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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1430202
This article is part of the Research Topic Analyses on Health Status and Care Needs among Older Adults View all 14 articles

The Relationship between Self-Efficacy, Health Literacy, and Quality of Life in Patients with Chronic Diseases-A Cross-Sectional Study in China

Provisionally accepted
Ying’e Gao Ying’e Gao 1Yujia Zheng Yujia Zheng 2Yuanyuan He Yuanyuan He 1Jingjing Lin Jingjing Lin 3Fangyi Liu Fangyi Liu 1Jie Fu Jie Fu 1Rongjin Lin Rongjin Lin 1,3*
  • 1 School of Nursing Fujian Medical University, Fuzhou, Fujian Province, China
  • 2 School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian Province, China
  • 3 First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

The final, formatted version of the article will be published soon.

    Background: Self-efficacy and health literacy are closely related to the quality of life in patients with chronic diseases; however, it remains unclear whether their combined effects on the quality of life (QoL)in these patients operate through mediation, interaction, or a combination of both.The research occurred in China between July 10 and September 15, 2021. A multi-stage random sampling technique was utilized to gather information on self-efficacy, health literacy, and QoL among individuals with chronic diseases. Linear regression models investigated the relationships between these patients' self-efficacy, health literacy, and QoL. Additionally, the fourway decomposition method was used to decompose the overall effects of self-efficacy and health literacy on the QoL in patients with chronic diseases.Results: Significant correlations were found between self-efficacy, health literacy, and QoL among individuals with chronic diseases (all P < 0.05). In the four-way decomposition results, the results of the European Quality of Life Five Dimension Five Level (EQ-5D-5L) displayed the interaction effects mediated by self-efficacy, and the reference interaction effects were not significant, with small effect sizes observed. The influence of health literacy levels on the QoL in these patients was primarily attributed to the controlled direct effect (CDE), accounting for approximately 86.12%[excess relative risk=0.00415; 95% CI: 0.00326, 0.00504; P < 0.0001]. The proportion solely attributable to the pure indirect effect (PIE) of self-efficacy was 14.5% [excess relative risk=0.0007; 95% CI: 0.00031, 0.00109; P < 0.0001]. In the EQ visual analog scale(EQ-VAS) results, the proportion of the controlled direct effect was 84.9% [excess relative risk=0.62443; 95% CI: 0.52269, 0.72618; P < 0.0001], while the proportion solely attributable to the pure indirect effect of mediation was 14.8% [excess relative risk=0.10876; 95% CI: 0.06409, 0.15344; P < 0.0001].Self-efficacy and health literacy primarily influence QoL in patients with chronic diseases through controlled and pure indirect effects. Enhancing patients' health literacy and selfefficacy can contribute to improving their QoL.

    Keywords: Health Literacy, self-efficacy, Quality of Life, Chronic Disease, Four-way decomposition

    Received: 09 May 2024; Accepted: 09 Sep 2024.

    Copyright: © 2024 Gao, Zheng, He, Lin, Liu, Fu and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Rongjin Lin, School of Nursing Fujian Medical University, Fuzhou, Fujian Province, China

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