BACKGROUND: Improvement of self-care behaviour is an aim of several non-pharmacological nurse-led management programmes for patients with heart failure. These programmes are often evaluated based on their effects on readmission, costs and quality of life. It is, however, also important to know how patients changed their self-care behaviour as a result of such a programme. Therefore a comprehensive, reliable and valid measure of the self-care behaviour of HF patients is needed. OBJECTIVES: To develop a scale measuring the behaviour that heart failure patients perform to maintain life, healthy functioning, and well-being. METHOD: The European Heart Failure Self-Care Behaviour Scale (EHFScBS) was developed in three phases: (1) concept analysis and first construction; (2) revision of items and response and scoring format; and (3) testing of the new scale for validity and reliability. RESULTS: The European Heart Failure Self-Care Behaviour Scale is a 12-item, self-administered questionnaire that covers items concerning self-care behaviour of patients with heart failure. Face-validity and concurrent validity was established and the internal consistency of the scale was tested using pooled data of 442 patients from two centres in Sweden, three in the Netherlands and one in Italy. Cronbachs's alpha was 0.81. CONCLUSION: The instrument is a valid, reliable and practical scale to measure the self-reported self-care behaviour of heart failure patients. It is ready to use by investigators evaluating the outcome of heart failure management programmes that target changes in patients' self-care practices.