Dyadic Health Literacy and Its Association with Care Collaboration and Satisfaction in Heart Failure Patient–Caregiver Dyads: A Cross-Sectional Study

Background: Effective heart failure self-care depends on robust collaboration within patient-caregiver dyads. Health literacy is crucial for illness management, but its patterns and links to dyadic care collaboration and satisfaction are unclear. Objective: This study aimed to identify the latent profiles of health literacy in heart failure patient-caregiver dyads and to examine how these profiles relate to dyadic care collaboration and satisfaction with care type. Methods: A cross-sectional descriptive study was conducted. A total of 231 heart failure patient-caregiver dyads were recruited from four tertiary hospitals in Beijing, China, between September 2023 and August 2024. Health literacy was measured using the Heart Failure-Specific Health Literacy Scale (HFS-HLS), while dyadic collaboration and satisfaction were assessed via the Dyadic Symptom Management Type scale (DSMT). Latent profile analysis was conducted using Mplus 8.3 to identify distinct health literacy profiles. Binary logistic regression analyses were performed to evaluate the associations between dyadic health literacy profiles, dyadic care collaboration, and satisfaction. Results: Latent profile analysis identified two distinct health literacy profiles: a “Low Dyadic Health Literacy” group and a “High Dyadic Health Literacy” group. Binary logistic regression revealed that patient gender, number of hospitalizations, caregiver gender, and caregiver education level were significant independent predictors of profile membership. Dyads classified in the high health literacy profile were significantly more likely to engage in collaborative care and to report higher levels of caregiver satisfaction. Conclusion: Heart failure patient-caregiver dyads with higher levels of dyadic health literacy are more inclined to adopt collaborative care approaches and express greater satisfaction with their care arrangements. These findings suggest that routine assessment of dyadic health literacy in clinical settings may help identify at-risk dyads and guide interventions development. Plain Language Summary: Managing daily heart failure care can be both stressful and challenging for patients and their caregivers. Effective self-care requires not only knowledge but also close teamwork. This study aimed to understand how the shared health literacy of heart failure patient-caregiver dyads influences the way they work together and their satisfaction with the care they provide. Our findings show that patient-caregiver dyads with higher shared health literacy were more likely to engage in collaborative care-communicating more effectively and sharing care tasks in a coordinated way. Caregivers in these dyads also expressed higher levels of satisfaction with their care arrangements. These findings suggest that improving the joint health literacy of patients and caregivers can enhance teamwork and boost caregiver satisfaction. Therefore, healthcare providers should routinely assess and strengthen health literacy within the dyad, especially in families with lower education levels or higher caregiving burdens. Tailored support can then be offered to help them manage heart failure more effectively in everyday life. Keywords: heart failure, dyad, caregivers, health literacy