Evidence-Based Intervention to Improve Health Literacy among Older Adults with Newly Diagnosed Atrial Fibrillation.

다국어 초록 (Multilingual Abstract)

Background and Significance: Atrial fibrillation (AFib) is the most common arrhythmia encountered in the healthcare setting. As of 2018, approximately 6.1 million people in the United States were living with AFib which is projected to increase to 12.1 million by 2030. Older adults are at higher risk of developing AFib and its complications. AFib is a chronic condition that requires targeted patient education by healthcare providers in different healthcare settings. Patient’s low health literacy regarding the condition is a significant barrier to therapy adherence. Given the high rate of poor health literacy among individuals newly diagnosed with AFib and the adverse outcomes associated with it, improving health literacy in this population is significant. Purpose: This project aimed to increase the health literacy of older adults newly diagnosed with AFib in Nevada. Methods: A convenient sample of newly diagnosed AFib patients that included English and Spanish speakers were recruited from an outpatient Cardiology clinic and an acute care hospital, both located in Las Vegas, Nevada. The data on demographic characteristics, health literacy, attitudes, and confidence in AFib knowledge and its management were collected using Qualtrics®. Participants scanned a QR code to take the test on their phones. A tablet was available for those who did not have a smartphone. The COVID-19 protocol was followed as required. Data were collected pre and post-educational intervention. A pamphlet was provided with key points of the presentation at the end of the session. A dependent t-test for matched pairs was used to analyze the mean difference in health literacy pre-and post-intervention. Results: The project found statistically significant improvement in participants’ health literacy on AFib. The total sample size was 27, primarily English-speaking White males, with less than Bachelor's degree. There was a statistically significant difference between pre-test and post-test health literacy scores [t (25) = 6.59, p < 0.001]. The mean score of knowledge increased from13.42 (3.45) to 17.69 (0.55) after the educational intervention. A statistically significant improvement was noted post-intervention in confidence and attitudes using the Wilcoxon signed-rank test. For evaluation of the intervention, the majority of the participants either agreed or strongly agreed that the intervention was organized and appropriate and increased their knowledge about their condition. Conclusion: The educational presentation was beneficial in improving patient’s knowledge regarding AFib and its management. Future research should evaluate improved health literacy over time and its impact on quality of life, treatment adherence, and hospitalization rates. Implications for Nursing Practice: Patient’s knowledge of AFib and its management is essential for treatment effectiveness. Given that patients had significantly less health literacy about their condition, it is important that educational interventions like this project be implemented among newly diagnosed AFib patients during their hospital stay. Although long-term impact of this type of intervention was not measured, it may improve medication adherence and lower hospitalization and healthcare costs to treat AFib-related complications among older adults.