Frontiers in public health · 2026
Associations of social support and disease-specific quality of life with self-management among patients with chronic hepatitis B: a multicenter cross-sectional study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Yi Wen-Ting, Li Ling-Ling, Huang Mao-Ting, Yan Hui-Ling, Liu Jia-Jun, Chen Yi-Jing, Huang Xiao-Yan, Yang Jing-Zhi, Zhao Ke-Hao, Zeng Ying
Аннотация
BACKGROUND: Self-management behaviors are central to long-term care for chronic hepatitis B (CHB), but the independent associations of social support and disease-specific quality-of-life domains with self-management remain unclear. This study assessed self-management and its associated factors among patients with CHB.
METHODS: This multicenter cross-sectional study included 583 patients with CHB recruited by convenience sampling at three tertiary hospitals in Hengyang, China, from March to October 2025. Participants completed the Chronic Hepatitis B Self-Management Scale (CHBSMS), Social Support Rating Scale (SSRS), and Chronic Hepatitis B Quality of Life Instrument (CHBQOL). Hierarchical multiple linear regression, HC3 robust standard errors, and sensitivity analyses were used.
RESULTS: The mean total CHBSMS score was 85.03 ± 19.38. The sociodemographic model yielded an R 2 of 0.194. Adding clinical and healthcare utilization factors increased the explained variance (ΔR 2 = 0.083), and adding social support and the four CHBQOL domain scores further increased the explained variance (ΔR 2 = 0.102), yielding a final R 2 of 0.379. In the fully adjusted model, social support (B = 0.577, 95% CI: 0.416-0.739, p < 0.001), the emotional symptoms domain (B = 0.170, 95% CI: 0.039-0.301, p = 0.011), and the social stigma domain (B = 0.235, 95% CI: 0.082-0.388, p = 0.003) were positively associated with self-management scores. Higher scores in the latter two domains indicated fewer emotional symptoms and less social stigma, respectively. For a 1-SD higher value of each predictor, the corresponding CHBSMS differences were 4.79, 1.90, and 2.15 points for social support, emotional symptoms, and social stigma, respectively, equivalent to 4.79, 1.90, and 2.15% of the score range. The somatic symptoms and belief domains were not significantly associated with self-management. Robustness and sensitivity analyses did not materially alter the main findings.
CONCLUSION: Among patients with CHB recruited from three tertiary hospitals, social support, the emotional symptoms domain, and the social stigma domain were associated with self-management after adjustment for sociodemographic, clinical, and healthcare utilization factors. Further longitudinal research is needed to clarify the temporal direction and clinical relevance of these associations.
METHODS: This multicenter cross-sectional study included 583 patients with CHB recruited by convenience sampling at three tertiary hospitals in Hengyang, China, from March to October 2025. Participants completed the Chronic Hepatitis B Self-Management Scale (CHBSMS), Social Support Rating Scale (SSRS), and Chronic Hepatitis B Quality of Life Instrument (CHBQOL). Hierarchical multiple linear regression, HC3 robust standard errors, and sensitivity analyses were used.
RESULTS: The mean total CHBSMS score was 85.03 ± 19.38. The sociodemographic model yielded an R 2 of 0.194. Adding clinical and healthcare utilization factors increased the explained variance (ΔR 2 = 0.083), and adding social support and the four CHBQOL domain scores further increased the explained variance (ΔR 2 = 0.102), yielding a final R 2 of 0.379. In the fully adjusted model, social support (B = 0.577, 95% CI: 0.416-0.739, p < 0.001), the emotional symptoms domain (B = 0.170, 95% CI: 0.039-0.301, p = 0.011), and the social stigma domain (B = 0.235, 95% CI: 0.082-0.388, p = 0.003) were positively associated with self-management scores. Higher scores in the latter two domains indicated fewer emotional symptoms and less social stigma, respectively. For a 1-SD higher value of each predictor, the corresponding CHBSMS differences were 4.79, 1.90, and 2.15 points for social support, emotional symptoms, and social stigma, respectively, equivalent to 4.79, 1.90, and 2.15% of the score range. The somatic symptoms and belief domains were not significantly associated with self-management. Robustness and sensitivity analyses did not materially alter the main findings.
CONCLUSION: Among patients with CHB recruited from three tertiary hospitals, social support, the emotional symptoms domain, and the social stigma domain were associated with self-management after adjustment for sociodemographic, clinical, and healthcare utilization factors. Further longitudinal research is needed to clarify the temporal direction and clinical relevance of these associations.