The roles of health literacy and social support in improving adherence to self-care behaviours among older adults with heart failure.

The study only measured things at one time point, so it cannot show that health literacy or social support caused better self-care. It was done in one cardiac outpatient clinic in South Korea, and it excluded people needing haemodialysis, with terminal cancer, with psychiatric disease, or who were unable to communicate clearly due to cognitive impairment and residing in long-term care facilities, so results may not apply to all older adults with heart failure. Most participants had NYHA class I-II and left ventricular ejection fraction above 50%, so it says little about patients with more severe symptoms or reduced ejection fraction. Self-care was measured by patient report, not by observed behaviour or clinical outcomes such as readmission. The study did not examine types of social support separately, such as emotional, instrumental or informational support. It did not include factors such as cognitive function, depression or anxiety, which the authors note can affect heart failure self-care.

The authors reported no conflict of interest. The paper does not state a funding source.

Do not conclude that improving health literacy or social support will improve self-care. This was a cross-sectional survey of 252 older adults with heart failure, so it shows associations at one time point, not cause and effect.