The Influence of Social Support on Health-related Quality of Life: Exploring the Mediating Role of Self-Efficacy Among the Zhengzhou Sample

Abstract

University students are in the stage of emerging adulthood and face multiple challenges related to academics, employment, and social adaptation. These challenges have important implications for their health-related quality of life (HRQoL). With the guidance of the social ecological framework, this research examined the relationships between social support, self-efficacy, and HRQoL in university students and tested the mediating role of self-efficacy. In June 2025, a questionnaire was conducted using convenience sampling with 598 university students in Zhengzhou, China. The survey employed standardized instruments, and all items were rated on a five-point Likert scale. Data were analyzed using SPSS 27.0 and PROCESS 4.1. The results indicated that HRQoL was positively associated with both social support and self-efficacy. In addition, self-efficacy significantly mediated the relationship between social support and HRQoL, accounting for 60.46% of the total effect. These findings underscore the crucial role of social support in enhancing students’ HRQoL, largely by strengthening self-efficacy. This study extends the theoretical understanding of the psychological mechanisms underlying HRQoL and provides practical implications for higher education practices. Furthermore, the findings are aligned with the United Nations’ Sustainable Development Goals (SDGs) and emphasize the importance of supportive educational and social environments in promoting sustainable development.