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18-10-2019 | Uitgave 2/2020

Quality of Life Research 2/2020

Effect of health literacy on quality of life among patients with chronic heart failure in China

Quality of Life Research > Uitgave 2/2020
Junhua Zhang, Stuart Gilmour, Yancun Liu, Erika Ota
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Despite advances in treatment and management, Chronic heart failure (CHF) is still associated with poor prognosis, a high rate of hospitalization and readmission, and reduced quality of life (QOL). However, the relationship between QOL and health literacy in patients with CHF remains unclear. This study aimed to examine the association between health literacy and QOL, among Chinese patients with CHF.


This is a cross-sectional study of a convenience sample from a cardiovascular hospital in Henan Province in China. Subjects completed a self-administered questionnaire that assessed the heart failure-specific health literacy score. QOL was measured using the Minnesota Living with heart failure scale. Unadjusted and adjusted multiple linear regression were used to explore the association between health literacy and QOL.


This study sampled 299 patients, with a mean age of 61.9 ± 14.9 years old. The association between health literacy and QOL was significant only in the unadjusted model (P < 0.001) and was no longer statistically significant after controlling for covariates. The final best-fitted model identified 9 significant predictors, accounting for 38.6% of the variance in quality of life.


This study suggests that there is no relationship between health literacy and QOL in Chinese CHF patients after adjusting for covariates. Residence, monthly income, self-care management, self-efficacy and social support are significantly associated with QOL. Compared patients with high health literacy, patients with low health literacy may have problems comprehending healthcare information and following disease management instructions, which might contribute to diminished QOL. Therefore, in clinical practice, effective interventions such as creating appropriate materials for low-literacy patients and performing education to raise self-care management, self-efficacy, might improve the QOL of patients with CHF.

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