ORIJINAL ARAŞTIRMA
Akut Koroner Sendrom Sonrası Kardiyak Rehabilitasyona Katılım Engelleri ve Sağlık Okuryazarlığı Arasındaki İlişkilerin Araştırılması: Prospektif Bir Çalışma
Exploring the Relationships Between Health Literacy and Enrolment Barriers in Post-Acute Coronary Syndrome Cardiac Rehabilitation: A Prospective Study
Received Date : 16 Nov 2024
Accepted Date : 02 Dec 2024
Available Online : 10 Dec 2024
Levent KARATAŞa, Ayça UTKAN KARASUa, İlknur ONURLUa, Orhan Batur ŞAHİNb,
Salih TOPALb, Nesrin DEMİRSOYa
aGazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, Türkiye
bGazi University Faculty of Medicine, Department of Cardiology, Ankara, Türkiye
Doi: 10.31609/jpmrs.2024-106786 - Makale Dili: EN
Turkiye Klinikleri Journal of Physical Medicine and Rehabilitation Sciences. 2025;28(1):70-81
ÖZET
Amaç: Bu çalışma, akut koroner sendromu (AKS) takiben kardiyak rehabilitasyona
(KR) katılımda sağlık okuryazarlığının (SOY) öngörücü rolünü
araştırmayı ve SOY ile KR’ye katılım engelleri arasındaki ilişkiyi değerlendirmeyi
amaçladı. Gereç ve Yöntemler: Ağustos 2022-Aralık 2023 tarihleri arasında,
KR’ye uygun 60 AKS hastası koroner yoğun bakım ünitesinden taburcu
edilmeden önce değerlendirildi. Hastaların demografik ve klinik özellikleri kaydedildi,
fiziksel performans ve yaşam kalitesi değerlendirildi. SOY düzeyi Türkiye
Sağlık Okuryazarlığı Ölçeği-32 (TSOY-32) ile ölçüldü. Tüm hastalara KR
hakkında bilgi verildi ve programa başlama randevusu planlandı. KR’ye katılmayanlara
ulaşılıp Kardiyak Rehabilitasyon Engelleri Skalası (KRES) uygulandı.
Lojistik regresyon ve korelasyon analizleriyle, SOY, demografik ve klinik özellikler
ve KR katılım engelleri arasındaki ilişkiler incelendi. Bulgular: Hastaların
%62'sinin THLS-32 skorları 33'ün altında olup, özellikle hastalıkların önlenmesi
ve sağlığın teşviki alanlarında problemli veya yetersiz SOY'u gösterdi. Hastaların
yalnızca %18'i KR'ye katıldı ve katılım açısından anlamlı bir öngörücü belirlenemedi.
İş/zaman çatışmaları ve KR'ye ihtiyaç duyulmama algısı, belirgin
engeller arasında yer aldı. Zayıf fiziksel performans, ileri yaş ve düşük SOY düzeyi,
komorbidite ve düşük motivasyonla ilişkili engellerle korele bulunurken;
daha yüksek THLS-32 skorları, KR'ye ihtiyaç duymama algısı ile ilişkili bulundu.
Sonuç: SOY düzeyi KR’ye katılımı doğrudan öngörmese de KR’ye katılım engelleriyle
ilişkiliydi. Bu bulgular, KR’ye katılım engellerine bireysel zeminde
çözüm üretmek için SOY düzeyini dikkate almamız gerektiğini vurgulamaktadır.
Anahtar Kelimeler: Kardiyak rehabilitasyon; akut koroner sendrom; sağlık okuryazarlığı; katılım engelleri
ABSTRACT
Objective: This study aimed to investigate the predictive role of
health literacy (HL) in cardiac rehabilitation (CR) enrolment following acute
coronary syndrome (ACS) and to assess relationship between HL and barriers to
CR enrolment. Material and Methods: Between August 2022 and December
2023, 60 ACS patients eligible for CR were enrolled pre-discharge from the coronary
intensive care unit. Data on demographics, clinical profiles, physical performance,
quality of life, and HL were collected using the Turkish Health Literacy
Scale-32 (THLS-32). All patients received CR information and were scheduled
to start the programme. The Cardiac Rehabilitation Barriers Scale assessed barriers
for non-attendees during follow-up. Logistic regression and correlation analyses
examined associations between HL, demographics, and CR participation
barriers. Results: Sixty-two percent of patients had THLS-32 scores below 33, indicating
problematic or inadequate HL, particularly in disease prevention and
health promotion. Only 18% of patients enrolled in CR, with no significant predictors
identified. Work/time conflicts and the perception of not needing CR were
prominent barriers. Poor physical performance, older age, and lower HL correlated
with barriers related to comorbidity and low motivation, while higher THLS-
32 scores correlated with the perception of not needing CR. Conclusion: HL was
associated with barriers to CR rather than directly predicting CR enrolment. These
findings highlight the need for tailored interventions that address HL deficits to
help overcome CR barriers on an individual level.
Keywords: Cardiac rehabilitation; acute coronary syndrome; health literacy; enrolment barriers
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