ConheSer - Fatores associados aos conhecimentos em doença cardíaca nas pessoas com doença cardíaca isquémica

Abstract

Introduction: Timely and appropriate treatment, improvement of treatment techniques, as well as better control of risk factors contributed to the reduction of mortality associated with cardiovascular diseases. However, poor adherence to prevention and treatment measures contributes to its still high prevalence. Health education programs that can enhance prevention, adherence to treatments and correct management of the therapeutic regimen may be useful. It is therefore important to determine what knowledge the patient has about his condition. Characterizing the information needs will allow the development of tailored and more cost-effective interventions. Objective: The main objective is to determine the knowledge about heart disease of patients with diagnosed ischemic heart disease. As secondary objectives, we intend to design an instrument that allows assessing knowledge on heart disease, analyzing the health literacy of patients with ischemic heart disease and identifying more vulnerable groups in terms of literacy and knowledge. Methodology: Cross-sectional, descriptive study with a sequential convenience sample of patients with ischemic heart disease admitted between May 2nd and July 30th, 2022 at the cardiology service of Centro Hospitalar Universitário do Porto. A self-administered questionnaire covering several dimensions was developed and applied to 165 patients: sociodemographic characteristics, clinical history, lifestyle, number of hospitalizations for heart disease and characterization of the current admission. 28 items were also associated to determine knowledge about heart disease (Questionnaire for the Assessment of Knowledge in Heart Disease: QAC-DC), the Medical Term Recognition Test (METER) to measure literacy and the Hospital Anxiety and Depression Scale (HADS). Patients were evaluated during their hospital stay, where they had been admitted for acute illness or for scheduled interventions. Results: Women, the least educated and those with inadequate literacy levels are the groups with the lowest levels of knowledge. Regarding the areas of knowledge, it was found that the least recognized cardiovascular risk factors were family history of ischemic heart disease (86%), diabetes mellitus (73%) and sex (19%). The symptom most frequently identified as a symptom of heart disease was chest discomfort (92%), followed by difficulty breathing or shortness of breath (84%), while mandibular, cervical or interscapular discomfort was only recognized by 54% of respondents. Symptoms of stroke and acute myocardial infarction are confused by 88% of the sample. Conclusion: There are important gaps in some areas of knowledge about heart disease amongst patients with ischemic heart disease. These gaps are particularly important in certain patient subgroups. Health intervention strategies must be sensitive to these data. The QAC-DC knowledge assessment instrument proved to be reliable, valid and applicable in clinical practice.