Zhang Shi Qing, Deng Man, Xu Xue Jun, Yang Yue, Zhao Shuang, Yue Jianxin, Chen Yong Xia, Wang Fu Zhi, Yang Xiumu
School of Nursing, Bengbu Medical University, Bengbu, China.
School of Nursing, Anhui Medical University, Hefei, China.
Front Public Health. 2025 Aug 12;13:1637017. doi: 10.3389/fpubh.2025.1637017. eCollection 2025.
With the rapid aging of the global population and the continuous increase in the incidence of chronic diseases among the older adult, self-management activation has become a key factor in improving patients' quality of life. This study examines the relationship between social support and self-management activation in older adult patients with chronic diseases, with a focus on the mediating roles of illness acceptance and fatigue within this framework.
A convenience sampling method was employed to recruit 317 older adult patients with chronic diseases from three communities in Hefei, Anhui Province, China, between August and November 2023. Data collection involved the use of a general information questionnaire, the Illness Acceptance Scale, the Self-Rating Social Support Scale, the Chinese version of the Multidimensional Fatigue Inventory, and the Public Health Activation Index Scale. The influencing factors were examined through independent t-tests, one-way ANOVA, and Pearson correlation analysis in SPSS 26.0. Additionally, a structural equation model (SEM) in AMOS 26.0 was employed to evaluate the possible mediating roles of acceptance of illness and fatigue in the connection between social support and self-management activation.
A strong positive relationship was observed between social support, acceptance of illness, and Self-management activation ( = 0.615 and 0.787, < 0.01). In contrast, a significant negative correlation was observed between fatigue and self-management activation ( = -0.695, < 0.01). Further analysis using structural equation modeling (SEM) demonstrated that the model exhibited a good fit (RMSEA = 0.076, < 0.05). The results indicated that acceptance of illness and fatigue significantly mediate the connection between social support and self-management activation. Mediation effect analysis revealed that the direct impact of social support, acceptance of illness, and fatigue on self-management activation accounted for 24.2% of the overall effect. In comparison, the indirect effects made up 75.8%.
This study demonstrates that the Self-management activation of older adult adults with chronic conditions is generally low and may be influenced by various individual and environmental factors. The findings highlight that enhancing acceptance of illness and alleviating fatigue symptoms are crucial intervention strategies to improve Self-management activation, particularly for patients with low levels of social support.
随着全球人口的快速老龄化以及老年人慢性病发病率的持续上升，自我管理激活已成为改善患者生活质量的关键因素。本研究探讨了慢性病老年患者社会支持与自我管理激活之间的关系，重点关注在此框架下疾病接纳和疲劳的中介作用。
采用便利抽样法，于2023年8月至11月间从中国安徽省合肥市的三个社区招募了317名慢性病老年患者。数据收集使用了一般信息问卷、疾病接纳量表、自评社会支持量表、中文版多维疲劳量表和公共卫生激活指数量表。在SPSS 26.0中通过独立样本t检验、单因素方差分析和Pearson相关分析来检验影响因素。此外，使用AMOS 26.0中的结构方程模型（SEM）来评估疾病接纳和疲劳在社会支持与自我管理激活之间的联系中可能的中介作用。
观察到社会支持、疾病接纳与自我管理激活之间存在强正相关关系（r = 0.615和0.787，p < 0.01）。相比之下，疲劳与自我管理激活之间存在显著负相关（r = -0.695，p < 0.01）。使用结构方程模型（SEM）进行的进一步分析表明，该模型拟合良好（RMSEA = 0.076，p < 0.05）。结果表明，疾病接纳和疲劳在社会支持与自我管理激活之间的联系中起显著中介作用。中介效应分析显示，社会支持、疾病接纳和疲劳对自我管理激活的直接影响占总效应的24.2%。相比之下，间接效应占75.8%。
本研究表明，慢性病老年患者的自我管理激活普遍较低，可能受到各种个体和环境因素的影响。研究结果强调，提高疾病接纳度和缓解疲劳症状是改善自我管理激活的关键干预策略，特别是对于社会支持水平较低的患者。
