Objective: To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease. Methods: A hundred young and middle-aged patients with coronary heart disease from our hospital between March and October 2024 were randomly divided into an observation group and a control group, with 50 patients in each group. Both groups received routine nursing intervention, while the observation group also received intervention based on the Stages of Change (SOC) model. The intervention period was 30 days. Changes in self-efficacy, health literacy, and disease uncertainty were compared between the two groups before and after the intervention. Results: After the intervention, the self-efficacy scores of both groups increased significantly, and the observation group had higher self-efficacy scores than the control group, with a significant difference (P < 0.05). Additionally, the observation group showed significantly higher levels of health literacy than the control group (P < 0.001). Furthermore, the observation group had significantly lower scores for disease uncertainty compared to the control group (P < 0.001). Conclusion: The SOC model, in addition to routine nursing, significantly affects self-efficacy, disease uncertainty, and health literacy among young and middle-aged patients with coronary heart disease. It helps to enhance patients’ knowledge of coronary heart disease, improve health literacy levels, and reduce disease uncertainty, making it worthy of clinical promotion and application.