ArticleBMC public health2023
The mediating role of health literacy between the presence of chronic disease and psychological distress among older persons in Xi'an city of China.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Mental health literacy mediates associations of self rated health and chronic disease status with anxiety and depression in Chinese residents.Scientific reports · 2026Article
- Correlation between life satisfaction, pleasure level, and negative emotion in patients with chronic renal failure.World journal of psychiatry · 2026Article
- Influence of sociodemographic factors on the health literacy of individuals with mental disorders.Revista brasileira de enfermagem · 2026Article
- Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults.World journal of psychiatry · 2025Article
- Health literacy and chronic disease prevalence: age-group differences in Zhejiang, China.Frontiers in public health · 2025Article
- Health literacy and falls among community-dwelling older people in China: is there a sex difference?Aging clinical and experimental research · 2024Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
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Abstract
backgroundThe increased number of older persons in China, and the prevalence of most chronic diseases raised with age significantly increased the total disease burden. When a person ages, psychological distress happens when they are faced with stressors that they cannot cope with. Psychological distress refers to non-specific symptoms of depression, anxiety, and stress. Health literacy influences several health outcomes, such as emotional functioning among the population. The primary purpose of this study is to examine the mediator role of health literacy between the presence of chronic disease and psychological distress among older persons living in Xi'an city. Thus, this study used the Cognitive Behavior Theory (CBT) as a combination of the basic behavioral and cognitive psychology principles to explain the cognitive processes associated with psychological distress.
methodsThis study employs a quantitative research design using a cross-sectional survey of 300 older persons over 60 years living in the six urban districts of Xi'an city. Data were collected using the Health Literacy Questionnaire (HLQ) and the Depression Anxiety Stress Scale (DASS-21). This study employed descriptive statistics and inferential methods to analyze the data. The inferential methods applied structural equation modeling (SEM) to test the hypothesis of the mediator role of health literacy between the presence of chronic disease and psychological distress.
resultsIn this study, chronic disease had an effect on health literacy among older persons living in Xi'an city (β=-0.047, p < 0.01); chronic disease impact on psychological distress among older persons living in Xi'an city (β = 0.047, p < 0.01); health literacy was identified effect on psychological distress among older persons in Xi'an city (β=-0.738, p < 0.001); health literacy as a partial mediator between chronic disease and psychological distress (β = 0.07, p < 0.01).
conclusionPsychological distress among older persons is affected by chronic disease and health literacy. Health literacy had a partial mediating effect on the presence of chronic disease and psychological distress. Improved health literacy measures should be considered when treating older persons with psychological distress.
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