This study was aimed to test the mediation effect of self-care on the associations of social support and heart failure (HF) knowledge with health-related quality of life (HRQOL). We analyzed baseline data from patients with HF (n = 122) enrolled in a randomized controlled trial. Mediation analysis was conducted using Hayes' PROCESS macro for SPSS with Model 4, based on the bias-corrected bootstrap method. Higher levels of social support and HF knowledge were associated with better self-care. Better self-care was associated with better HRQOL. While social support and HF knowledge had no significant direct effects on HRQOL, they indirectly affected HRQOL through self-care. Our findings suggest that social support and HF knowledge affect HRQOL indirectly through self-care. To improve the HRQOL in patients with HF, it is necessary to motivate them to perform regular self-care by enhancing their HF knowledge and providing social support.Clinical trial identifier: KCT0002400 (https://cris.nih.go.kr).
Keywords: heart failure; knowledge; quality of life; self-care; social support.