The Mediating Role of General Self-Efficacy in Health Self-Management and Psychological Stress Among Older Adults in Shanghai: A Structural Equation Modeling Analysis.

BACKGROUND

Given the demographic shift towards an older population, it is crucial to understand the determinants and implications of psychological distress among this demographic group. This study explores the relationship between health self-management and psychological distress in older Chinese adults, focusing on the mediating role of general self-efficacy (GSE).

METHODS

We conducted a cross-sectional study in five districts of Shanghai from 1 November to 31 December 2021, employing a random cluster sampling method. Data were collected using the Health Self-Management Scale, the General Self-Efficacy Scale (GSES), and the Kessler-10 Scale. Out of 2050 participants approached, 1905 completed the survey, resulting in a response rate of 91.76%. Data analysis included correlation studies, hierarchical linear regression, and structural equation modeling.

RESULTS

The average Kessler-10 score among elderly individuals in Shanghai was 15.59 ± 6.35. Of these, 22.10% had mild psychological distress, 11.92% had moderate stress, and 5.30% had severe stress. We found significant negative correlations between psychological distress and health self-management (r = -0.34, < 0.05) and GSE (r = -0.26, < 0.05). Health self-management had a total effect of -0.284 (95%CI: -0.330 to -0.234) on psychological distress, with GSE mediating approximately 20.42% of this effect.

CONCLUSIONS

GSE plays a significant mediating role between health self-management and psychological distress. These findings highlight the importance of promoting health self-management and GSE to alleviate psychological distress among older adults in Shanghai. This approach could enhance holistic health outcomes and improve the quality of life within this growing population segment.