Influence of Social Support on Subjective Well-being of Patients with Chronic Diseases in China: Chain-mediating Effect of Self-efficacy and Perceived Stress

Overview

Journal Front Public Health

Specialty Public Health

Date 2023 Jul 10

PMID 37427286

Authors

Zhenni Luo

Sisi Zhong

Siyu Zheng

Yun Li

Yan Guan

Weihong Xu

Lu Li

Siyuan Liu

Haozheng Zhou

Xuanhao Yin

Yibo Wu

Diyue Liu

Jiangyun Chen

Affiliations

Soon will be listed here.

Abstract

Introduction: The well-being of patients with chronic diseases is an issue of widespread concern in public health. While social support is thought to have a positive effect on it, the mechanisms of its influence have not been fully addressed. Thus, we explored the possible mediating effects of self-efficacy and perceived stress to determine the relationship between social support and well-being in these patients.

Methods: A cross-sectional study was conducted among 4,657 patients with chronic diseases in China. The PROCESS Macro model 6 of SPSS was employed to explore the intermediary role between variables.

Results: Self-efficacy and perceived stress played a partial intermediary role between social support and subjective well-being, with an effect ratio of 48.25% and 23.61%, respectively. Self-efficacy and perceived stress had a chain intermediary effect (28.14%) between social support and subjective well-being.

Discussion: This study suggested that improving the self-efficacy of patients with chronic diseases to cope with the changes in social support caused by the disease could reduce stress and enhance subjective well-being.

Citing Articles

Characteristics and needs of physical and mental health among older adult individuals with disabilities under the background of smart healthcare: according to data from the China family panel studies.

Zou Q, Guan X, Cao X, Gu H, Wang C, Ming X Front Public Health. 2025; 13:1475466.

PMID: 40061462 PMC: 11885138. DOI: 10.3389/fpubh.2025.1475466.

Cross-cultural adaptation and psychometric evaluation of the Thai version of the Enhancing Recovery in Coronary Heart Disease Social Support Inventory in individuals with chronic illnesses.

Phetrnui S, Suwanno J, Chiaranai C, Bunsuk C, Koson N, Kumanjan W Int J Nurs Sci. 2025; 12(1):65-73.

PMID: 39990982 PMC: 11846552. DOI: 10.1016/j.ijnss.2024.12.013.

Socioeconomic disparities in childhood vaccine hesitancy among parents in China: The mediating role of social support and health literacy.

Yao X, Fu M, Peng J, Feng D, Ma Y, Wu Y Hum Vaccin Immunother. 2025; 21(1):2444008.

PMID: 39773178 PMC: 11730617. DOI: 10.1080/21645515.2024.2444008.

The IMPACT Survey: the humanistic impact of osteogenesis imperfecta in adults.

van Welzenis T, Westerheim I, Hart T, Wekre L, Semler O, Rauch F BMC Public Health. 2024; 24(1):3318.

PMID: 39609757 PMC: 11605868. DOI: 10.1186/s12889-024-20555-0.

The relationship between self-efficacy, health literacy, and quality of life in patients with chronic diseases: a cross-sectional study in China.

Gao Y, Zheng Y, He Y, Lin J, Liu F, Fu J Front Public Health. 2024; 12:1430202.

PMID: 39391157 PMC: 11466233. DOI: 10.3389/fpubh.2024.1430202.

References

Poort H, Jacobs J, Pirl W, Temel J, Greer J . Fatigue in patients on oral targeted or chemotherapy for cancer and associations with anxiety, depression, and quality of life. Palliat Support Care. 2019; 18(2):141-147. PMC: 7489872. DOI: 10.1017/S147895151900066X. View

Hajek A, Brettschneider C, Rohr S, Guhne U, van der Leeden C, Luhmann D . Which Factors Contribute to Frailty among the Oldest Old? Results of the Multicentre Prospective AgeCoDe and AgeQualiDe Study. Gerontology. 2020; 66(5):460-466. DOI: 10.1159/000508723. View

Bandura A . Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977; 84(2):191-215. DOI: 10.1037//0033-295x.84.2.191. View

Wang X, Chen P . Population ageing challenges health care in China. Lancet. 2014; 383(9920):870. DOI: 10.1016/S0140-6736(14)60443-8. View

