The Mediating Role of Social Support in the Relationship Between Health Literacy and Self-Management Among Patients With Chronic Liver Disease

Abstract

To investigate the status and influencing factors of self-management ability in patients with chronic liver disease, and explore the relationship among self-management ability, health literacy and social support. A total of 207 patients with chronic liver disease were recruited from the infection clinic of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Data were collected using a general information questionnaire, the Partners in Health Scale (PIH), the Health Literacy Scale for Chronic Patients (HLSCP), and the Social Support Rating Scale (SSRS). A structural equation model was constructed using the Bootstrap method to examine the mediating effect of social support on the relationship between health literacy and self-management ability. The total score of self-management ability (the original PIH scale) of patients with chronic liver disease was (54.22±17.13). The influencing factors of self-management ability were the type of liver disease, 1 dimensions (willingness to promote health) of HLSCP, and 2 dimensions (subjective support, support utilization) of SSRS ( P < 0.05). Health literacy can positively affect self-management ability through social support ( β =0.523), the effect was composed of direct effect ( β =0.411) and indirect effect ( β =0.112), the above P <0.01. The self-management ability of patients with chronic liver disease is at a medium level, and medical staff should combine the disease and socio-demographic characteristics of patients to improve the level of self-management ability, through improving health literacy and effectively using social support. Clinical interventions should focus on identifying key populations and developing tailored training programs. These programs should aim to improve self-management behaviors by enhancing patients’ health literacy and promoting the full utilization of their social support systems, including involving family members in the management plan.