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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
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.
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.
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