National Health Commission of the People’s Republic of China. China health statistics yearbook. Beijing: Peking Union Medical College Press; 2020.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.
Google Scholar
Baljani E, Rahimi J, Amanpour E, Salimi S, Parkhashjoo M. Effects of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases. J Hayat. 2011;17:45–54.
Han K, Lee P, Lee S, Park E. Factors influencing quality of life in people with chronic illness in Korea. J Nurs Scholarsh. 2003;35:139–44.
Google Scholar
Afendy A, Kallman JB, Stepanova M, Younoszai Z, Aquino RD, Bianchi G, et al. Predictors of health-related quality of life in patients with chronic liver disease. Aliment Pharmacol Ther. 2009;30:469–76.
Google Scholar
Peters M, Potter CM, Kelly L, Fitzpatrick R. Self-efficacy and health-related quality of life: a cross-sectional study of primary care patients with multi-morbidity. Health Qual Life Outcomes. 2019;17:37.
Google Scholar
Chu HH, Lee KS, Ho Lee K, Chung JH, Shin KC, Hwang TY. Association of physical and psychological health status between chronic obstructive pulmonary disease patients and their family caregivers. Health Care Women Int. 2019;40:1019–30.
Google Scholar
Chae YR, Lee SH, Jo YM, Kang HY. Factors related to family support for hemodialysis patients: A systematic review and meta-analysis. Korean J Adult Nurs. 2019;31:123–35.
Google Scholar
Kim O, Yeom EY, Jeon HO. Relationships between depression, family function, physical symptoms, and illness uncertainty in female patients with chronic kidney disease. Nurs Health Sci. 2020;22:548–56.
Google Scholar
Alizadeh F, Addepalli A, Chaudhuri SR, Budongo AM, Owembabazi I, Chaw GF, et al. Family health sheets: a vital instrument for village health workers providing comprehensive healthcare. BMC Health Serv Res. 2021;21:1138.
Google Scholar
Weiss-Laxer NS, Crandall A, Okano L, Riley AW. Building a Foundation for Family Health Measurement in National Surveys: A Modified Delphi Expert Process. Matern Child Health J. 2020;24:259–66.
Google Scholar
Haomiao L, Ju S, Qiang Y, Yibo W. Family health: concept, measurement, and current situation in China (in Chinese). Res Health Policy China. 2022;15:1–7.
Hsiao FH, Klimidis S, Minas H, Tan ES. Cultural attribution of mental health suffering in Chinese societies: the views of Chinese patients with mental illness and their caregivers. J Clin Nurs. 2006;15(8):998–1006.
Google Scholar
Ying L. Cross cultural comparative study of health concepts between China and the West (in Chinese)[D]. Hei Longjiang: Harbin University of Science and Technology; 2015.
Haomiao L, Yibo W, Ju S, Qiang Y. Family health and chronic disease control: the mediating role of health literacy, health behavior, and trust in grassroots services (in Chinese). Popul Dev. 2023;29:145–60.
Coffman MJ. Effects of tangible social support and depression on diabetes self-efficacy. J Gerontol Nurs. 2008;34(4):32–9.
Google Scholar
Bahari G, Scafide K, Krall J, Mallinson RK, Weinstein AA. Mediating role of self-efficacy in the relationship between family social support and hypertension self-care behaviours: A cross-sectional study of Saudi men with hypertension. Int J Nurs Pract. 2019;25(6):e12785.
Google Scholar
Zakiei A, Norouzi E, Ghasemi SR, Komasi S, Rostampour M, Khazaie H. Controlling risky behavior associated with AIDS: the role of social support, family functioning, self-efficacy and AIDS risk perception. BMC Psychol. 2022;10:132.
Google Scholar
Chang C-W, Chen F-P. Family social networks and personal recovery among Chinese people with mental illness in Hong Kong: The mediating effects of self-esteem and self-efficacy. Psychiatr Rehabil J. 2020;45(3):247–54.
Google Scholar
Wensu Z, Xidi Z, Shaojie L, Baohua Z, Yunhan Y, Huilan X, et al. Does the presence of anxiety and depression symptoms mediate the association between family functions and self-efficacy in pregnant women in the third trimester?: a community-based cross-sectional survey. Front Psychiatry. 2021;12: 726093.
Google Scholar
Puspasari J, Nur Rachmawati IN, Budiati T. Family support and maternal self-efficacy of adolescent mothers. Enfirm Clin. 2018;28:227–31.
Google Scholar
Mei YX, Xiang DD, Zhang ZX, Twumwaah Budu J, Lin BL, Chen SY. Family function, self-efficacy, care hours per day, closeness and benefit finding among stroke caregivers in China: A moderated mediation model. J Clin Nurs. 2023;32:506–16.
