The Mediating Effect of Self-Efficacy on Health Literacy and Social Support in Young and Middle-Aged Patients with Coronary Heart Disease After PCI

OBJECTIVE: To investigate the mediating effect of self-efficacy in the relationship between social support and health literacy among young and middle-aged patients with coronary heart disease following PCI. METHODS: A cross-sectional study was conducted on convenience samples of 325 young and middle-aged patients with coronary heart disease who underwent PCI within 1 to 3 months. The data were collected from the outpatient department of a tertiary general hospital in Wenzhou, China, between July 2022 and February 2023. The questionnaire format was utilized to gather data on demographic characteristics, social support, self-efficacy, and health literacy. A structural equation model was employed to establish and validate the pathways. RESULTS: The mean age of the patients included in the study was 45.32 years old, while their levels of health literacy, self-efficacy, and social support were 64.12±7.45, 27.71±4.23, and 65.53±6.43 respectively. Significant associations were observed between social support and health literacy in the CHD population, with self-efficacy playing a partial mediating role. Together, social support and self-efficacy accounted for 53.3% of the variance in health literacy. The Pearson correlation analysis revealed a significant positive association between health literacy and both social support (r = 0.390, P < 0.01) and self-efficacy (r = 0.471, P < 0.01). CONCLUSION: Social support exerted a direct impact on health literacy and an indirect effect on health literacy through self-efficacy among patients with CHD.