Abstract
Background
Hypertension is one of the world’s leading risk factors for death and disability. With a higher prevalence of hypertension, older adults need to strengthen self-management behaviors. The synergistic effects on self-management behaviors and the potential underlying mechanisms between self-management behaviors, health education, health literacy, and social support remain unclear.
Methods
A cross-sectional design and stratified multi-stage random sampling method were used to investigate hypertensive patients aged 60 years and older in six provinces from the eastern, central, and western regions of China. We collected data using questionnaires, and examined interactions among the factors using a structural equation model.
Results
1140 participants were included in this study. The SEM had a good overall fit. Health literacy, social support, and health education had a direct positive relationship with self-management behaviors (β = 0.157, β = 0.187, β = 0.158, P < 0.001). Social support had an indirectly positive relationship with self-management behaviors through health education and health literacy. Health education had an indirectly positive relationship with self-management behaviors through health literacy.
Conclusions
The situation of adopting self-management behaviors among elderly patients with hypertension is uneven in this study. Social support, health education, and health literacy all have direct or indirect impacts on self-management behaviors.