Path analysis of the influence of digital health literacy on self-management behaviour among elderly patients with chronic diseases in rural China.

Abstract

Background: Chronic disease self-management is very important for the progression and treatment of diseases worldwide. The management of chronic diseases among elderly individuals in rural areas is an urgent public health concern in China. The purpose of this study was to investigate the relationship between digital health literacy and chronic disease self-management behaviour in elderly Chinese patients with chronic diseases in rural areas, as well as the chain mediating effects of social support and depression. The objective was to provide a scientific basis for improving the active health behaviour of rural elderly patients with chronic diseases in China and worldwide.

Methods: Using convenience sampling, the survey subjects were elderly patients with chronic diseases in rural areas of Anhui Province, China. A self-designed questionnaire was used to collect general survey data, digital health literacy scale scores, social support scale scores, depression scale scores, and chronic disease self-management behaviour scale scores. Common method bias tests, descriptive statistics and correlation analyses were performed via SPSS 29.0. The structural equation model was constructed and tested via AMOS 27.0. Differences for which p < 0.05 were considered statistically significant.

Results: In all, 202 elderly patients with chronic diseases who resided in rural areas were enrolled. The digital health literacy score was 39.25 ± 9.00, and the chronic disease self-management behaviour score was 27.82 ± 9.56. The self-management behaviours of rural elderly patients with chronic diseases were positively correlated with digital health literacy and social support and were negatively correlated with depression (p < 0.01). After the mediating effect test, the total indirect effect value of social support and depression was 0.167, which accounted for 36.07% of the total effect. Among them, social support and depression were partial mediators of digital health literacy and chronic disease self-management behaviour, with effect values of 0.055 (95% CI: 0.012, 0.127) and 0.094 (95% CI: 0.024, 0.201), which accounted for 11.88% and 20.3% of the total effect, respectively. Social support and depression were chain mediators of digital health literacy and chronic disease self-management behaviour, with an effect value of 0.018 (95% CI: 0.004, 0.055) and an effect share of 3.89%.

Conclusion: The self-management level of elderly patients with chronic diseases in rural China is low. Digital health literacy not only directly affects the chronic disease self-management behaviour of elderly individuals but also indirectly predicts chronic disease self-management behaviour through the mediating effects of social support and depression.