Patient Preference and Adherence (Oct 2023)
Disease-Related Knowledge and Need for Revision of Care for Patients with Atrial Fibrillation: A Cross Sectional Study
Abstract
Helga Yr Erlingsdottir,1,2 Audur Ketilsdottir,1,2 Jeroen M Hendriks,3,4 Brynja Ingadottir1,5 1Faculty of Nursing and Midwifery, School of Health Sciences, University of Iceland, Reykjavik, Iceland; 2Cardio-Vascular and Cancer Center, Landspitali – The National University Hospital of Iceland, Reykjavik, Iceland; 3Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; 4Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia; 5Office of Chief Nursing Officer, Landspitali – The National University Hospital of Iceland, Reykjavik, IcelandCorrespondence: Helga Yr Erlingsdottir, Cardio-Vascular and Cancer Center, Landspitali – The National University Hospital of Iceland, Hringbraut, 101, Reykjavik, Iceland, Tel +354 865 7764, Email [email protected]: To evaluate the disease-related knowledge of outpatients with atrial fibrillation (AF), and the relationship with health literacy and other background variables.Patients and Methods: In this cross-sectional survey study, conducted in Iceland, patients with AF scheduled for an electrical cardioversion or AF catheter ablation were recruited from a hospital outpatient clinic. They completed the validated Atrial Fibrillation Knowledge Scale (AFKS), a 11-item instrument (with possible score 0– 10, 10 being the best knowledge) which evaluates knowledge pertaining to AF in general, AF symptom detection and AF treatment. Health literacy was assessed with the 16 item European Health Literacy Survey Questionnaire (HLS-EU-Q) and patients answered questions about their background. Data was analysed with parametric tests.Results: In total, 185 participants completed the questionnaire (mean age 63 ± 10), 77% were male, 74% with previous electrical cardioversion and 76% were on non-vitamin K antagonist oral anticoagulants (NOAC) medication. The mean score on the AFKS was 6.5 (± 1.8). The best knowledge was concerning oral anticoagulation therapy (96% answered correctly) and the least knowledge was regarding responses to AF episodes (17% answered correctly). Patients with sufficient health literacy (52%) had better knowledge of AF (M 6.8 ± 1.7 vs M 6.3 ± 1.9, p = 0.05). Age, educational level, health literacy and AF pattern explained 22% of the variance in AF knowledge.Conclusion: Patients with AF have inadequate knowledge of their condition, potentially as a result of insufficient health literacy. AF knowledge may be improved using integrated management where patients are actively involved in the care and health literacy is considered in the provided patient education.Keywords: atrial fibrillation, health literacy, patient education, patient knowledge, self-care
