The Relationship Between Personality and Self-Management Behavior in Chinese Young and Middle-Aged People with Chronic Illness: The Chain Mediating Role of Family Health and Health Literacy

Abstract

Purpose: Although the factors influencing chronic disease self-management have been extensively investigated, the ways in which personality traits, family health, and health literacy influence self-management require further exploration. This study aimed to explore the relationships and pathways among personality traits, family health, health literacy, and chronic disease self-management, with the goal of providing insights for chronic disease management. Patients and Methods: This study was based on a national cross-sectional survey conducted in 2021, which included 1063 young and middle-aged individuals (aged 19–59) with chronic diseases. Structural equation modeling was used to analyze the path relationships between personality traits, family health, health literacy, and chronic disease self-management levels. Results: Agreeableness directly and negatively predicted self-management outcomes (estimate: −0.557, 95% CI: −0.964 to −0.149). When examining health as the mediating variable between personality traits and self-management, it was observed that although different personality traits exert either positive or negative influences on family health, family health invariably had negative impact on self-management to varying extents (βextraversion: −0.111, P<0.01; βagreeableness: −0.083, P<0.05; βconscientiousness: −0.113, P<0.01; βneuroticism: −0.111, P<0.01; βopenness: −0.107, P<0.01). However, when considering the chain mediation effect, family health could positively influence health literacy, which subsequently had a beneficial impact on self-management. Additionally, health literacy served as an independent mediator in the relationship between extraversion and openness and self-management, with indirect effects of 0.163 and 0.274, respectively. Conclusion: Different personality traits exerted varying effects on self-management, which could be either direct or indirect, through the mediating roles of family health and health literacy. Family health seemed to be a double-edged sword for self-management. Future chronic disease self-management should consider the importance of family health, health literacy, and the complex pathways through which personality traits influence management behaviors, to maximize self-management outcomes.