Research on the impact of health empowerment on self-management in older patients with chronic disease: based on chain mediating effect analysis

TIEMEI WANG¹LIU YAN^2*SHIQING HUANG³JINXIA LIU¹

• ¹Chengdu Third People's Hospital, Chengdu, China
• ²Sichuan University West China School of Public Health, Chengdu, China
• ³West China Hospital of Sichuan University, Chengdu, China

Objective: This study investigates the mediating effect of chronic disease resource utilization and self-efficacy on the relationship between health empowerment and self-management in older adults with chronic diseases. Methods: A convenience sampling method was used to select 826 older adult patients with chronic diseases from twelve tertiary hospitals in Sichuan Province. General demographic information, self-management, health empowerment, chronic disease resource utilization, and self-efficacy were assessed using standardized scales. Data were analyzed using SPSS 25.0, and the PROCESS macro was employed to test the mediating effect of chronic disease resource utilization and self-efficacy. Results: The mean score for self-management was 40.89 ± 11.71, for health empowerment was 22.07 ± 7.13, for chronic disease resource utilization was 67.02 ± 10.65, and for self-efficacy was 21.25 ± 4.77. Health empowerment was positively correlated with chronic disease resource utilization (r=0.87, p < 0.001) and self-efficacy (r=0.75, p < 0.001), as well as self-management (r=0.73, p < 0.001). Chronic disease resource utilization was positively correlated with self-efficacy (r=0.68, p < 0.001), and self-management (r=0.86, p < 0.001). Self-efficacy was positively correlated with self-management (r= 0.68, p < 0.001). Health empowerment can directly and positively affect self-management, with an estimated value of 0.174, accounting for 37.6% of the total effect, and it can influence self-management through chronic disease resource utilization, with an estimated value of 0.123, accounting for 26.6% of the total effect. Health empowerment can influence self-management through self-efficacy, with an estimated value of 0.103, accounting for 22.2% of the total effect, and it can also influence self-management through the chain mediating effect of chronic disease resource utilization and self-efficacy, with an estimated value of 0.063, accounting for 13.6% of the total effect. Conclusion: Health empowerment can directly affect the self-management of elderly patients with chronic diseases, and it can also influence it indirectly through the utilization of chronic disease resources and self-efficacy. The utilization of chronic disease resources and self-efficacy play a mediating role between health empowerment and self-management. Healthcare providers can improve health empowerment and self-management in older adult patients through effective interventions to enhance chronic disease resource utilization and self-efficacy.