Google Scholar
Mahmoudi A. Effect of self-esteem and self-efficacy in family dynamics. Proc Soc Behav Sci. 2012;46:53–6.
Google Scholar
Hemati Z, Abbasi S, Oujian P, Kiani D. Relationship between parental communication patterns and self-efficacy in adolescents with parental substance abuse. Iran J Child Neurol. 2020;14:49–56.
Google Scholar
Shamali M, Konradsen H, Stas L, Østergaard B. Dyadic effects of perceived social support on family health and family functioning in patients with heart failure and their nearest relatives: using the Actor-Partner Interdependence Mediation Model. PLoS ONE. 2019;14:e0217970.
Google Scholar
Iovino P, Nolan A, De Maria M, Ausili D, Matarese M, Vellone E, et al. The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the ‘SODALITY’ observational study. Aging Ment Health. 2023;27:820–8.
Google Scholar
Gurbuz IZ, Akin S. Relationship between quality of life, self-efficacy and social support in patients with multiple sclerosis. Int J Palliat Nurs. 2023;29:598–612.
Google Scholar
Safi F, Areshtanab HN, Ghafourifard M, Ebrahimi H. The association between self-efficacy, perceived social support, and family resilience in patients undergoing hemodialysis: a cross-sectional study. BMC Nephrol. 2024;25(1):207.
Google Scholar
Hacihasanoglu Asilar R, Yildirim A, Saglam R, Demirturk Selcuk E, Erduran Y, Sarihan O. The effect of loneliness and perceived social support on medication adherence self-efficacy in hypertensive patients: an example of Turkey. J Vasc Nurs. 2020;38:183–90.
Google Scholar
Benson PR. The longitudinal effects of network characteristics on the mental health of mothers of children with ASD: the mediating role of parent cognitions. J Autism Dev Disord. 2016;46:1699–715.
Google Scholar
Saleh OA, Halperin O, Baron-Epel O. Predictors of maternal self-efficacy and the mediating role of postpartum fatigue for Jewish and Arab women in Northern Israel. Midwifery. 2022;107: 103281.
Google Scholar
Fierloos IN, Windhorst DA, Fang Y, Hosman CMH, Jonkman H, Crone MR, et al. The association between perceived social support and parenting self-efficacy among parents of children aged 0–8 years. BMC Public Health. 2023;23(1):1888.
Google Scholar
Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun. 2010;15(Suppl 2):9–19.
Google Scholar
Duong TV, Aringazina A, Kayupova G, Nurjanah Pham TV, Pham KM, Truong TQ, et al. Development and validation of a new short-form health literacy instrument (HLS-SF12) for the general public in six Asian countries. Health Lit Res Pract. 2019. https://doi.org/10.3928/24748307-20190225-01.
Google Scholar
Liu W, Yang W, Qian S. The mediating effect of self-efficacy on health literacy and social support in young and middle-aged patients with coronary heart disease after PCI. Vasc Health Risk Manag. 2023;19:341–9.
Google Scholar
Suarilah I, Lin CC. Factors influencing self-management among Indonesian patients with early-stage chronic kidney disease: a cross-sectional study. J Clin Nurs. 2022;31:703–15.
Google Scholar
Shiyanbola OO, Unni E, Huang Y-M, Lanier C. The association of health literacy with illness perceptions, medication beliefs, and medication adherence among individuals with type 2 diabetes. Res Social Adm Pharm. 2018;14:824–30.
Google Scholar
Ishikawa H, Kiuchi T. Association of health literacy levels between family members. Front Public Health. 2019;7:169.
Google Scholar
Nasiri S, Heydari N, Rafiee S, Paran M. Effect of family centered education on Patient’s self-care. Sadra Med J. 2020;8:311–20.
Ong-Artborirak P, Seangpraw K, Boonyathee S, Auttama N, Winaiprasert P. Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: a cross-sectional study in Thai communities. BMC Geriatr. 2023;23:297.
Google Scholar
Pelikan JM, Ganahl K, Roethlin F. Health literacy as a determinant, mediator and/or moderator of health: empirical models using the European Health Literacy Survey dataset. Glob Health Promot. 2018;25(4):57–66.
Google Scholar
Fang S, Mushtaque I. The Moderating Role of Health Literacy and Health Promoting Behavior in the Relationship Among Health Anxiety, Emotional Regulation, and Cyberchondria. Psychol Res Behav Manag. 2024;17:51–62.
Google Scholar
Ni H, Lin Y, Peng Y, Li S, Huang X, Chen L. Relationship Between Family Functioning and Medication Adherence in Chinese Patients With Mechanical Heart Valve Replacement: A Moderated Mediation Model. Front Pharmacol. 2022;13: 817406.
