Can smartphone use affect chronic disease self-management among Chinese middle-aged and older adults? A moderated mediation model

Fangmin Gong; Zhaowen Lei; Hewei Min; Yebo Yu; Zhen Huang; Jingyao Liu; Wenyu Wu; Jingqi Tang; Xinying Sun; Yibo Wu

doi:10.3389/fpsyg.2022.1019335

Can smartphone use affect chronic disease self-management among Chinese middle-aged and older adults? A moderated mediation model

Front Psychol. 2022 Dec 22:13:1019335. doi: 10.3389/fpsyg.2022.1019335. eCollection 2022.

Authors

Fangmin Gong¹, Zhaowen Lei¹, Hewei Min², Yebo Yu², Zhen Huang², Jingyao Liu³, Wenyu Wu⁴, Jingqi Tang⁵, Xinying Sun², Yibo Wu²

Affiliations

¹ School of Literature and Journalism Communication, Jishou University, Jishou, China.
² School of Public Health, Peking University, Beijing, China.
³ School of Public Health, Shandong University, Jinan, Shandong Province, China.
⁴ School of Health Management, Harbin Medical University, Harbin, Heilongjiang Province, China.
⁵ School of Philosophy, Anhui University, Hefei, Anhui Province, China.

Abstract

Introduction: Chronic disease self-management is influenced by many factors. Previous studies have linked patients' media use with chronic disease self-management, but the underlying mechanisms of this relationship are less understood.

Objectives: The purpose of this study is to explore the mediating role of family health (FH) between frequency of smartphone use (FOSU) and self-management behaviors among middle-aged and older patients with chronic diseases (SBAMAOPWCD) through a moderated mediation model, and whether this indirect relationship is modified by the solitary status of middle-aged and older Chinese patients with chronic disease.

Methods: Surveys were collected from 1,424 (N = 1,424; age > 45) middle-aged and older with one or more chronic conditions in China on self-reports of FOSU, FH and Chronic disease self-management behaviors were used to examine the moderated mediation model.

Results: The results showed that the FOSU was significantly and positively associated with SBAMAOPWCD (β = 0.220, p < 0.001; β = 0.170, p < 0.001; β = 0.167, p < 0.001; β = 0.158, p < 0.001); The Family health resources (FHR) dimension of FH and the Family external social supports (FESS) dimension mediated the relationship between the FOSU and SBAMAOPWCD (β = -0.0758, CI: -0.1402, -0.0236; β = 0.0721, CI: 0.0141, 0.1458), Among them, the FHR dimension mediated mainly among FOSU, exercise and cognitive symptom management practices (CSMP; β = -0.0344, CI: -0.0652, -0.0102; β = -0.0401, CI: -0.0725, -0.0138), the FESS dimension of the FH mediated the relationship between the FOSU and communication with physicians (CWP; β = 0.0376, CI: 0.0116, 0.0705); Solitary state played a moderating role in the relationship between FHR dimension and SBAMAOPWCD (live alone β = -0.2395, CI: -0.4574, -0.0661; not live-alone β = -0.0599, CI: -0.1164, -0.0172). In addition, solitary state played a moderating role in the relationship among FHR dimension and CSMP for middle-aged and older patients (live alone β = -0.1095, CI: -0.1961, -0.0378; not live-alone β = -0.0334, CI: -0.0633, -0.0102). Interestingly, the relationship between FESS dimension and SBAMAOPWCD was moderated only by the non-live alone population (β = 0.0676, CI: 0.0008, 0.1478), and not by the live-alone population (β = 0.1026, CI: -0.1061, 0.3278).Unexpectedly, we found that when their FHR were lower, they reported higher levels of chronic disease self-management, middle-aged and older patients with chronic diseases who live alone are more significant in this impact relationship.

Conclusions: The study further deepens our understanding of the mechanisms linking frequency of smartphone use with chronic disease self-management behaviors, and it helps to develop interventions to improve chronic disease self-management behaviors in middle-aged and older adults.

Keywords: chronic disease self-management; family health; frequency of smartphone use; middle-aged and elder people; moderated mediation model.