AUTHOR=Gong Fangmin , Lei Zhaowen , Min Hewei , Yu Yebo , Huang Zhen , Liu Jingyao , Wu Wenyu , Tang Jingqi , Sun Xinying , Wu Yibo 

TITLE=Can smartphone use affect chronic disease self-management among Chinese middle-aged and older adults? A moderated mediation model

JOURNAL=Frontiers in Psychology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.1019335

DOI=10.3389/fpsyg.2022.1019335

ISSN=1664-1078

ABSTRACT=<sec><title>Introduction</title><p>Chronic disease self-management is influenced by many factors. Previous studies have linked patients’ media use with chronic disease self-management, but the underlying mechanisms of this relationship are less understood.</p></sec><sec><title>Objectives</title><p>The purpose of this study is to explore the mediating role of family health (FH) between frequency of smartphone use (FOSU) and self-management behaviors among middle-aged and older patients with chronic diseases (SBAMAOPWCD) through a moderated mediation model, and whether this indirect relationship is modified by the solitary status of middle-aged and older Chinese patients with chronic disease.</p></sec><sec><title>Methods</title><p>Surveys were collected from 1,424 (<italic>N</italic> = 1,424; age &gt; 45) middle-aged and older with one or more chronic conditions in China on self-reports of FOSU, FH and Chronic disease self-management behaviors were used to examine the moderated mediation model.</p></sec><sec><title>Results</title><p>The results showed that the FOSU was significantly and positively associated with SBAMAOPWCD (<italic>β</italic> = 0.220, <italic>p</italic> &lt; 0.001; <italic>β</italic> = 0.170, <italic>p</italic> &lt; 0.001; <italic>β</italic> = 0.167, <italic>p</italic> &lt; 0.001; <italic>β</italic> = 0.158, <italic>p</italic> &lt; 0.001); The Family health resources (FHR) dimension of FH and the Family external social supports (FESS) dimension mediated the relationship between the FOSU and SBAMAOPWCD (<italic>β</italic> = −0.0758, CI: −0.1402, −0.0236; <italic>β</italic> = 0.0721, CI: 0.0141, 0.1458), Among them, the FHR dimension mediated mainly among FOSU, exercise and cognitive symptom management practices (CSMP; <italic>β</italic> = −0.0344, CI: −0.0652, −0.0102; <italic>β</italic> = −0.0401, CI: −0.0725, −0.0138), the FESS dimension of the FH mediated the relationship between the FOSU and communication with physicians (CWP; <italic>β</italic> = 0.0376, CI: 0.0116, 0.0705); Solitary state played a moderating role in the relationship between FHR dimension and SBAMAOPWCD (live alone <italic>β</italic> = −0.2395, CI: −0.4574, −0.0661; not live-alone <italic>β</italic> = −0.0599, CI: −0.1164, −0.0172). In addition, solitary state played a moderating role in the relationship among FHR dimension and CSMP for middle-aged and older patients (live alone <italic>β</italic> = −0.1095, CI: −0.1961, −0.0378; not live-alone <italic>β</italic> = −0.0334, CI: −0.0633, −0.0102). Interestingly, the relationship between FESS dimension and SBAMAOPWCD was moderated only by the non-live alone population (<italic>β</italic> = 0.0676, CI: 0.0008, 0.1478), and not by the live-alone population (<italic>β</italic> = 0.1026, CI: −0.1061, 0.3278).Unexpectedly, we found that when their FHR were lower, they reported higher levels of chronic disease self-management, middle-aged and older patients with chronic diseases who live alone are more significant in this impact relationship.</p></sec><sec><title>Conclusions</title><p>The study further deepens our understanding of the mechanisms linking frequency of smartphone use with chronic disease self-management behaviors, and it helps to develop interventions to improve chronic disease self-management behaviors in middle-aged and older adults.</p></sec>