An objective and subjective health literacy analysis among heart transplant recipients

Health literacy (HL) is associated with patient adherence, healthcare utilization, patient self-management, however there is limited data available on how it should be interpreted and measured among heart transplant recipients.

In a cross-sectional study among heart transplant recipients (n = 98) under follow-up at Semmelweis University Heart and Vascular Centre, HLS-EU-Q47 and Newest Vital Sign test were used to measure objective and subjective HL.

The HLS-EU-Q47, a measure for subjective HL, showed that 49.5% of heart transplant recipients had excellent, 35.1% sufficient, 14.4% problematic and 1% inadequate HL. For objective HL, measured with the NVS test, the frequency of HL categories (adequate HL 49%, possibility of limited HL 26.5%, high likelihood of limited HL 24.5%) was significantly different. We were not able to identify a significant predictor of subjective HL. However, objective HL showed a significant association with both age (β = -0.445, p < 0.001) and educational attainment (β = 0.212, p = 0.023). There was no significant association between HL and health risks or health-promoting behaviors (alcohol consumption, physical exercise).

The results of our research indicate that subjective and objective (performance-based) HL are two different concepts and should be treated separately. Finding ways to improve HL among heart transplant recipients should be a priority and requires a complex assessment process, a multi-faceted approach both for caregivers and stakeholders.