Abstract
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 12 tertiary hospitals in Sichuan Province. General demographic information was collected using a questionnaire, and 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 older adults 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.