Mediating effect of self-efficacy on family health and health literacy among middle-aged and elderly patients with chronic diseases in rural areas
LI Yanbing1, ZHOU Shutong2, LI Yingying2, BI Shanlin2, LI Youwei2
1. School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu 211198, China; 2. School of Health Management, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
Abstract：Objective To explore the mediating effect of self-efficacy on family health and health literacy among middle-aged and elderly chronic diseases patients in rural areas, so as to provide a basis for developing targeted health literacy improvement strategies. Methods Based on the publicly available 2021 "Survey of Chinese Residents' Psychology and Behavior" database, rural chronic diseases patients aged >45 years were selected as the study subjects. Data on demographic information, family type, and chronic diseases comorbidities were collected. The Chinese simplified Family Health Scale, General Self-Efficacy Scale, and Health Literacy Scale were used to assess family health, self-efficacy, and health literacy, respectively. Correlation analysis was employed to explore the relationships between variables, and the 4.1 Process program was used to analyze the mediating effect of self-efficacy on family health and health literacy. The Bootstrap method was applied to test the significance of the mediating effect. Results A total of 449 participants were included, of whom 241 were male (53.67%) and 208 were female (46.33%). The majority (205 cases, 45.66%) were aged 60-<76 years. There were 168 cases (37.42%) with chronic disease comorbidities. The total score for family health was (37.96±6.25) points. The self-efficacy score was (27.28±5.40) points, the health literacy index was (27.72±8.08) points, and the health literacy proficiency rate was only 14.90% (67 patierts). Mediating effect analysis showed that family health could directly and positively influence health literacy, with a direct effect value of 0.090 (95%CI: 0.001-0.179). It could also indirectly and positively influence health literacy through self-efficacy, with a mediating effect value of 0.164 (95%CI: 0.099-0.234). The mediating effect accounted for 64.31% of the total effect. Conclusion Self-efficacy plays a positive mediating role between family health and health literacy among middle-aged and elderly chronic diseases patients in rural areas.
李燕冰, 周树彤, 李莹莹, 毕善琳, 李友卫. 农村中老年慢性病患者自我效能感在家庭健康与健康素养间的中介效应分析[J]. 预防医学, 2026, 38(1): 75-78,84.
LI Yanbing, ZHOU Shutong, LI Yingying, BI Shanlin, LI Youwei. Mediating effect of self-efficacy on family health and health literacy among middle-aged and elderly patients with chronic diseases in rural areas. Preventive Medicine, 2026, 38(1): 75-78,84.
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