Zhang H, Wang Z, Wang G, Song X, Qian Y, Liao Z . Understanding the Connection between Gut Homeostasis and Psychological Stress. J Nutr. 2023; 153(4):924-939. DOI: 10.1016/j.tjnut.2023.01.026. View

Gao Y, Hu R, Zhang Y, Yuan M, Xu Y, Ma J . Perceived stress in Chinese patients with coronary heart disease: a cross-sectional study. BMJ Open. 2022; 12(3):e051419. PMC: 8971805. DOI: 10.1136/bmjopen-2021-051419. View

Pinquart M, Sorensen S . Influences of socioeconomic status, social network, and competence on subjective well-being in later life: a meta-analysis. Psychol Aging. 2000; 15(2):187-224. DOI: 10.1037//0882-7974.15.2.187. View

Zhu Y, Song Y, Wang Y, Ji H, Wang D, Cai S . Relationships among social support, self-efficacy, and patient activation in community-dwelling older adults living with coronary heart disease: A cross-sectional study. Geriatr Nurs. 2022; 48:139-144. DOI: 10.1016/j.gerinurse.2022.09.008. View

Walshe C, Roberts D, Calman L, Appleton L, Croft R, Skevington S . Peer support to maintain psychological wellbeing in people with advanced cancer: findings from a feasibility study for a randomised controlled trial. BMC Palliat Care. 2020; 19(1):129. PMC: 7433175. DOI: 10.1186/s12904-020-00631-z. View

10.

Huang F, Li H . Factors influencing integrated wellbeing in older Chinese outpatients with chronic diseases. Aust J Prim Health. 2018; 24(2):189-195. DOI: 10.1071/PY17026. View

11.

Zhou J, Yu H . Contribution of social support to home-quarantined Chinese college students' well-being during the COVID-19 pandemic: the mediating role of online learning self-efficacy and moderating role of anxiety. Soc Psychol Educ. 2021; 24(6):1643-1662. PMC: 8543427. DOI: 10.1007/s11218-021-09665-4. View

12.

Han K . [Perceived stress, mood state, and symptoms of stress of the patient with chronic illness]. Taehan Kanho Hakhoe Chi. 2004; 33(1):87-94. DOI: 10.4040/jkan.2003.33.1.87. View

13.

Noujaim D, Fortinsky R, Barry L . The Relationship Between Emotional Support and Health-Related Self-Efficacy in Older Prisoners. J Aging Health. 2017; 31(3):439-462. DOI: 10.1177/0898264317733363. View

14.

Katon W, Sullivan M . Depression and chronic medical illness. J Clin Psychiatry. 1990; 51 Suppl:3-11; discussion 12-4. View

15.

Perera B, Jayasuriya R, Caldera A, Wickremasinghe A . Assessing mental well-being in a Sinhala speaking Sri Lankan population: validation of the WHO-5 well-being index. Health Qual Life Outcomes. 2020; 18(1):305. PMC: 7488505. DOI: 10.1186/s12955-020-01532-8. View

16.

Maguire R, Hanly P, Maguire P . Living well with chronic illness: How social support, loneliness and psychological appraisals relate to well-being in a population-based European sample. J Health Psychol. 2019; 26(10):1494-1507. DOI: 10.1177/1359105319883923. View

17.

Gao J, Weaver S, Fu H, Jia Y, Li J . Relationships between neighborhood attributes and subjective well-being among the Chinese elderly: Data from Shanghai. Biosci Trends. 2017; 11(5):516-523. DOI: 10.5582/bst.2017.01170. View

18.

Freire C, Ferradas M, Regueiro B, Rodriguez S, Valle A, Nunez J . Coping Strategies and Self-Efficacy in University Students: A Person-Centered Approach. Front Psychol. 2020; 11:841. PMC: 7248269. DOI: 10.3389/fpsyg.2020.00841. View

19.

Cohen S, Kamarck T, Mermelstein R . A global measure of perceived stress. J Health Soc Behav. 1983; 24(4):385-96. View

20.

Thanakwang K . Family support, anticipated support, negative interaction, and psychological well-being of older parents in Thailand. Psychogeriatrics. 2015; 15(3):171-8. DOI: 10.1111/psyg.12107. View