A structural equation model linking health literacy, self efficacy and quality of life in adults with coronary heart disease

Background Cardiovascular disease is the world major cause of death. There is sufficient evidence that patients with coronary heart disease (CHD) experience poor quality of life. Health literacy and self efficacy are modifiable psychosocial factors that could affect quality of life, and these factors should be considered as targets for intervention. As the relationships among health literacy, self efficacy, and quality of life in the CHD population have not been well understood. Thus, we constructed the structure equation model in these valuables. Methods A cross-sectional study of a convenience sample among 200 patients with CHD were participated from outpatient clinics in three tertiary general hospitals in Baoding City in mainland China, from December 2018 to June 2019. Data regarding demographic features, health literacy, self efficacy and quality of life were assessed. A structure equation model was used to construct and validate the pathways. Results The mean age of the study sampled patients was 65.37 years old. The average level of health literacy, self efficacy and quality of life were 9.6 [+ or -] 3.5, 28.8 [+ or -] 13.9 and 381.8 [+ or -] 130.1 respectively. Significant associations were observed from health literacy to quality of life, and self efficacy played a partial mediating role between health literacy and quality of life in the CHD population. Health literacy and self efficacy explained for 59.6% of the variance in quality of life. Conclusions Health literacy had a direct influence on quality of life, and an indirect influence on quality of life via self efficacy in the patients with CHD. Keywords: Coronary heart disease, Health literacy, Self efficacy, Quality of life, Structural equation modelling