Social Support and Hospital Discharge Readiness in CHD Patients: Mediating Roles of Self-Efficacy and Adherence

Objective: To explore the associations among social support, self-efficacy, medication adherence, and discharge readiness in patients with coronary heart disease (CHD), specifically examining the mediating roles of self-efficacy and medication adherence. Methods: Participants included 463 patients with coronary heart disease (CHD) recruited from a tertiary hospital in Wuhu City (February–June 2025) via convenience sampling. To assess the key variables, we employed the Oslo-3 Social Support Scale, the GSES, the MMAS-8 1 [ 1 MMAS ® 2006 used with permission www.moriskyscale.com ], and the RHDS. Data analysis was performed in SPSS 26.0 for descriptive statistics, followed by the PROCESS macro (version 3.5) to examine the hypothesized mediation pathways. Results: Among the 463 participants with valid responses, the mean score for readiness for hospital discharge was 66.75± 23.29. Correlation analysis indicated that social support, self-efficacy, and medication adherence were each significantly and positively associated with discharge readiness ( p < 0.050). Mediation analysis revealed that social support showed a significant and positive association with self-efficacy ( В =1.425, p < 0.001). The Bootstrap test confirmed a significant indirect relationship between social support and discharge readiness through the mediating role of self-efficacy (95% CI : [0.262,1.187]). While the moderating effect of medication adherence on the “self-efficacy→discharge readiness” pathway was not statistically significant ( p = 0.121), medication adherence itself showed a significant and direct positive association with readiness for hospital discharge ( В =4.039, p < 0.001). Conclusion: In conclusion, our findings underscore that social support exerts a significant indirect effect on readiness for hospital discharge via the mediating role of self-efficacy. Although the moderating effect of medication adherence was not supported in this specific pathway, it emerged as a critical and independent factor related to discharge readiness. Consequently, clinical nursing interventions should prioritize a multifaceted approach: mobilizing social support systems, bolstering patients’ psychological self-efficacy, and rigorously reinforcing medication adherence. Such targeted strategies are beneficial to support a safe, high-quality transition from hospital to home for patients with coronary heart disease.