Health literacy is independently associated with self-care behavior in patients with heart failure

•Poorer adherence to self-care behavior correlated with patients with lower HL.•Critical HL was an independent predictor of self-care behavior in patients with HF.•It is necessary for HF patients to measure the communicative and critical HL.•To improve patient skills for critically analyzing information is effective.

ObjectiveHealth literacy (HL) has been recognized as an important concept in patient education and disease management for heart failure (HF). However, previous studies on HL have focused predominantly on the relationships between functional HL (the ability to read and write), comprehensive HL including the ability to access information (communicative HL), and the ability to critically evaluate information (critical HL). Self-care behavior has not been evaluated. This study determined the relationship between functional, communicative, and critical HL and self-care behavior in HF patients.MethodsCross-sectional analysis of the data was completed for HL, HF-related knowledge, and HF-related self-care behaviors. Sociodemographic and clinical characteristics were also assessed. Multivariate linear regression analysis was used to estimate the associations between literacy and self-care behavior.Results249 patients with HF were assessed (mean age, 67.7 ± 13.9 years). Patients with low HL had poorer knowledge and self-care behavior than those with high HL. Critical HL was an independent determinant of self-care behavior (sβ = −0.154, P = 0.027).ConclusionsCritical HL was independently associated with self-care behavior in HF patients.Practice implicationsEffective intervention should be developed to improve patient skills for critically analyzing information and making decisions.