Avaliação do conhecimento, letramento em saúde, autoeficácia para exercícios físicos e capacidade funcional em indivíduos hospitalizados por doenças cardiovasculares

Abstract

Introduction: Health education is a central component of cardiac rehabilitation (CR), including during hospitalization, a period when patients may be more receptive to behavior change. However, factors such as disease-related knowledge, health literacy, information needs, and exercise self-efficacy may influence the development and effectiveness of educational interventions. Therefore, the aim of this study was to assess, in individuals hospitalized for cardiovascular disease (CVD), the factors related to health education and their correlation with functional capacity. Methods: This was an exploratory study including adult individuals hospitalized due to cardiovascular conditions, who were assessed at hospital discharge regarding disease-related knowledge (Coronary Artery Disease Education Questionnaire – Short Version, CADE-Q SV), health literacy (14-item Health Literacy Scale, HLS-14), information needs (Information Needs in Cardiac Rehabilitation Questionnaire, INCR), and exercise self-efficacy (Bandura’s Exercise Self-Efficacy Scale, BESES), in addition to functional capacity (six-minute walk test - 6MWT). After three months, participants were contacted by telephone to record the occurrence of death, rehospitalization, return to work, engagement in physical exercise, and participation in outpatient CR. Descriptive analyses, Spearman’s correlation, and the chi-square test were performed. Results: A total of 95 individuals were included, with a mean age of 58.8±12.6 years; most had low educational attainment (61.1%) and low income (71.6%). The main cause of hospitalization was acute coronary syndrome (36.8%), with a median length of stay of 8 (518) days. Although disease-related knowledge was classified as "good" (73% correct answers), 71.3% had low health literacy and reported high information needs. Exercise selfefficacy was low (57.9%), and functional capacity was reduced (6MWT distance = 375±103 m; 66% of predicted). At three-month follow-up, 2.9% of the individuals had died, 18.8% were rehospitalized, and 11.9% had initiated outpatient CR. Approximately 54% reported engaging in physical exercise and 55% had returned to work. No significant correlations were found between health education variables and functional capacity or follow-up outcomes. Conclusion: Individuals hospitalized for CVD presented, at hospital discharge, low health literacy and low exercise self-efficacy. After three months, they showed limited adherence to outpatient CR and physical exercise. These findings reinforce the importance of personalized and early initiated health education programs during hospitalization to support recovery and continuity of care.