The Effect of Health Literacy on Disease Management Self-Efficacy in Chronic Disease Patients: The Mediating Effects of Social Support and the Moderating Effects of Illness Perception

Purpose: To test a hypothetical pathway model to estimate the links between health literacy, social support, illness perception, and disease management self-efficacy. Methods: This cross-sectional study, conducted from June to October 2022, involved the recruitment of 210 patients with chronic diseases at two primary care facilities. Participants completed the Health Literacy Management Scale, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Social Support Rating Scale and Brief Illness Perception Questionnaire. We used the PROCESS macro for R to determine the hypothetical pathway model. Results: The direct effect of health literacy on self-efficacy was significant ( β =0.1792, 95% CI: 0.0940– 0.2644), and social support played a partial mediating role between health literacy and self-efficacy (ES=0.0761, 95% CI: 0.0398– 0.1204). Illness perception moderated the relationship between social support and self-efficacy ( β =− 0.0153, 95% CI: − 0.0268- − 0.0039). Conclusion: Proposed a conceptual model including the mediating effect of social support and the moderating effect of illness perception, which helps to clarify the underlying mechanisms between health literacy and self-efficacy.