Abstract
BACKGROUND: Despite the growing recognition of the importance of social support and physical literacy in managing hypertension among young and middle-aged patients, there is a lack of research exploring the mediating effects of sense of coherence and self-efficacy in this relationship. This study aims to bridge this gap by investigating the interplay between social support, physical literacy, sense of coherence, and self-efficacy, thus contributing to a deeper understanding of effective interventions for hypertension management. METHODS: A cross-sectional study was conducted using convenience sampling to survey 280 young and middle-aged patients diagnosed with hypertension from five community settings in Zhejiang and Anhui provinces between January and February 2024. Measurement instruments included the General Information Questionnaire, Physical Literacy Scale for Young and Middle-aged Patients with Hypertension, Sense of Coherence Scale 13, General self-efficacy Scale, and Perception Social Support Scale. Data analysis was performed using SPSS 27.0 and AMOS 28.0, with reporting following the STROBE checklist. RESULTS: A total of 270 valid questionnaires were collected. The total score of physical literacy for young and middle-aged patients with hypertension ranged from 18 to 90, with a mean score of 62.30 ± 13.92, indicating a moderate level. There was a positive correlation between the physical literacy score and the scores of social support (r = 0.557, P<0.01), sense of coherence (r = 0.392, P<0.01), and self-efficacy (r = 0.466, P<0.01) among young and middle-aged patients with hypertension. Furthermore, social support was found to have multiple mediating effects through sense of coherence and self-efficacy on physical literacy. CONCLUSION: This study sheds light on the interconnectedness of social support, physical literacy, sense of coherence, and self-efficacy among young and middle-aged patients with hypertension. The findings underscore the importance of considering these factors holistically in hypertension management strategies.