Google Scholar
Hollister-Wagner GH, Foshee VA, Jackson C. Adolescent aggression: models of resiliency 1. J Applied Social Pyschol. 2021;31:445–66.
Google Scholar
Wang YJ, Kaierdebieke A, Fan SY, Zhang RF, Huang MJ, Li H, et al. Study protocol: a cross-sectional study on psychology and behavior investigation of Chinese residents. PBICR Psychosom Med Res. 2022;4:19.
Google Scholar
Yang Y, Fan S, Chen W, Wu Y. Broader Open Data Needed in Psychiatry: Practice from the Psychology and Behavior Investigation of Chinese Residents. Alpha Psychiatry. 2024;25(4):564–5. Published 2024 Aug 1.
Wu Y, Fan S, Liu D, Sun X. Psychology and Behavior Investigation of Chinese Residents: Concepts, Practices and Prospects[J]. Chinese General Practice. 2024;27(25):3069–75. https://doi.org/10.12114/j.issn.1007-9572.2024.0075.
Google Scholar
Crandall A, Weiss-Laxer NS, Broadbent E, Holmes EK, Magnusson BM, Okano L, et al. The family health scale: reliability and validity of a short- and long-form. Front Public Health. 2020;8: 587125.
Google Scholar
Chen G, Gully SM, Eden D. Validation of a new general self-efficacy scale. Organ Res Methods. 2001;4:62–83.
Google Scholar
Feng X, Chen XY. Reliability and Validity of New General Self-efficacy Scale (NGSSE)[J]. J Mudanjiang Normal Univ (Philosophy Social Sciences Edition). 2012;4:127–9.
Wang F, Chen K, Du Z, Wu Y, Tang J, Sun X, et al. Reliability and validity analysis and Mokken model of New General Self-Efficacy Scale-Short Form. 2022; https://doi.org/10.13140/RG.2.2.23191.04006.
Ge P, Li Q, Dong M, Niu Y, Han X, Xiong P, et al. Self-medication in Chinese residents and the related factors of whether or not they would take suggestions from medical staff as an important consideration during self-medication. Front Public Health. 2022;10:1074559.
Google Scholar
Health promotion glossary of terms. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0IGO.
HLS-EU Consortium Comparative Report of Health Literacy in Eight EU Member States. The European Health Literacy Project 2009–2012. Accessed 15 Aug 2021.
Ferreira WA, Camelo L, Viana MC, Giatti L, Barreto SM. Is subjective social status a summary of life-course socioeconomic position? Cad Saude Publica. 2018;34(5): e00024317.
Google Scholar
Ross CE, Mirowsky J. Age and the gender gap in the sense of personal control. Soc Psychol Q. 2002;65(2):125–45.
Google Scholar
Jianrong M, Lina L, Ling Z, Yibo W, Xinying S. Effects of self-efficacy on health literacy among Chinese residents. China Health Educ (in Chinese). 2022;38:579–82+588.
Bartlett SJ, Lambert SD, McCusker J, Yaffe M, de Raad M, Belzile E, et al. Self-management across chronic diseases: Targeting education and support needs. Patient Educ Couns. 2020;103(2):398–404.
Google Scholar
García-Ovejero E, Pisano-González M, Salcedo-Diego I, Serrano-Gallardo P. Impact of Chronic Disease Self-Management Program on the Self-Perceived Health of People in Areas of Social Vulnerability in Asturias, Spain. Healthcare (Basel). 2024;12(8):811.
Google Scholar
Munari SC, Wilson AN, Blow NJ, Homer CSE, Ward JE. Rethinking the use of “vulnerable.” Aust N Z J Public Health. 2021;45(3):197–9.
Google Scholar
Mace Firebaugh C, Wojtyna A, Rich D, Beeson T. Examining self-efficacy and COVID-19 disease prevention behaviors among socially vulnerable populations. J Community Psychol. 2023;51(3):1427–34.
Google Scholar
Dzerounian J, Pirrie M, AlShenaiber L, Angeles R, Marzanek F, Agarwal G. Health knowledge and self-efficacy to make health behaviour changes: a survey of older adults living in Ontario social housing. BMC Geriatr. 2022;22(1):473.
Google Scholar
Cui Y, Zhao QP, Zhang XY, Zhu JY, Wang FL, Zhang P. The relationship between frailty and depression in middle-aged and elderly people with chronic diseases: the chain mediating effect of perceived social support and resilience. [J] Nurse Continuing Educ. 2024;39(03):236–40.
