目的 基于SOR框架，探讨不孕症患者病耻感对社交媒体社交焦虑的影响机制，明确电子健康素养与网络健康信息搜寻行为的单中介及链式中介作用，为临床心理干预提供依据。 方法 选取2023年1月至2025年8月于广东省生殖医院就诊的458例女性不孕症患者为研究对象，采用不孕症病耻感量表、网络健康信息搜寻行为量表、社交媒体用户社交焦虑量表、电子健康素养量表进行问卷调查。采用Spearman相关、线性回归、Bootstrap法（5 000次）及结构方程模型检验中介效应。 结果 （1）相关性分析显示：不孕症病耻感与网络健康信息搜寻行为（rs = -0.472，P 0.001）、电子健康素养（rs = -0.591，P 0.001）呈显著负相关；不孕症病耻感与社交媒体社交焦虑呈显著正相关（rs = 0.590，P 0.001）；电子健康素养与社交媒体社交焦虑呈极强负相关（rs = -0.972，P 0.001）。（2）线性回归显示：不孕症病耻感可显著正向预测社交媒体社交焦虑（β = 0.465，P 0.001），模型R2 = 0.343，调整R2 = 0.341，F = 237.913，P 0.001。（3）单中介分析：电子健康素养中介效应显著（a*b = 0.445，95%CI：0.391 ~ 0.497，P 0.001）；网络健康信息搜寻行为单中介效应显著（a*b = -0.170，95%CI：-0.210 ~ -0.132，P 0.001）。（4）链式中介分析：链式路径“病耻感→搜寻行为→电子健康素养→社交焦虑”效应显著（效应值-0.154，95%CI：-0.193 ~ -0.119，P 0.001），总间接效应0.418（95%CI：0.365 ~ 0.472），总效应0.465（P 0.001）。 结论 SOR框架下，不孕症病耻感可通过单中介（电子健康素养、网络健康信息搜寻行为）及链式中介2条路径影响社交媒体社交焦虑；电子健康素养为核心中介路径，链式路径稳定成立。临床干预应同步提升电子健康素养及规范信息搜寻行为，以缓解社交焦虑。

Objective To explore the influence of infertility-related stigma on social anxiety in the context of social media based on the SOR framework， and to verify the separate and chain mediating effects of electronic health literacy and online health information-seeking behavior， thereby providing evidence for clinical psychological intervention. Methods A total of 458 female infertile patients who were treated in a hospital from January 2023 to August 2025 were enrolled in the study. All participants completed questionnaires， which included the Infertility Stigma Scale， Online Health Information-Seeking Behavior Scale， Social Media User Social Anxiety Scale， and Electronic Health Literacy Scale. Spearman correlation analysis， linear regression， the Bootstrap method （with 5 000 iterations）， and structural equation modeling were employed to test the mediating effects. Results （1） Correlation analysis demonstrated that infertility-related stigma was negatively correlated with online health information-seeking behavior （rs = -0.472， P 0.001） and electronic health literacy （rs = -0.591， P 0.001）， and positively correlated with social media social anxiety （rs = 0.590， P 0.001）. Electronic health literacy was strongly negatively correlated with social media social anxiety （rs = -0.972， P 0.001）. （2） Linear regression indicated that infertility-related stigma significantly and positively predicted social media social anxiety （β = 0.465， P 0.001）， with a model R2 of 0.343， an adjusted R2 of 0.341， and F = 237.913 （P 0.001）. （3） Separate mediation analysis revealed significant mediation effects of electronic health literacy （a*b = 0.445， 95%CI： 0.391 - 0.497， P 0.001） and online health information-seeking behavior （a*b = -0.170， 95%CI： -0.210 - -0.132， P 0.001）. （4） Chain mediation analysis confirmed a significant chain path： "stigma→information-seeking behavior→electronic health literacy→social anxiety" （effect value = -0.154， 95%CI： -0.193 - -0.119， P 0.001）. The total indirect effect was 0.418 （95%CI： 0.365 - 0.472）， and the total effect was 0.465 （P 0.001）. Conclusions Under the SOR framework， infertility-related stigma influences social anxiety on social media via two pathways： separate mediation （electronic health literacy and online health information-seeking behavior） and chain mediation. Electronic health literacy serves as the core mediator， and the chain-mediating path is stably verified. Clinical interventions should concurrently enhance electronic health literacy and standardize information-seeking behavior to relieve social anxiety.