The effect of health literacy on quality of life in patients with heart failure: the mediating role of self-care confidence

Background Heart failure (HF) is a global epidemic that seriously affects the quality of life (QoL) of most patients. Self-care is an important factor affecting QoL, and health literacy (HL) plays a key role in self-care. However, the relationship between HL, self-care and QoL in patients with HF remains unclear. Objectives To explore whether self-care confidence mediates the relationship between HL and QoL in patients with HF. Methods A total of 320 HF patients from three hospitals in Chengdu, China were selected as the research subjects. Data were collected using the Chinese version of the HF HL scale, self-care confidence scale, and QoL scale. The influencing factors of QoL were analyzed by independent samples t-test, one-way analysis of variance, and multiple linear regression. Pearson correlation analysis was used to analyze the correlation between HL, self-care confidence and QoL. Mediating effects were analyzed and validated using the PROCESS macro (Model 4) and Bootstrap method. Results The HL score was (24.45 ± 9.44) points, the self-care confidence score was (33.66 ± 18.63) points, and the QoL score was (48.50 ± 13.32) points. HL was positively correlated with self-care confidence ( r = 0.807, P < 0.01), and negatively correlated with QoL ( r = −0.472, P < 0.01). Self-care confidence was negatively correlated with QoL ( r = −0.454, P < 0.01). The total effect value of HL on QoL was −0.666, and the mediating effect value was −0.240. Self-care confidence played a mediating role between HL and QoL, and the mediating effect accounted for 36%. Conclusions HL significantly impacts QoL, and self-care confidence mediates the relationship between HL and QoL. Therefore, in the care of HF patients, healthcare professionals should focus on improving patients' HL and self-care confidence. It is recommended to implement targeted health education programs for patients in clinical practice, emphasizing disease management knowledge and cultivating self-care confidence to further reduce the risk of readmission for HF patients and optimize overall prognosis.