To investigate the chain mediating effect of family health and self-efficacy in the relationship between health literacy and self-management behaviors in older adults with chronic comorbidities.
Based on data from the 2021 Psychology and Behavior Investigation of Chinese Residents, 310 patients aged ≥60 years with chronic comorbidities were selected for the study. They were investigated using the Health Literacy Scale (HLS-SF12), Chronic Disease Self-Management Behavior Scale, Family Health Scale (FHS-SF), and New General Self-Efficacy Scale (NGSES). Partial correlation analysis was used to explore the correlation between health literacy, family health, self-efficacy, and self-management behaviors. The chain mediating effect was analyzed using Model 6 of the PROCESS 4.2 plugin in SPSS 27.0.
Family health and self-efficacy played a chain mediating role in the relationship between health literacy and self-management behaviors. The direct effect of health literacy on self-management behaviors was significant (β=0.446, 95% CI: 0.239-0.653), accounting for 66.87% of the total effect. The separate mediating effect of family health was significant (β=0.071, 95% CI: 0.004-0.154), accounting for 10.64% of the total effect. The separate mediating effect of self-efficacy was significant (β=0.117, 95% CI: 0.043-0.206), accounting for 17.54% of the total effect. The chain mediating effect of family health and self-efficacy was also significant (β=0.034, 95% CI: 0.010-0.067), accounting for 5.10% of the total effect.
Health literacy not only directly influences self-management behaviors of elderly patients with chronic comorbidities, but also indirectly through family health and self-efficacy as separate or chain-mediated pathways. It is recommended to promote the self-management behaviors of elderly patients with chronic comorbidities in a multidimensional way by enhancing health literacy, improving the family health environment, and increasing self-efficacy.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |