Assessing Health Literacy to Improve Heart Failure Self-Management through Video-Based Education Counseling

Background: The Heart Failure Society of America recommends assessment of health literacy in heart failure (HF) patients and the use of various learning options such as videos. Health literacy affects an individual’s ability to engage in self-care and chronic disease management. Self-care regimens in HF are complex, which requires consistent educational resources and patient-centered approaches. Tailored interventions using video-based education (VBE) may represent a strategy to improve disease management in HF patients with literacy deficits.
Purpose: This project evaluated the effectiveness of VBE counseling on improving self-management and knowledge in adult HF patients in an outpatient setting. Differences were examined between participants with adequate and limited health literacy in improving HF self-management skills and HF knowledge after receiving VBE counseling.
Methods: A one-group pretest-posttest design was used in a convenience sample of fifteen participants from two outpatient HF clinics. Ten participants completed the six-week study. Participants enrolled for individualized weekly counseling support consisting of health literacy screening, a VBE brochure, HF VBE access via tablet or personal computer, and 15-30-minute telephone consultations and face-to-face education sessions with a healthcare provider. Four questionnaires were used to collect the data: a demographic questionnaire, the Short Test of Functional Health Literacy in Adults, the Self-Care of HF Index v. 7.2, and the Atlanta HF Knowledge Test.
Results: The project demonstrated significant differences across variables in pre-post intervention scores. HF knowledge increased (mean 2.0, SD = 2.10, p = .011). Self-care management (mean 18.48, SD = 14.24, p = .005) and symptom perception improved significantly (mean 12.39, SD = 14.67, p = .021). Self-care maintenance (mean 11.25, SD = 8.99, p = .003) and self-care confidence scores (mean 9.0, SD = 10.15, p = .015) were significant respectively. There were no significant differences in improving HF knowledge, self-care maintenance, and self-care symptom perception between the adequate and limited health literacy groups. There were significant differences in improving self-care management (mean 8.08, SD = 3.49, p = .033) and self-care confidence (mean .00, SD = 2.50, p = .017) between the health literacy groups.
Conclusion: VBE counseling was effective for improving HF self-management and knowledge for adult HF patients with limited or adequate health literacy. Health literacy screening individualizes education and identifies patients who require more educational support to make lifestyle and behavioral changes. VBE may be considered as an important adjunct to support HF management in outpatient settings.
Implications for Practice: DNP-prepared nurses are at the forefront of healthcare to improve the quality and delivery of patient education by directing educational programs for chronic disease management. HF nurses or navigators are essential healthcare professionals who can assist HF patients to adapt self-management skills through the use of VBE. DNP-prepared nurses are in the position to foster a multidisciplinary approach to patient education that focuses on health literacy and tailored educational interventions.