Development and Validation of a Health Literacy Scale for Patients With Cardiovascular Disease (HLS-CVD)

Abstract

Background: Assessing health literacy has become important as a component of strategies to increase self-care behaviour for patients with cardiovascular disease (CVD). Aim: This study aimed to develop a scale for measuring health literacy in patients with CVD and to evaluate its reliability and validity. Methods: This is an instrument development study with a psychometric analysis. The initial questions were based on the components identified in a concept analysis, and the reliability and validity were evaluated with 391 patients visiting outpatient hospitals due to CVD such as myocardial infarction, arrhythmia and heart failure. Results: The final scale consisted of 22 items across four factors: ‘Understanding and searching for health information’, ‘Actively selecting and evaluating health information’, ‘Utilization of health information resources’ and ‘Interacting with healthcare providers’. The four-factor structure demonstrated acceptable model fit in confirmatory factor analysis. Convergent and criterion validity were supported by significant correlations with established health literacy tools. Internal consistency was high (Cronbach's α = 0.891), and test–retest reliability was satisfactory. Conclusion: This health literacy scale for patients with CVD can be utilized in future surveys or intervention studies to enhance the self-care behaviour of individuals with CVD. Its psychometric analysis should be repeated with CVD patients in other countries or hospital settings.