Background: In Canada, as acute ischemic stroke treatment advances and the population ages, more individuals are surviving stroke and returning home with minor deficits. Self-management education tailored to one’s health literacy level is a critical and overlooked aspect in minor ischemic stroke survivors’ recovery. During the first month after minor ischemic stroke, when the risk of recurrence is highest, minor ischemic stroke survivors experience numerous transitions and report unmet health information needs that place them at risk for poor health outcomes. Although minor ischemic stroke-specific data is lacking, American data suggests 59% of stroke survivors have marginal to inadequate health literacy at the time of hospital discharge. Low health literacy in stroke survivors has been associated with poor education retention; issues with medication administration, adherence and self-efficacy; reduced physical functioning; and depression. Increasingly it is recognized that health literacy should be considered a contextual entity. There is a need to better understand the level of health literacy and contextual factors associated with health literacy in minor ischemic stroke survivors to prevent poor health outcomes and health disparities. Purpose: This project aimed to determine the level of health literacy and contextual factors associated with health literacy in recent minor ischemic stroke survivors who were predicted to return to the community within 30 days after their stroke. Methods: This cross-sectional survey was grounded by Sorensen’s Integrated Model of Health Literacy (2012) and employed the HLS19-Q12 to measure health literacy. Contextual factors were assessed using a survey developed from a comprehensive literature review. Forty-two minor ischemic stroke survivors were recruited from the acute stroke unit and stroke rehabilitation unit and completed the questionnaires. Statistical analyses were completed in SPSS. Summary statistics of the HLS19-Q12 scores in minor ischemic stroke survivors were reported and compared with HLS19-Q12 scores of the general population published in the2019-2021 Health Literacy Population Survey. Contextual factors were reported as summary statistics and associations with health literacy were analyzed using Spearman correlation, Kruskal-Wallis tests, Mann-Whitney U tests and multiple linear regression. Results: The average HLS19-Q12 score was 76.3 and similar to the results obtained in the 2019-2021 Health Literacy Populations Survey. The need for information about financial support, a higher number of total barriers to health literacy and issues related to health care provider continuity, feeling uncomfortable asking a health care provider to explain something you didn’t understand (stigma) and memory were associated with lower levels of health literacy in recent minor ischemic stroke survivors.
Discussion: Although the average level of health literacy was similar to that of the general
population, many participants reported problematic (26.2%) or inadequate (16.7%) health
literacy. This thesis is unique in its use of a contextual perspective to explore health literacy in
minor ischemic stroke survivors. This perspective enabled the identification of personal,
situational and societal/environmental factors that may be critical in promoting optimal health of recent minor ischemic stroke survivors. The results of this study suggest care continuity, the patient-health care provider relationship and financial support may be critical factors.
Conclusion: This data can be used to inform future equity-focused research designs and holistic interventions to support recent minor ischemic stroke survivors with lower levels of health literacy who return to the community. These interventions have the potential to reduce the risk for poor health outcomes after a minor ischemic stroke / Thesis / Master of Science in Nursing (MSN)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/29556 |
| Date | January 2024 |
| Creators | Vandervelde, Cheyanne |
| Contributors | Strachan, Patricia, Nursing |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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