The mediating role of health-related behaviors between social capital and primary healthcare physicians’ health-related quality of life

This study aimed to evaluate the correlation between social capital and physicians' health-related quality of life(HRQoL) in primary healthcare institutions. Simultaneously, we examined the mediating role of health-related behaviors in the process. Data was obtained from a nationwide cross-sectional survey conducted in 2021. Demographic characteristics and health-related behaviors were collected by a self-administered questionnaire. We used the social capital of healthcare organizations reported by employees (SOCAPO-E) scale to measure the social capital and the EuroQol-five dimension-five level (EQ-5D-5L) to measure physicians' HRQoL. The Tobit model was performed to evaluate the association between social capital and HRQoL. Spearman's test was applied to investigate the relationship between social capital, health-related behaviors and HRQoL. A bootstrap approach was used to assess the mediating effect of health-related behaviors. The regression results showed that social capital (β = 0.605, p<0.001) was significantly and positively associated with physicians' HRQoL. Spearman's correlation analysis showed that social capital was positively correlated with health-related behaviors (r = 0.211, p < 0.01), health-related behaviors were positively correlated with HRQoL (r = 0.134, p < 0.01), and social capital was positively correlated with HRQoL (r = 0.253, p < 0.01). Health-related behaviors moderately mediated the relationship between social capital and HRQoL (BootSE = 0.006, BootCI=[0.005,0.030]). Social capital not only directly affected physicians' HRQoL, but also indirectly affected HRQoL through health-related behaviors. Our findings suggested that future intervention measures could complement the strengthening of social capital with health behavior promotion programs to achieve more comprehensive health improvements.