Chen Qingru, Gong Ke, Bao Zhijun, Yin Yuanfang, Zhao Lirong, Chen Yan-Yan
Medical Social Work Department, Huadong Hospital, Fudan University, Shanghai 200031, China.
Shanghai Institute of Geriatrics and Gerontology, Shanghai 200031, China.
Healthcare (Basel). 2025 Jul 7;13(13):1626. doi: 10.3390/healthcare13131626.
The mechanisms through which information and communication technology (ICT) use influences chronic disease self-management remain unclear. This cross-sectional investigation examined the mediating effects of health literacy, social support, and self-efficacy on the association between ICT use and self-management behaviors among older adults (≥60 years) with comorbidities in China ( = 520). The participants were recruited from a tertiary hospital in Shanghai (July 2023-June 2024), and data on sociodemographics, self-management, health literacy, social support, self-efficacy, and ICT use were collected via structured questionnaires. Pearson's correlation analysis revealed a significant association between ICT use, health literacy, social support, self-efficacy, and chronic disease self-management ( < 0.001). Multiple mediation modeling revealed a direct positive effect of ICT use on self-management ( = 1.3314, 95% CI = 0.6629, 2.0002). Furthermore, significant indirect effects were observed, mediated independently by both health literacy and social support. Additional serial mediation pathways included health literacy → social support, health literacy → self-efficacy, social support → self-efficacy, and a comprehensive pathway from health literacy through social support to self-efficacy. These findings collectively indicate that ICT use directly enhances chronic disease self-management among older adults with comorbidities. Moreover, ICT use indirectly improves self-management by enhancing health literacy, augmenting social support, and bolstering self-efficacy.
信息通信技术（ICT）的使用对慢性病自我管理产生影响的机制尚不清楚。这项横断面调查研究了健康素养、社会支持和自我效能感在中国患有合并症的老年人（≥60岁）（n = 520）中，对ICT使用与自我管理行为之间关联的中介作用。参与者从上海一家三级医院招募（2023年7月至2024年6月），通过结构化问卷收集社会人口统计学、自我管理、健康素养、社会支持、自我效能感和ICT使用的数据。Pearson相关性分析显示，ICT使用、健康素养、社会支持、自我效能感与慢性病自我管理之间存在显著关联（p < 0.001）。多重中介模型显示，ICT使用对自我管理有直接的正向影响（β = 1.3314，95%CI = 0.6629，2.0002）。此外，观察到显著的间接效应，分别由健康素养和社会支持独立介导。额外的序列中介路径包括健康素养→社会支持、健康素养→自我效能感、社会支持→自我效能感，以及从健康素养经社会支持到自我效能感的综合路径。这些发现共同表明，ICT使用直接增强了患有合并症的老年人的慢性病自我管理。此外，ICT使用通过提高健康素养、增强社会支持和提升自我效能感间接改善自我管理。
