| Purpose:To understand the current status of health literacy,social support,perceived control and health empowerment of chronic diseases patients in the community and their differences in general demographics;to analyze the relationship between health literacy,social support,perceived control and health empowerment;The influence of literacy,social support and perceived control on the health empowerment of the research subjects;explore the path and size of the health literacy,social support and perceived control on the health empowerment of the research subjects,providing scientific reference for relevant research and interventions for the empowerment of chronic diseases.Methods:Using cross-sectional surveys in non-experimental studies,454 middle-aged and elderly patients with chronic diseases health care in a community health service center in Yanji City was selected as research subjects.The patient empowerment scale,the health literacy scale,the social support rating scale and the health-related control sense questionnaire were investigated.The data were analyzed by SPSS 20.0 and AMOS 22.0.Results:(1)Characteristics of participants:The average age of study subjects was(63.37 ± 8.91)years old,259 males(57%)and 195 females(43%).There are 285 Hans(62.8%),Koreans and other ethnic minorities 169(37.2%).398 subjects(87.7%)had a spouse,56(12.3%)had no spouse.374(82.4%)study subjects lived in cities and 80(17.6%)study subjects lived in rural areas.In terms of education level,108(23.8%)subjects were college degree or above,135(29.7%)subjects were senior high school and technical secondary school,129(28.4%)subjects were junior high school diploma,82(18.1%)for elementary school education and below.371(81.7%)of the study subjects lived on wages or pensions,and 83(18.2%)were supported by children or other sources.(2)Health empowerment,health literacy,social support and perceived level of participants:The average score of health empowerment was 120.56 ± 17.01,the Han nationality,have a spouse,live in a city,live with couple,have a high education level,receive a salary or pension,have a high monthly income,have a good self-assessment,and have a medical background subjects with good diet and exercise had higher health empowerment scores.The average score of health literacy was 90.59± 11.13,the age was 45 to 60 years,Han nationality,had a spouse,lived in the city,cohabited with immediate family members,had high education and received a salary or pension,subjects with high monthly income,high medical insurance reimbursement rate,good self-assessment health status,medical background and good diet and exercise status were in higher health literacy.The average level of social support was 34.67±6.75,the Han nationality,has a spouse,lives in the city,lives with their spouse’s children,has a high educational level,earns a living from salary or retirement,a high monthly family income,Subjects with high reimbursement rates,good self-assessed health status,medical background,and good diet and exercise scored higher social support scores.The average score of perceived control was 92.60±10.19,the age was 45 to 60 years,Han nationality,had a spouse,lived in the city,had a high education level and received a salary or pension,subjects with high monthly household income,high medical insurance reimbursement ratio,good self-assessment health status,medical background score higher.(3)Effects of health literacy,social support and perceived control on health empowerment of participants:Pearson correlation analysis showed health literacy,social support,perceived control and its dimensions were positively correlated with health empowerment and its dimensions,r=0.169～0.867,and the difference was statistically significant(P<0.001).Hierarchical stepwise linear regression showed that general demographic characteristics could explain health empowerment by 41.4%(F=12.868,P<0.001),and after controlling demographic characteristics,health literacy explained variation was 22.6%(F=32.439,P<0.001),the total variation explained by social support was 2.8%(F=34.606,P<0.001),and the total variation explained by perceived control was 1.7%(F=36.308,P<0.001).SEM shows that the health literacy of the research subjects affects health empowerment by affecting perceived control.The path effect size is 0.757.Social support directly affects health empowerment directly.Perceived control directly affects health empowerment.Perceived control is social support and health.Weighted intermediary variables,model indicators fit well.Conclusions:(1)The health empowerment of community middle-aged and elderly chronic patients was in a low level.Han Chinese,has a spouse,lives in a city,couples live together,have higher education,work in an institution,the source of living is salary or pension,high monthly family income,no other chronic diseases,self-rated in health status and in good diet and exercise had higher health empowerment scores.(2)The higher level of the health literacy and social support of middle-aged and elderly chronic patients in the community,the higher the level of perceived control,the higher the level of health empowerment.Living situation,medical background,health literacy,social support and perceived control can all significantly positive affect the health empowerment of middle-aged and elderly chronic patients in the community and the combined chronic disease situation has a negative affect.(3)Health literacy has an indirect positive impact on health empowerment by affecting perceived control.The sub-dimension of economic literacy of health literacy as an independent factor positively affects the health empowerment of the research object;social support and perceived control can independently and positively affect health empowerment of middle-aged and elderly chronic patients in the community,as a mediating variable of social support and health empowerment,indirectly positively affects health empowerment through social support. |
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