Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Abstract

Background Chronic non-communicable diseases (CNCDs) are an urgent public health issue in China, especially among older adults. Hence, self-management is crucial for disease progression and treatment. Electronic health (e-health) literacy and self-efficacy positively correlate with self-management. However, we know little about their underlying mechanisms in older adults with CNCDs. Objective To explore the factors that influence chronic disease self-management (CDSM) and verify self-efficacy as the mediator between e-health literacy and self-management behavior in older patients with CNCDs. Methods This cross-sectional study included 289 older patients with CNCDs from Hunan province, China, between July and November 2021. E-health literacy, self-efficacy, social support, and CDSM data were collected through questionnaires. The influence of each factor on CDSM was explored with multiple linear regression analysis. Intermediary effects were computed via a structural equation model. Results The total CDSM score in the patients was 29.39 ± 9.60 and only 46 (15.92%) patients used smart healthcare devices. The regression analysis showed e-health literacy, self-efficacy, and social support were the factors that affected CDSM. Furthermore, the structural equation model revealed that self-efficacy directly affected CDSM (β = 0.45, P < 0.01), whereas e-health literacy affected it directly (β = 0.42, P < 0.01) and indirectly (β = 0.429, P < 0.01) through self-efficacy. Conclusions This study revealed that self-management among older patients with CNCDs is at a low level, and few of them use smart healthcare devices. Self-efficacy plays a partial intermediary role between e-health literacy and self-management in older patients with CNCDs. Thus, efforts to improve their CDSM by targeting e-health literacy may be more effective when considering self-efficacy.

Relationship Between Electronic Health Literacy and Self-Management in People With Type 2 Diabetes Using a Structural Equation Modeling Approach

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Self-management support (SMS) in primary care practice: a qualitative focus group study of care professionals’ experiences

“…To monitor SMS, focus group participants emphasise the use of practical tools and devices. Although this can be very useful, it is important to approach it cautiously (32,33), especially since several support techniques require digital skills from patients (34). In addition, the use of questionnaires to guide this dynamic process is well-described in literature and was also mentioned by the focus group participants (35,36).…”

Mediating Effect of Self-management on Health Empowerment and Quality of Life of Elderly Comorbid Patients

“…In China, the self-management of elderly patients with chronic diseases is still at a low level [8]. Most elderly people have limited knowledge of diseases, and their poor management may lead to additional complications and medical expenses, and at the same time have a certain impact on their quality of life [9]. Studies have shown that self-management of chronic diseases can improve the health status and quality of life of elderly patients with chronic diseases and reduce the incidence of complications [10].…”