健康自我管理行为作为电子健康素养与健康相关生活质量之间的桥梁：来自中国的横断面研究

Health Self-Management Behaviors as a Bridge Between Electronic Health Literacy and Health-Related Quality of Life: Cross-Sectional Study From China.

作者信息

Zhang Meihui, Tao Shunyu, Ge Xin, Zhang Hongying, Xu Zhongqing, Gong Ruijie, Liu Yujie, Xu Chen, Wang Suping, Cai Yong

机构信息

School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Public Health Research Center, Tongren Hospital, Shanghai Jiao Tong University, Xianxia Road, No.1111, Shanghai, 200336, China, 86 13611677244.

出版信息

J Med Internet Res. 2025 Aug 13;27:e74056. doi: 10.2196/74056.

DOI:10.2196/74056

PMID:40802975

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12349732/

Abstract

BACKGROUND

Electronic health literacy (eHL) has been increasingly associated with health-related quality of life (HRQoL). However, the underlying mechanisms, especially in the general population, remain insufficiently explored.

OBJECTIVE

This study aimed to investigate the mediating role of health self-management behaviors (HSMB) in the relationship between eHL and HRQoL.

METHODS

A cross-sectional study was conducted in Shanghai, China, from October to December 2022. Participants were recruited via convenience sampling from 7 community health service centers. Data were collected through an online survey platform Wenjuanxing. Validated scales, including the eHL Scale, the adults' health self-management skill rating scale, and the 12-item short form health survey were used to measure eHL, HSMB, and HRQoL, respectively. The HRQoL was summarized into the physical component summary (PCS) and the mental component summary (MCS). Correlation analysis, multivariate linear regression with stepwise backward selection, and mediation analysis were performed to explore the relationships among eHL, HSMB, PCS, and MCS, with adjustments for sociodemographic and health-related covariates.

RESULTS

Among the 2364 participants recruited from urban, periurban, and rural areas, eHL scores varied significantly by demographic characteristics. Positive correlations among eHL, HSMB, PCS, and MCS were observed, with Spearman correlation coefficients ranging from 0.24 to 0.46 (P<.001). Multivariate analysis showed that eHL was significantly positively associated with PCS (R2=0.14, 95% CI 0.09-0.18, P<.001) and MCS (R2=0.23, 95% CI 0.17-0.28, P<.001). Mediation analysis indicated that eHL had a significant direct (PCS: βc=.18, 95% CI 0.13-0.23, P<.001; MCS: βc=.32, 95% CI 0.25-0.38, P<.001) and an indirect effect on HRQoL through HSMB (PCS: βc'=.11, 95% CI 0.09-0.14, P<.001; MCS: βc'=.14, 95% CI 0.10-0.17, P<.001).

CONCLUSIONS

This study demonstrated a positive association between eHL and HRQoL, with HSMB acting as a partial mediator among the general population in Shanghai. Targeted interventions should be implemented to improve eHL and HSMB.

摘要

背景

电子健康素养（eHL）与健康相关生活质量（HRQoL）的关联日益密切。然而，其潜在机制，尤其是在普通人群中的机制，仍未得到充分探索。

目的

本研究旨在探讨健康自我管理行为（HSMB）在eHL与HRQoL关系中的中介作用。

方法

2022年10月至12月在中国上海进行了一项横断面研究。通过便利抽样从7个社区卫生服务中心招募参与者。数据通过在线调查平台问卷星收集。分别使用经过验证的量表，包括eHL量表、成人健康自我管理技能评定量表和12项简短健康调查问卷，来测量eHL、HSMB和HRQoL。HRQoL总结为身体成分总结（PCS）和心理成分总结（MCS）。进行相关分析、逐步向后选择的多元线性回归和中介分析，以探讨eHL、HSMB、PCS和MCS之间的关系，并对社会人口学和健康相关协变量进行调整。

结果

在从城市、城郊和农村地区招募的2364名参与者中，eHL得分因人口统计学特征而异。观察到eHL、HSMB、PCS和MCS之间存在正相关，Spearman相关系数范围为0.24至0.46（P<0.001）。多变量分析表明，eHL与PCS（R2 = 0.14，95%CI 0.09 - 0.18，P<0.001）和MCS（R2 = 0.23，95%CI 0.17 - 0.28，P<0.001）显著正相关。中介分析表明，eHL对HRQoL有显著的直接效应（PCS：βc = 0.18，95%CI 0.13 - 0.23，P<0.001；MCS：βc = 0.32，95%CI 0.25 - 0.38，P<0.001），并通过HSMB对HRQoL有间接效应（PCS：βc' = 0.