The effect of education and counselling program on outcomes of patients with cardiac implantable electronic device and low health literacy

The aim of the study was to investigate the effect of the education and counseling program on the activities of daily life, CIED-related knowledge and health literacy levels of patients with cardiac implantable electronic device and low health literacy. The research consists of two phases. The first phase was conducted in a descriptive qualitative design with 18 patients in order to reveal the factors preventing the improvement of health literacy of patients with cardiac devices. Four main themes emerged in the study: "communication with health professionals", "individual characteristics", "lack of awareness of self-care responsibility" and "health system characteristics". The training and counseling program prepared for the barriers that emerged in the first phase was implemented in the second phase. The second phase was conducted as a randomized controlled trial with pre-post and control groups with 61 patients. Data were collected with the European Health Literacy Scale Q16, Implantable Electronic Cardiac Device Knowledge scale and Duke Activity Status Index. Data were collected by telephone and face-to-face interviews before the intervention and at 1, 3 and 6 months. Face-to-face education was given to the patients, comic books were given as written material and a counseling program was carried out for six months. Data were evaluated with number, percentage, mean, student t test, chi-square test, one-way and multi-way analysis of variance in repeated measures, Mann-Whitney U, Friedman, Wilcoxon tests in SPSS 29 package program. No difference was found between the intervention and control groups in terms of sociodemographic and medical characteristics (p>0.05). It was found that there was a statistically significant increase in the activity level, knowledge level and health literacy level of the patients in the intervention group (p<0.05). In addition, it was found that the activity level, knowledge level and health literacy level of the intervention group were significantly higher than the control group in post-intervention measurements (p<0.05). Therefore, it is thought that the education and counseling program positively affected the activity level, knowledge level and health literacy level. Keywords: Cardiac implantable electronic device, activities of daily life, knowledge level, health literacy