健康素养与自我效能在失能老年人赋能水平与生活质量的并行中介效应分析

doi:10.3969/j.issn.1006-5725.2026.07.016

Abstract

Abstract:

Objective Guided by the empowerment theory framework， this study aimed to investigate the relationship between empowerment levels in older adults with disabilities and their quality of life （QoL）， as well as the mediating roles of health literacy and self-efficacy in this association. Methods A questionnaire survey was conducted using convenience sampling from March 2022 to May 2023. Data were collected through the following validated instruments： the Sociological Data Questionnaire， Katz Activities of Daily Living （ADL） Scale， Chinese Simplified Elders' Health Empowerment Scale， Chinese version of the Short Form-36 （SF-36） Health Survey， Health literacy Scale for chronic disease patients and General Self-Efficacy Scale. Following data collection， a parallel mediating model was constructed and statistically validated. Results 313 valid questionnaires were returned， for a valid response rate of 96.31%. The empowerment score of 313 older adults with disabilities was （27.47 ± 3.99）； quality of life score was （244.91 ± 102.98）； health literacy score was （83.21 ± 19.83）； and self-efficacy score was （21.39 ± 7.26）. Empowerment， health literacy， self-efficacy and quality of life were positively correlated in older adults with disabilities （r value： 0.279 - 0.639， P < 0.01）. Older adults with disabilities' empowerment level cannot directly affect their quality of life， but empowerment level can positively affect their quality of life through their health literacy and self-efficacy， with effect values of 0.065 and 0.113， respectively， and the parallel mediated effects is statistically significant. Conclusion The level of empowerment， self-efficacy， health literacy and quality of life of older adults with disabilities needs to be improved. The level of empowerment of older adults with disabilities does not directly affect their quality of life， but can positively influence it through health literacy and self-efficacy.

Key words: older adults with disabilities, empowerment, quality of life, health literacy, self-efficacy

CLC Number:

R473.1

Meixian LIU,Yadong WANG,Ke TANG,Chunlan ZHOU. Analysis of the parallel mediating effects of health literacy and self-efficacy on empowerment and quality of life among older adults with disabilities[J]. The Journal of Practical Medicine, 2026, 42(7): 1235-1242.

Figures/Tables 7

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References 42

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项目	例数	构成比/%	自我效能		赋能水平		健康素养		生活质量
项目	例数	构成比/%	χ²值	P值	χ²值	P值	χ²值	P值	χ²值	P值
性别			2.826	0.005	1.788	0.075	4.241	< 0.001	0.108	0.914
男	170	54.31
女	143	45.69
年龄			1.350	0.127	1.355	0.148	1.265	0.094	1.125	0.291
60 ~ 70岁	203	64.86
71 ~ 80岁	76	24.28
≥ 81岁	34	10.86
教育背景			5.295	< 0.001	3.404	< 0.001	2.437	< 0.001	0.894	0.729
小学及以下	187	59.74
初中	82	26.20
高中或中专	31	9.91
大学及以上	13	4.15
居住地			1.686	0.024	2.043	0.007	1.307	0.068	0.922	0.674
城市	95	30.35
城镇/乡	103	32.91
农村	115	36.74
职业			1.122	0.316	2.213	0.003	1.675	0.002	0.984	0.549
农民	189	60.38
职工	90	28.76
其他	34	10.86
失能时间			2.848	< 0.001	0.935	0.539	1.080	0.328	1.152	0.252
< 1年	93	29.71
1 ~ < 3年	55	17.57
3 ~ < 5年	37	11.82
≥ 5年	128	40.90
失能程度			3.002	< 0.001	2.339	0.001	1.912	< 0.001	1.654	0.009
部分	207	66.13
轻度	18	5.75
中度	23	7.35
重度	65	20.77
与亲属同住			3.487	0.001	1.679	0.094	2.743	0.006	1.717	0.087
是	304	97.12
否	9	2.88
辅助器使用			5.469	< 0.001	3.376	0.001	6.654	< 0.001	7.843	< 0.001
是	163	52.08
否	150	47.92
子女数量			0.540	0.967	0.916	0.563	1.060	0.365	1.401	0.054
0个	18	5.75
1个	12	3.83
2个	68	21.73
≥ 3个	215	68.69
失能原因			1.899	0.007	0.852	0.643	0.850	0.795	1.258	0.136
疾病	238	76.04
意外	60	19.17
其他	15	4.79
经济收入水平			2.457	< 0.001	2.044	0.007	1.133	0.239	1.172	0.226
≤ 3 000元	218	69.65
3 001 ~ 6 000元	85	27.15
≥ 6 001元	10	3.20

变量	方程1：健康素养
变量	β	SE	t值	P值
赋能水平	0.471	0.044	10.600	< 0.001
辅助器使用	0.156	0.048	3.296	0.001
失能程度	-0.255	0.048	5.290	< 0.001

变量	方程2：自我效能
变量	β	SE	t值	P值
赋能水平	0.343	0.050	6.887	< 0.001
辅助器使用	0.121	0.053	2.274	0.024
失能程度	-0.261	0.054	4.834	< 0.001

变量	方程3：生活质量
变量	β	SE	t值	P值
赋能水平	-0.031	0.053	0.589	0.556
辅助器使用	0.169	0.049	3.440	< 0.001
失能程度	-0.229	0.052	4.422	< 0.001
健康素养	0.138	0.065	2.126	0.034
自我效能	0.329	0.058	5.676	< 0.001

路径	效应值	Boot SE	95%CI
赋能水平→健康素养→生活质量	0.065	0.030	0.009 ~ 0.130
赋能水平→自我效能→生活质量	0.113	0.025	0.067 ~ 0.166
直接效应	-0.031	0.053	-0.136 ~ 0.073
总效应	0.147	0.049	0.050 ~ 0.243

Analysis of the parallel mediating effects of health literacy and self-efficacy on empowerment and quality of life among older adults with disabilities

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变量	赋能水平	自我效能	健康素养	生活质量
赋能水平	1
自我效能	0.432^**	1
健康素养	0.565^**	0.639^**	1
生活质量	0.279^**	0.545^**	0.491^**	1

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