This study examined the eHealth literacy, health knowledge, health behavior of a population of older Chinese adults, and the impact of using library or community activities for health information seeking. A survey was conducted among 215 participants 45 years or older. Data were analyzed using chi-square test, one-way analysis of variance, bivariate correlation, and multiple regression. The results showed that participants who were urban residents, non-farm workers, and had 9 years of education or more were more likely to use the library or community activities for health information seeking. Health behavior had a significant relationship with eHealth literacy and health knowledge. Both eHealth literacy and health knowledge showed a significant positive relationship with using the library or community activities for health information. These results support the idea that libraries play an important role in providing high-quality eHealth literacy services to enhance healthy behavior and health outcomes in their communities.
Post-acute Care Services Received by Older Adults Following a Cardiac Event: A Population-based Analysis07/01/2010
Post-acute care (PAC) is available for older adults who need additional services after hospitalization for acute cardiac events. With the aging population and an increase in the prevalence of cardiac disease, it is important to determine current PAC use for cardiac patients to assist health care workers to meet the needs of older cardiac patients. The purpose of this study was to determine the current PAC use and factors associated with PAC use for older adults following hospitalization for a cardiac event that includes coronary artery bypass graft and valve surgeries, myocardial infarction (MI), percutaneous coronary intervention (PCI), and heart failure (HF).
METHODS AND RESULTS:
A cross-sectional design and the 2003 Medicare part A database were used for this study. The sample (n = 1493521) consisted of patients 65 years and older discharged after their first cardiac event. Multinomial logistic regression was used to examine factors associated with PAC use. Overall, PAC use was 55% for cardiac valve surgery, 50% for MI, 45% for HF, 44% for coronary artery bypass graft, and 5% for PCI. Medical patients use more skilled nursing facility care, and surgical patients use more home health care. Only 0.1% to 3.4% of the cardiac patients use intermediate rehabilitation facilities. Compared with those who do not use PAC, those who use home health care and skilled nursing facility care are older and female, have a longer hospital length of stay, and have more comorbidity. Asians, Hispanics, and Native Americans were less likely to use PAC after hospitalization for an MI or HF.
The current rate of PAC use indicates that almost half of nondisabled Medicare patients discharged from the hospital following a cardiac event use one of these services. Health care professionals can increase PAC use for Asians, Hispanics, and Native Americans by including culturally targeted communication. Optimizing recovery for cardiac patients who use PAC may require focused cardiac rehabilitation strategies.
What is Your Patient's Cognitive Profile? Three Distinct Subgroups of Cognitive Function in Persons with Heart Failure01/01/2015
The aim of this study was to determine whether patients with heart failure (HF) have distinct profiles of cognitive impairment.
Cognitive impairment is common in HF. Recent work found three cognitive profiles in HF patients—(1) intact, (2) impaired, and (3) memory-impaired. We examined the reproducibility of these profiles and clarified mechanisms.
HF patients (68.6 ± 9.7 years; N = 329) completed neuropsychological testing. Composite scores were created for cognitive domains and used to identify clusters via agglomerative-hierarchical cluster analysis.
A 3-cluster solution emerged. Cluster 1 (n = 109) had intact cognition. Cluster 2 (n = 123) was impaired across all domains. Cluster 3 (n = 97) had impaired memory only. Clusters differed in age, race, education, SES, IQ, BMI, and diabetes (ps ≤ .026) but not in mood, anxiety, cardiovascular, or pulmonary disease (ps ≥ .118).
We replicated three distinct patterns of cognitive function in persons with HF. These profiles may help providers offer tailored care to patients with different cognitive and clinical needs.