Liqin Z, Zhiquan X, Li Y, Lanfang Z, Cailian R. Cognitive function status and its relationship with frailty in hospitalized elderly patients with comorbidities of chronic diseases (in Chinese). Guangdong Med J. 2023;44:1061–6.
Yuan Y, Xu HW, Zhang S, Wang Y, Kitayama A, Takashi E, et al. The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases. Nurs Open. 2021;8:3566–74.
Google Scholar
Cene CW, Haymore B, Dolon-Soto DR, Lin FC, Pignone M, DeWalt D, et al. Perceived social support operates through self-efficacy to positively influence heart failure self care management. Circulation. 2011;124(21 Suppl 1):A18299.
Kline KS, Scott LD, Britton AS. The use of supportive-educative and mutual goal-setting strategies to improve self-management for patients with heart failure. Home Healthc Nurse. 2007;25:502–10.
Google Scholar
Wu S, Zheng X. The effect of family adaptation and cohesion on the well-being of married women: A multiple mediation effect. J Gen Psychol. 2020;147:90–107.
Google Scholar
Yan W, Zhang L, Li W, You X, Kong F. Associations of family subjective socioeconomic status with hedonic and eudaimonic well-being in emerging adulthood: A daily diary study. Soc Sci Med. 2022;298: 114867.
Google Scholar
Konradsen H, Dieperink KB, Lauridsen J, Sorknaes AD, Ostergaard B. Validity and reliability of the Danish version of the ice expressive family functioning and ice family perceived support questionnaires. Scand J Caring Sci. 2018;32:1447–57.
Google Scholar
Wu F, Sheng Y. Social support network, social support, self-efficacy, health-promoting behavior and healthy aging among older adults: a pathway analysis. Arch Gerontol Geriatr. 2019;85: 103934.
Google Scholar
Feng Z, Cramm JM, Nieboer AP. Social participation is an important health behaviour for health and quality of life among chronically ill older Chinese people. BMC Geriatr. 2020;20:299.
Google Scholar
Ayalon R, Bachner YG. Medical, social, and personal factors as correlates of quality of life among older cancer patients with permanent stoma. Eur J Oncol Nurs. 2019;38:50–6.
Google Scholar
Lara R, Vázquez ML, Ogallar A, Godoy-Izquierdo D. Psychosocial resources for hedonic balance, life satisfaction and happiness in the elderly: a path analysis. Int J Environ Res Public Health. 2020;17:56–84.
Google Scholar
Wang F, Wu Y, Sun X, Wang D, Ming WK, Sun X, et al. Reliability and validity of the Chinese version of a short form of the family health scale. BMC Prim Care. 2022;23:108.
Google Scholar
Lima-Rodríguez JS, Domínguez-Sánchez I, Lima-Serrano MM. Family and social variables associated with family health. West J Nurs Res. 2022;44:920–31.
Google Scholar
Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, et al. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006;21:806–12.
Google Scholar
White S, Chen J, Atchison R. Relationship of preventive health practices and health literacy: a national study. Am J Health Behav. 2008;32:227–42.
Google Scholar
Kobayashi R, Ishizaki M. Relationship between health literacy and social support and the quality of life in patients with cancer: questionnaire study. J Particip Med. 2020;12: e17163.
Google Scholar
Lee SD, Arozullah AM, Cho YI, Crittenden K, Vicencio D. Health literacy, social support, and health status among older adults. Educ Gerontol. 2009;35:191–201.
Google Scholar
Zakiei A, Vafapoor H, Alikhani M, Farnia V, Radmehr F. The relationship between family function and personality traits with general self-efficacy (parallel samples studies). BMC Psychol. 2020;8:88.
Google Scholar
Inoue M, Takahashi M, Kai I. Impact of communicative and critical health literacy on understanding of diabetes care and self-efficacy in diabetes management: a cross-sectional study of primary care in Japan. BMC Fam Pract. 2013;14:40.
Google Scholar
Ishikawa H, Takeuchi T, Yano E. Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care. 2008;31:874–9.
Google Scholar
Maleki Chollou K, Gaffari-Fam S, Babazadeh T, Daemi A, Bahadori A, Heidari S. The association of health literacy level with self-care behaviors and glycemic control in a low education population with type 2 diabetes mellitus: a cross-sectional study in Iran. Diabetes Metab Syndr Obes. 2020;13:1685–93.
Google Scholar
Lee YJ, Shin SJ, Wang RH, Lin KD, Lee YL, Wang YH. Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus. Patient Educ Couns. 2016;99:287–94.
Google Scholar
China.gov. Health Literacy Level of the Nation’s Residents to Reach. 2023. Accessed 22 Feb 2024.
link