SavedAdd your journal

Journals / Ege Üniversitesi Hemşirelik Fakültesi Dergisi / 2026 / Cilt: 41 Sayı: 2

Determination of the Relationship Between Medication Adherence, Self-Efficacy, and Health Literacy in Patients Receiving Anticoagulant Medication: A Cross-Sectional Study

Antikoagülan ilaç kullanan hastalarda ilaç uyumu, öz yeterlilik ve sağlık okuryazarlığı arasındaki ilişkinin belirlenmesi: Kesitsel Bir Çalışma

Eda Ayten Kankaya(Dokuz Eylül Üniversitesi Hemşirelik Fakültesi)0000-0002-2519-4732
Özlem Bilik(DOKUZ EYLÜL ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)0000-0002-8372-8974
Aylin Durmaz Edeer(DOKUZ EYLÜL ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)0000-0002-0681-5863
Pages
239–247
Publication Date
2025-08-22
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It was found that there was no difference between the groups according to gender (p=0.06; p=0.052), marital status (p=0.65; p=0.98) and educational status (p=0.25; p=0.26) in the subscales of medication use and protection from complications.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Determination of the relationship between medication adherence, self-efficacy and health literacy in patients receiving anticoagulant medication : A cross-sectional study Objective: The aim of this study was to examine the relationship between self-efficacy and health literacy with treatment adherence in patients using non-vitamin K antagonist oral anticoagulants and warfarin.
📊
Key Findings & Data:Data were collected by the researchers between September 2021 and September 2022 by using the sociodemographic-clinical characteristics form, Self-Efficacy Scale, Anticoagulant Therapy Adherence Scale and Health Literacy Scale and by face-to-face interviews with patients.
💡
Conclusion & Impact:It was found that there was no difference between the groups according to gender (p=0.06; p=0.052), marital status (p=0.65; p=0.98) and educational status (p=0.25; p=0.26) in the subscales of medication use and protection from complications.
🔬Design:Araştırma Makalesi
📍Scope:2021 Verileri
⚙️Variables:hemşirelik · ilaç uyumu · sağlık okur yazarlığı

Abstract

Determination of the relationship between medication adherence, self-efficacy and health literacy in patients receiving anticoagulant medication : A cross-sectional study Objective: The aim of this study was to examine the relationship between self-efficacy and health literacy with treatment adherence in patients using non-vitamin K antagonist oral anticoagulants and warfarin. MEthods: This study was cross-sectional and correlational. The study was conducted in the cardiovascular surgery inpatient clinic of a university hospital. Data were collected by the researchers between September 2021 and September 2022 by using the sociodemographic-clinical characteristics form, Self-Efficacy Scale, Anticoagulant Therapy Adherence Scale and Health Literacy Scale and by face-to-face interviews with patients. Results: The mean age of the patients who participated in the study was 61.34±17.43 years and 62.61% (n=67) were male. It was found that there was no difference between the groups according to gender (p=0.06; p=0.052), marital status (p=0.65; p=0.98) and educational status (p=0.25; p=0.26) in the subscales of medication use and protection from complications. It was determined that there was a weak positive correlation between health literacy and medication use (ρ=0.344, p<0.001); and there was a moderate positive correlation between the complication prevention sub-dimension (r=0.44, p<0.001). As the health literacy and self efficacy levels of the patients increased, the mean scores of anticoagulant therapy medication use and anticoagulant therapy protection from complications increased. Conclusion: Self-efficacy and health literacy may improve medication adherence and prevention of complications in patients receiving anticoagulant therapy.

Özet

Antikoagülan ilaç kullanan hastalarda ilaç uyumu, öz yeterlilik ve sağlık okuryazarlığı arasındaki ilişkinin belirlenmesi : Kesitsel Bir Çalışma Öz: Bu çalışmanın amacı, yeni nesil antikoagulan ve varfarin kullanan hastalarda öz yeterlilik ve sağlık okuryazarlığı ile tedavi uyumu arasındaki ilişkiyi incelemektir. Yöntem: Bu çalışma kesitsel ve korelasyoneldir. Çalışma bir üniversite hastanesinin kardiyovasküler cerrahi yatan hasta kliniğinde yürütülmüştür. Veriler Eylül 2021-Eylül 2022 tarihleri arasında araştırmacılar tarafından sosyodemografik-klinik özellikler formu, Öz Yeterlilik Ölçeği, Antikoagülan Tedaviye Uyum Ölçeği ve Sağlık Okuryazarlığı Ölçeği kullanılarak ve hastalarla yüz yüze görüşülerek toplanmıştır. Bulgular: Çalışmaya katılan hastaların yaş ortalaması 61.34±17.43 yıl olup, %62.61'i (n=67) erkektir. İlaç kullanımı ve komplikasyonlardan korunma alt ölçeklerinde cinsiyet (p=0.06; p=0.052), medeni durum (p=0.65; p=0.98) ve eğitim durumuna (p=0.25; p=0.26) göre gruplar arasında fark olmadığı saptandı. Sağlık okuryazarlığı ile ilaç kullanımı arasında pozitif yönde zayıf bir korelasyon (ρ=0.344, p<0.001); komplikasyondan korunma alt boyutu arasında ise pozitif yönde orta düzeyde bir korelasyon (r=0.44, p<0.001) olduğu tespit edilmiştir. Hastaların sağlık okuryazarlığı düzeyleri ve öz yeterlik düzeyleri arttıkça antikoagülan tedavi ilaç kullanımı ve antikoagülan tedavinin komplikasyonlardan koruma puan ortalamaları da artmıştır. Sonuç: Öz yeterlilik ve sağlık okuryazarlığı antikoagülan tedavi alan hastalarda ilaç uyumu ve komplikasyonlardan korunmayı arttırabilir. Anahtar kelimeler: Hemşirelik, ilaç uyumu, sağlık okur yazarlığı, öz yeterlik

