Mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation

Background: Health literacy refers to individual skills to access, process, understand, and use health information to stay healthy. Social support is a multi-faceted construct including of perceived, enacted, and structural support dimensions and negative social reactions. This study explored the mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation (PCI). Methods: Between December 2021 and March 2022, a total of 249 older patients who underwent PCI in our hospital were included in this cross-sectional study using the convenience sampling method. The demographic and health history of patients was collected by questionnaire. Exercise of self-care agency scale (ESCA), chronic disease health literacy management scale (HeLMS) and social support rating scale (SSRS) were also analyzed and their correlations were evaluated. Results: This study indicated that the total scores of health literacy, self-care ability and social support after PCI were 85.96±20.03, 82.82±27.65 and 25.3±4.93, respectively. Correlation analysis showed that health literacy, social support and self-care ability were positively correlated. Both social support (P=0.003) and health literacy (P=0.03) could positively predict self-care ability. Health literacy played a partial mediating role between social support and self-care ability, and the mediating effect was 0.015, accounting for 7.32% of the total effect. Conclusions: The health literacy and social support are at the high levels, and the self-care ability of PCI patients is at a medium level. The health literacy of older patients after PCI is the ability of social support and self-care ability. Medical staff can enhance the health literacy of patients by improving their level of social support, and then promote their self-care ability.