Abstract
ObjectivesTo explore the multiple mediating roles of the learned helplessness’s core system in the relationship between health literacy/social support and self-management.DesignCross-sectional survey design.SettingChangsha, China.Participants239 Chinese maintenance haemodialysis (MHD) patients.MethodsTwo multiple mediator models were constructed based on the COM-B (Capacity, Opportunity, Motivation - Behaviour) model. A total of 239 Chinese MHD patients participated in a cross-sectional study, which included surveys on the Learned Helplessness Scale for MHD patients, Dialysis Knowledge Questionnaire, Social Support Scale and Self-Management Scale for Haemodialysis. The PROCESS macro in SPSS was used for mediated effects analysis.ResultsHelplessness and internality partially mediated the relationship between health literacy/social support and self-management ((β=−0.212, p<0.01; β=0.240, p<0.01)/(β=−0.331, p<0.001; β=0.376, p<0.001)). The mediation effect size was 0.780 (95% CI (0.373 to 1.218)) in the health literacy model, accounting for 45.29% of the total effect, and 0.286 (95% CI (0.207 to 0.377)) in the social support model, accounting for 57.88% of the total effect. The differences in effect sizes for helplessness and internality in the two models were −0.080 (95% CI (−0.374 to 0.216)) and −0.041 (95% CI (−0.127 to 0.043)), respectively.ConclusionHealth literacy/social support directly affects MHD patients’ self-management and indirectly affects it by changing learned helplessness, such as increasing internality while reducing helplessness.
Funder
Central South University
2022 Hunan Province Postgraduate Scientific Research Innovation Project
Major Scientific and Technological Projects in Hunan Province
the National Natural Science Foundation of China