Lin Chunni, Zhu Xiayi, Wang Xiaohui, Wang Lingyue, Wu Ying, Hu Xiang, Wen Jing, Cong Li
Health Science Center , Hunan Normal University, 371 Tongzipo Road, Changsha, 410013, China.
Kiang Wu Nursing College of Macau, Macao, Macao SAR, 999078, China.
BMC Geriatr. 2025 Apr 26;25(1):284. doi: 10.1186/s12877-025-05902-z.
Chronic disease self-management is a critical concern in public health, in which perceived social support plays an important role. However, the underlying pathways and mechanisms linking perceived social support to chronic disease self-management remained unclear. This study investigated whether psychological resilience and health empowerment mediated the relationship between perceived social support and the effectiveness of chronic disease self-management.
A total of 368 older inpatients with chronic non-communicable diseases were recruited from three grade-A tertiary hospitals in Changsha City, China, using a convenience sampling method between January and June 2023. Data were collected using the General Information Questionnaire, the Chronic Disease Self-Management Scale, the Perceived Social Support Scale, the Connor-Davidson Resilience Scale, and the Health Empowerment Scale. Descriptive demographic analysis and Pearson correlation analysis were conducted using SPSS 26.0, and model 6 in the macro program Process 4.1 was employed to test the chain mediation effect.
Most older inpatients were aged 60-69 years (52.2%), followed by those aged 70-79 years (30.7%). Regression analysis revealed that perceived social support, psychological resilience, and health empowerment collectively explained 45.7% of the variance in chronic disease self-management. Mediation analysis demonstrated that perceived social support not only had a direct positive impact on chronic disease self-management (effect = 0.141, 95% CI: LL = 0.041, UL = 0.241), but also indirectly affected chronic disease self-management through three significant mediating pathways: the independent mediating effect of psychological resilience (effect = 0.102, 95% CI: LL = 0.061, UL = 0.155), the independent mediating effect of health empowerment (effect = 0.042, 95% CI: LL = 0.010, UL = 0.080), and the chain mediating effect between psychological resilience and health empowerment (effect = 0.024, 95% CI: LL = 0.006, UL = 0.047).
Perceived social support influenced chronic disease self-management directly and indirectly through psychological resilience and health empowerment. These findings offered practical guidance for developing more effective intervention strategies aimed at improving chronic disease self-management among older inpatients.
慢性病自我管理是公共卫生领域的一个关键问题，其中感知到的社会支持起着重要作用。然而，将感知到的社会支持与慢性病自我管理联系起来的潜在途径和机制仍不清楚。本研究调查了心理韧性和健康赋权是否介导了感知到的社会支持与慢性病自我管理效果之间的关系。
2023年1月至6月，采用便利抽样法，从中国长沙市的三家三级甲等医院招募了368名患有慢性非传染性疾病的老年住院患者。使用一般信息问卷、慢性病自我管理量表、感知社会支持量表、康纳-戴维森韧性量表和健康赋权量表收集数据。使用SPSS 26.0进行描述性人口统计学分析和Pearson相关分析，并采用宏观程序Process 4.1中的模型6来检验链式中介效应。
大多数老年住院患者年龄在60 - 69岁之间（52.2%），其次是70 - 79岁的患者（30.7%）。回归分析显示，感知到的社会支持、心理韧性和健康赋权共同解释了慢性病自我管理中45.7%的变异。中介分析表明，感知到的社会支持不仅对慢性病自我管理有直接的正向影响（效应 = 0.141，95%置信区间：下限 = 0.041，上限 = 0.241），而且还通过三条显著的中介途径间接影响慢性病自我管理：心理韧性的独立中介效应（效应 = 0.102，95%置信区间：下限 = 0.061，上限 = 0.155）、健康赋权的独立中介效应（效应 = 0.042，95%置信区间：下限 = 0.010，上限 = 0.080）以及心理韧性和健康赋权之间的链式中介效应（效应 = 0.024，95%置信区间：下限 = 0.006，上限 = 0.047）。
感知到的社会支持通过心理韧性和健康赋权直接和间接地影响慢性病自我管理。这些发现为制定更有效的干预策略提供了实践指导，旨在改善老年住院患者的慢性病自我管理。
