Abstract
Background: Coronary heart disease (CHD) affects 197.2 million people worldwide and remains a predominant cause of death and disability. This is partly because of behavioural risk factors including changes in dietary habits and reduced physical activity that contribute to CHD development and greater risk of CHD progression. Behavioural risk factors can be modified with preventive actions and have consistently been reported to reduce the risk of recurrent coronary events and prevent serious complications.Purpose: The overall aim of the ‘RHYTHM Study’ presented in this thesis was to understand how people living with CHD who may have low levels of health literacy and/or limited English language proficiency engage in self-management behaviours. The quantitative phase of the study sought to investigate the relationship between sociodemographic factors, health literacy, language proficiency, self-efficacy and self- management behaviour among people living with CHD. The qualitative phase of the RHYTHM Study was designed to provide insights into the quantitative results and understand how health literacy influences self-management behaviour among people living with CHD.
Methods: The study was conducted using convergent mixed methods collecting quantitative and qualitative data simultaneously, with qualitative data embedded within a broader quantitative design. Participants were recruited using convenience sampling between 2016 and 2017. For the quantitative phase of the study, a cross-sectional survey of people living with CHD who were attending outpatient cardiology services was conducted in the South Western Sydney Local Health District. Data were also collected in a private cardiology clinic and in a community setting in the Greater Sydney metropolitan region.
Results: A total of 143 participants completed the survey: 111 in the outpatient setting and 32 in the community setting. Participants were grouped according to health literacy cluster profiles. In the outpatient setting, the findings indicated that men living with a partner or spouse, and those who belong to the Cluster 3 health literacy profile (highest health literacy mean scores) were more likely to have high self-efficacy scores.
Conclusions: The findings in the RHYTHM Study revealed a significant relationship between men, living with a partner or spouse, high health literacy and high self-efficacy. Moderate and high health literacy was associated with high self-efficacy. Likewise, a significant relationship was found between age of more than 70 years, men and living with a partner or spouse and high self-management. Moderate and high health literacy was associated with high self-management. The connection, confidence and capability that converged from the nine scales of the HLQ were crucial for effective engagement in self-management behaviour among those living with CHD. The ability to make informed decisions and engage in self-management behaviour requires a connection between healthcare professionals and support systems. Confidence reflects the individual’s self-efficacy in their capability to proactively manage their condition. A longitudinal study may offer a more comprehensive understanding of how stronger connections with healthcare professionals and support systems, the confidence or self- efficacy as well as individuals’ skills and capabilities impact sustained engagement in self-management behaviour in those living with CHD, particularly from culturally and linguistically diverse backgrounds and who do not speak the dominant language.
| Date of Award | 2023 |
|---|---|
| Original language | English |
| Awarding Institution |
|
| Supervisor | Jane Frost (Supervisor) |
Cite this
- Standard