Health Literacy, Disease Knowledge and Challenges Experienced After Cardiac Surgery: A Mixed Method Study

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Abstract
Introduction: This study aimed to identify the challenges faced after cardiac surgery and the factors that influence therapeutic adherence through the use of mixed methods associated with health literacy (HL) and coronary artery disease (CAD) knowledge. Objective: To assess the disease knowledge and HL in patients who underwent coronary artery bypass grafting (CABG) post-myocardial infarction, and identify the challenges experienced during cardiac rehabilitation. Method: A convergent parallel mixed-methods study was conducted in southern Brazil with 24 patients aged ≥18 years. Quantitative data were collected using the Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV) and the Eight-Item Health Literacy Assessment Tool (HLAT-8). Data were analyzed with descriptive and inferential statistics. The qualitative data was obtained through semi-structured interviews and analyzed using the IRAMUTEQ® software. Results: Most participants demonstrated unsatisfactory HL (58.3 %) and acceptable disease knowledge (54.1 %). The qualitative analysis identified three categories: Feelings experienced during the surgical process and rehabilitation; (mis)guidance and (mis)information related to care; and daily life transformed by the surgical procedure. Data integration revealed divergences and convergences when regarding knowledge, lifestyle changes, and risk factors. Conclusion: HL and disease knowledge were insufficient. The main challenge in rehabilitation is the lack of understanding of healthcare guidelines to support lifestyle changes.

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