The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 13: 2462 - 2470

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.13.023

Treatise：Mechanism and Practice

Exploring the mechanism of social media social anxiety in infertile patients based on the SOR framework： A chain mediating effect of electronic health literacy and online health information-seeking behavior

  • Xiaomei SHU ,
  • Huanxi XIAO ,
  • Biyan TAN ,
  • Guifang YE ,
  • Dan WANG ,
  • Lu HAN
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  • 1.Department of Nursing，Guangdong Provincial Fertility Hospital，Guangzhou 510600，Guangdong，China
    2.Department of Anesthesiology，Guangdong Provincial Fertility Hospital，Guangzhou 510600，Guangdong，China
    3.Department of Reproductive Immunology，Guangdong Provincial Fertility Hospital，Guangzhou 510600，Guangdong，China
    4.Department of Gynecology，Guangdong Provincial Fertility Hospital，Guangzhou 510600，Guangdong，China
    5.Department of Medical Education，Guangdong Provincial Fertility Hospital，Guangzhou 510600，Guangdong，China

Received date: 2026-03-11

  Online published: 2026-07-14

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Abstract

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.

Key words： SOR framework; infertility; social media social anxiety; electronic health literacy; online health information-seeking behavior; stigma

Cite this article

Xiaomei SHU , Huanxi XIAO , Biyan TAN , Guifang YE , Dan WANG , Lu HAN . Exploring the mechanism of social media social anxiety in infertile patients based on the SOR framework： A chain mediating effect of electronic health literacy and online health information-seeking behavior[J]. The Journal of Practical Medicine, 2026 , 42(13) : 2462 -2470 . DOI: 10.3969/j.issn.1006-5725.2026.13.023

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