🔖

Cite This Article

Kankaya, E. A., Bilik, Ö., Edeer, A. D. (2025). Determination of the Relationship Between Medication Adherence, Self-Efficacy, and Health Literacy in Patients Receiving Anticoagulant Medication: A Cross-Sectional Study. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, Cilt: 41 Sayı: 2, 239–247. https://doi.org/10.53490/egehemsire.1404894

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (41)

  1. Agralı, H., & Akyar, I. (2018). Diyabetli erişkin hastalarda sağlık okuryazarlığı: Ölçek geçerlik ve güvenirlik çalışması. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, (3), 314-321. https://doi.org/10.31067/0.2018.31
  2. An, N., & Park, I.S. (2016). The effect of health literacy and self-efficacy on treatment adherence of hypertensive elders. Indian Journal of Science and Technology, 9, 25. https://doi.org/10.17485/ijst/2016/v9i25/97205
  3. Aras, Z., & Bayık Temel, A. (2017). Evaluation of validity and reliability of the Turkish version of health literacy scale. Florence Nightingale Journal of Nursing, 25(2), 85-94. https://dergipark.org.tr/en/pub/fnjn/issue/30823/333466
  4. Bandura, A. (1994). Regulative function of perceived self-efficacy. In M. G. Rumsey, C. B. Walker, & J. H. Harris (Eds.), Personnel selection and classification (pp. 261–271). Lawrence Erlbaum Associates, Inc.
  5. Cabellos-García, A. C., Martínez-Sabater, A., Castro-Sánchez, E., Kangasniemi, M., Juárez-Vela, R., & Gea-Caballero, V. (2018). Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review. BMC Public Health, 18(1), 1157. https://doi.org/10.1186/s12889-018-6070-9
  6. Cabellos-García, A. C., Martínez-Sabater, A., Díaz-Herrera, M. Á., Gea-Caballero, V., & Castro-Sánchez, E. (2021). Health literacy of patients on oral anticoagulation treatment- individual and social determinants and effect on health and treatment outcomes. BMC Public Health, 21(1), 1363. https://doi.org/10.1186/s12889-021-11259-w
  7. Castellucci, L. A., Shaw, J., van der Salm, K., Erkens, P., Le Gal, G., Petrcich, W., & Carrier, M. (2015). Self-reported adherence to anticoagulation and its determinants using the Morisky medication adherence scale. Thrombosis Research, 136(4), 727–731. https://doi.org/10.1016/j.thromres.2015.07.007
  8. Chen, A. M., Yehle, K. S., Albert, N. M., Ferraro, K. F., Mason, H. L., Murawski, M. M., & Plake, K. S. (2013). Health Literacy Influences Heart Failure Knowledge Attainment but Not Self-Efficacy for Self-Care or Adherence to Self-Care over Time. Nursing Research and Practice, 353290. http://dx.doi.org/10.1155/2013/353290
  9. Chen, P. T., Wang, T. J., Hsieh, M. H., Liu, J. C., Liu, C. Y., Wang, K. Y., & Laio, W. C. (2019). Anticoagulation adherence and its associated factors in patients with atrial fibrillation: a cross-sectional study. BMJ Open, 9(9), e029974. https://doi.org/10.1136/bmjopen-2019-029974
  10. Chiu, P. E., Tsao, H. M., & Tsai, C. H. (2020). Discrepancy Among Self-Reported Adherence, Prescription Refills, and Actual Anticoagulant Control. The Journal of Nursing Research, 28(1), e63. https://doi.org/10.1097/jnr.0000000000000374
  11. Choudhry, N. K., Krumme, A. A., Ercole, P. M., Girdish, C., Tong, A. Y., Khan, N. F., Brennan, T. A., Matlin, O. S., Shrank, W. H., & Franklin, J. M. (2017). Effect of Reminder Devices on Medication Adherence: The REMIND Randomized Clinical Trial. JAMA Internal Medicine, 177(5), 624–631. https://doi.org/10.1001/jamainternmed.2016.9627
  12. Dumas, S., Rouleau-Mailloux, E., Bouchama, N., Lahcene, H., Talajic, M., Tardif, J. C., Gaulin, M. J., Provost, S., Dubé, M. P., & Perreault, S. (2016). Pillbox Use and INR Stability in a Prospective Cohort of New Warfarin Users. Journal of Managed Care & Specialty Pharmacy, 22(6), 676–684. https://doi.org/10.18553/jmcp.2016.22.6.676
