Objective To explore the effect of health education based on solution-focused model on postoperative self-efficacy and compliance in female patients with chest keloid. Methods A total of 80 female patients with chest keloid admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science&Technology from August 2024 to March 2026 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received conventional nursing, and the observation group received health education based on solution-focused model on the basis of the control group. The self-efffcacy, compliance and psychological status were compared between the two groups. Results After intervention, the GSES score in the two groups was higher than that before intervention, and that of the observation group was higher than that of the control group (P<0.05). The compliance rate of the observation group (95.00%) was higher than that of the control group (80.00%) (P<0.05). The scores of anxiety, depression, somatization and interpersonal sensitivity in the two groups after intervention were lower than those before intervention, and those in the observation group were lower than those in the control group (P<0.05). Conclusion Health education intervention based on solution-focused model for female patients with chest keloid can effectively improve patients’ postoperative self-efffcacy and compliance, and help to ameliorate their psychological status.