Background and Research Objective: Today’s complex health care system relies heavily on sophisticated self-care regimens. To navigate the system and follow self-care protocols, patients must be able to understand and use health information, which requires health literacy. However, nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Understanding how to effectively care for one’s self is thought to improve heart failure symptoms and patient outcomes, but little is actually known about how health literacy influences self-care in patients with heart failure. The purpose of this pilot study was to examine the relationship between health literacy and self-care of patients with heart failure.

Subjects and Methods: Patients with a diagnosis of heart failure were recruited from a variety of community settings. Participants completed the Short-Form Test of Functional Health Literacy (measured health literacy), the Self-Care Index of Heart Failure (measured self-care maintenance, management, and confidence), and a demographic questionnaire. Spearman’s Rho correlations were used to assess the strength of the relationship between health literacy level and self-care scores.

Results and Conclusions: Among the 49 participants recruited, health literacy was positively related to self-care maintenance (Rs=0.357, p=0.006). Health literacy had a negative relationship with self-care management (Rs=-0.573, p=0.001). There was no association between health literacy and self-care confidence (Rs=0.201, p=0.083). This project provides preliminary data regarding the association between health literacy and self-care in heart failure, showing support for higher health literate patients performing more self-care maintenance, which has been shown to improve patient outcomes in heart failure. Patients with higher health literacy trended toward having greater self-care confidence, which can increase the likelihood of performing self-care, but this finding was not significant. It was unexpected to find that lower health literate patients performed more self-care management.


This is the pre-peer reviewed version of the following article: Chen, A., Yehle, K., Plake, K., Murawski, M., & Mason, H. (2011). Health literacy and self-care of patients with heart failure. Journal of Cardiovascular Nursing, 26(11), 446-451, which has been published in final form at 10.1097/JCN.0b013e31820598d4.


Health Literacy, Self-Care, Heart Failure

Date of this Version