  13. Erdoğan, S., Nahcivan, N., & Esin, M. N. (2014). Research in nursing: Process, practice and critique. Nobel Bookstore.
  14. Gözüm, S., & Aksayan, S. (1999). Öz-etkililik-yeterlik ölçeği'nin Türkçe formunun güvenilirlik ve geçerliliği. Journal of Anatolia Nursing and Health Sciences, 2(1), 21-34. https://dergipark.org.tr/tr/pub/ataunihem/issue/2615/33667
  15. Huang, Y. M., Shiyanbola, O. O., & Smith, P. D. (2018). Association of health literacy and medication self-efficacy with medication adherence and diabetes control. Patient Preference and Adherence, 12, 793–802. http://dx.doi.org/10.2147/PPA.S153312
  16. Jimmy, B., & Jose, J. (2011). Patient medication adherence: measures in daily practice. Oman Medical Journal, 26(3), 155–159. https://doi.org/10.5001/omj.2011.38
  17. Kankaya, E. A., & Bilik, Ö. (2018). Anticoagulant treatment compliance after heart valve prosthesis. Turkish Journal of Cardiovascular Nursing, 9(18), 29-34. https://doi.org/10.5543/khd.2018.19870
  18. Kankaya, E. A., & Bilik, Ö. (2022). Development of an Adherence to Anticoagulant Therapy Scale: A Validity and Reliability Study. Journal of Basic and Clinical Health Sciences, 6(3), 815-823. https://doi.org/10.30621/jbachs.1032020
  19. Khouja, C., Brunton, G., Richardson, M., Stokes, G., Blanchard, L., Burchett, H., Khatwa, M., Walker, R., Wright, K., Sowden, A., & Thomas, J. (2022). Oral anticoagulants: a systematic overview of reviews on efficacy and safety, genotyping, self-monitoring, and stakeholder experiences. Systematic Reviews, 11(1), 232. https://doi.org/10.1186/s13643-022-02098-w
  20. Lee, T. W., Lee, S. H., Kim, H. H., & Kang, S. J. (2012). Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review. Asian Nursing Research, 6(4), 128–136. https://doi.org/10.1016/j.anr.2012.09.001
  21. Lima, P. R. G., Gonçalves, G. M. S., Rodrigues, R. C. M., & Oliveira-Kumakura, A. R. S. (2021). Factors related to patient adherence to the use of new oral anticoagulants. Revista da Escola de Enfermagem da USP, 56, e20210191. https://doi.org/10.1590/1980-220X-REEUSP-2021-0191
  22. Ni, Y. X., Liu, L. L., Feng, H., Li, Z., Qin, C. Y., & Chen, M. (2023). Adherence, belief, and knowledge about oral anticoagulants in patients with bioprosthetic heart valve replacement: a cross-sectional study. Frontiers in Pharmacology, 14, 1191006. https://doi.org/10.3389/fphar.2023.1191006
  23. Obamiro, K. O., Chalmers, L., Lee, K., Bereznicki, B. J., & Bereznicki, L. R. (2018). Adherence to Oral Anticoagulants in Atrial Fibrillation: An Australian Survey. Journal of Cardiovascular Pharmacology and Therapeutics, 23(4), 337–343. https://doi.org/10.1177/1074248418770201
  24. Öncü, E., Vayısoğlu, S. K., Güven, Y., Aktaş, G., Ceyhan, H., & Karakuş, E. (2020). Bir il örneğinde hipertansiyon hastalarının sağlık okuryazarlık düzeyi, sağlık hizmetlerinin niteliğine ilişkin değerlendirmeleri ve ilişkili faktörler. Turkish Journal of Public Health, 18(1), 10-25. https://doi.org/10.20518/tjph.555354
  25. Özalp-Türetgen, İ., & Cesur, S. (2005). Öz Etkinlik Ölçeği’nin psikometrik özellikleri-I. Öneri Dergisi, 24(6), 305–312. https://doi.org/10.14783/maruoneri.681022
  26. Park, S., & Jang, I. (2021). Factors Affecting Medication Adherence in Patients with Mechanical Heart Valves Taking Warfarin: The Role of Knowledge on Warfarin, Medication Belief, Depression, and Self-Efficacy. International Journal of Environmental Research and Public Health, 18(10), 5214. https://doi.org/10.3390/ijerph18105214
