patients with heart failure.

Objectives

To determine the relationships among cognitive function, health literacy, and cardiac event-free survival (ie, heart failure hospitalizations and cardiac mortality) in rural patients with heart failure.

Methods

This was a secondary data analysis of a randomized controlled trial of 573 rural patients with heart failure. Cognitive function was measured using the Mini-Cog test. Health literacy was measured by the Short Test of Functional Health Literacy in Adults. Cardiac event-free survival was followed for 2 years. Survival analyses (ie, Kaplan-Meier plots with log-rank test and Cox regression) were used.

Results

Cognitive impairment was associated with limited health literacy. Cognitive impairment and limited health literacy predicted worse cardiac event-free survival (P<.05). Patients with both cognitive impairment and limited health literacy had a 2.24 times higher risk of experiencing a cardiac event compared to those without cognitive impairment and with adequate health literacy (P<.001).

Conclusions

Patients with cognitive impairment and limited health literacy were at the highest risk of experiencing a cardiac event. It is important to screen rural patients with heart failure for cognitive impairment and limited health literacy. Interventions to improve outcomes need to be developed to target rural patients who have heart failure with cognitive impairment and limited health literacy.

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背景：心力衰竭患者，尤其是居住在农村地区的心力衰竭患者普遍存在认知功能障碍和健康素养有限的问题，这与不良的健康后果有关。人们对农村心衰患者的认知功能、健康素养、再住院和死亡之间错综复杂的关系知之甚少：确定农村心衰患者的认知功能、健康素养和无心脏事件生存（即心衰住院和心脏死亡）之间的关系：这是一项对 573 名农村心衰患者进行的随机对照试验的二次数据分析。认知功能通过迷你慢动作测试（Mini-Cog test）进行测量。健康素养通过 "成人功能性健康素养简短测试 "进行测量。无心脏事件生存期为 2 年。采用生存分析（即带有对数秩检验和 Cox 回归的 Kaplan-Meier 图）：结果：认知障碍与健康素养有限有关。认知障碍和健康知识水平有限预示着无心脏事件生存率（PConclusions：认知障碍和健康知识水平有限的患者发生心脏事件的风险最高。对农村心力衰竭患者进行认知障碍和健康知识不足筛查非常重要。需要针对认知障碍和健康知识水平有限的农村心衰患者制定干预措施，以改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.