Chung?Ying Lin|Maryam Ganji|Mark D. Griffiths|Marie Ernsth Bravell|Anders Broström|Amir H. Pakpour
Mediated effects of insomnia, psychological distress and medication adherence in the association of eHealth literacy and cardiac events among Iranian older patients with heart failure: a longitudinal study
Hong Kong Polytechnic University|Tehran University of Medical Sciences|Nottingham Trent University|Jönköping University|Jönköping University|Linköping University Hospital|Qazvin University of Medical Sciences
given importance improving health patients heart failure present study examined temporal associations ehealth literacy insomnia psychological distress medication adherence quality life cardiac events among older patients heart failurewith longitudinal design older patients echocardiography verified heart failure n468 504 new york heart association class ii mean age 69373 years 238 men need cardiac care seven iranian university outpatient clinics went clinical examinations completed following questionnaires baseline ehealth literacy scale eheals assessing ehealth literacy 5item medication adherence report scale mars5 assessing medication adherence minnesota living heart failure questionnaire mlhfq assessing quality life insomnia severity index isi assessing insomnia hospital anxiety depression scale hads assessing psychological distress patients completed isi hads 3 months later mars5 6 months later also cardiac events collected 18 months later three mediation models conductedehealth literacy direct indirect effects insomnia psychological distress medication adherence quality life moreover ehealth literacy protecting effects cardiac events hazard ratio hr 053 95 confidence interval ci 037 065 mediators insomnia hr 019 95 ci 015 026 psychological distress hr 008 95 ci 005 012 medication adherence hr 005 95 ci 004 008as ehealth literacy protector patients heart failure healthcare providers may plan effective programmes improve ehealth literacy population additional benefits improving ehealth literacy heart failure may decreased insomnia psychological distress improved quality life well decreased cardiovascular events