  27. Polsook, R., Aungsuroch, Y., & Thongvichean, T. (2016). The effect of self-efficacy enhancement program on medication adherence among post-acute myocardial infarction. Applied Nursing Research, 32, 67–72. https://doi.org/10.1016/j.apnr.2016.05.002
  28. Rolls, C. A., Obamiro, K. O., Chalmers, L., & Bereznicki, L. R. E. (2017). The relationship between knowledge, health literacy, and adherence among patients taking oral anticoagulants for stroke thromboprophylaxis in atrial fibrillation. Cardiovascular Therapeutics, 35(6), e12304. https://doi.org/10.1111/1755-5922.12304
  29. Rymer, J. A., Chiswell, K., Young, L., Chiu, A., Liu, L., Webb, L., Carlisle, M., Friedman, D., & Wang, T. Y. (2023). Analysis of Oral Anticoagulant Dosing and Adherence to Therapy Among Patients With Nonvalvular Atrial Fibrillation. JAMA Network Open, 6(6), e2317156. https://doi.org/10.1001/jamanetworkopen.2023.17156
  30. Salmasi, S., Loewen, P. S., Tandun, R., Andrade, J. G., & De Vera, M. A. (2020). Adherence to oral anticoagulants among patients with atrial fibrillation: a systematic review and meta-analysis of observational studies. BMJ Open, 10(4), e034778. https://doi.org/10.1136/bmjopen-2019-034778
  31. Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982). The self-efficacy scale: Construction and validation. Psychological Reports, 51(2), 663-671. http://dx.doi.org/10.2466/pr0.1982.51.2.663
  32. Smits, E., Andreotti, F., Houben, E., Crijns, H. J. G. M., Haas, S., Spentzouris, G., Schink, T., Gini, R., Bartolini, C., Penning-van Beest, F., & Herings, R. (2022). Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany. Drugs - Real World Outcomes, 9(2), 199–209. https://doi.org/10.1007/s40801-021-00289-w
  33. Sørensen, K., Van den Broucke, S., Pelikan, J. M., Fullam, J., Doyle, G., Slonska, Z., Kondilis, B., Stoffels, V., Osborne, R. H., Brand, H., & HLS-EU Consortium. (2013). Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13, 948. http://www.biomedcentral.com/1471-2458/13/948
  34. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics. Boston, Pearson.
  35. Toci, E., Burazeri, G., Jerliu, N., Sørensen, K., Ramadani, N., Hysa, B., & Brand, H. (2015). Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo. Health Promotion International, 30(3), 667–674. https://doi.org/10.1093/heapro/dau009
  36. Tran, M. H., Nguyen, H. H., Mai, Q. K., & Pham, H. T. (2023). Knowledge and medication adherence of oral anticoagulant-taking patients in Vietnam. Research and Practice in Thrombosis and Haemostasis, 7(1), 100044. https://doi.org/10.1016/j.rpth.2023.100044
  37. Witt, D. M., Nieuwlaat, R., Clark, N. P., Ansell, J., Holbrook, A., Skov, J., Shehab, N., Mock, J., Myers, T., Dentali, F., Crowther, M. A., Agarwal, A., Bhatt, M., Khatib, R., Riva, J. J., Zhang, Y., & Guyatt, G. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy. Blood Advances, 2(22), 3257–3291. https://doi.org/10.1182/bloodadvances.2018024893
  38. World Health Organization. Improving health literacy. https://www.who.int/activities/improving-health-literacy (Access date: 05.06.2023)
  39. Xiang, X., Cao, Y., Sun, K., Song, J., Tian, Y., Yin, Q., Juan, J., & Hu, Y. (2018). Real world adherence to oral anticoagulant in non-valvular atrial fibrillation patients in China. Current Medical Research and Opinion, 34(2), 255–261. https://doi.org/10.1080/03007995.2017.1391760
  40. Yıldırım, F., & İlhan, İ. Ö. (2010). Genel öz yeterlilik ölçeği Türkçe formunun geçerlilik ve güvenilirlik çalışması. Türk Psikiyatri Dergisi, 21(4), 301-308. https://www.turkpsikiyatri.com/PDF/C21S4/301-308.pdf
  41. Yılmaz Güven, D., Bulut, H., & Öztürk, S. (2018). Examining the Health Literacy Levels of Health Sciences Faculty Students. Tarih Kultur ve Sanat Arastırmaları Dergisi, 7(2). http://doi.org/10.7596/taksad.v7i2.1511