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

Xiaorong Lang,1 Sufang Huang,2 Yaru Xiao2 1Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Yaru Xiao, Email [email protected]: 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.Keywords: personality traits, family health, health literacy, self-management, chronic illness