Associations of social support and disease-specific quality of life with self-management among patients with chronic hepatitis B: a multicenter cross-sectional study.
- 1Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China.
- 2The First Affiliated Hospital, Department of Gastroenterology, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
- 3Hunan Engineering Research Center for Early Diagnosis and Treatment of Liver Cancer, Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, China.
Abstract
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.
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BibTeX
@article{yi2026associations,
title = {{Associations of social support and disease-specific quality of life with self-management among patients with chronic hepatitis B: a multicenter cross-sectional study.}},
author = {Wen-Ting Yi and Ling-Ling Li and Mao-Ting Huang and Hui-Ling Yan and Jia-Jun Liu and Yi-Jing Chen and Xiao-Yan Huang and Jing-Zhi Yang and Ke-Hao Zhao and Ying Zeng},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1962656},
url = {https://europepmc.org/article/MED/42908953},
note = {CC BY},
}
RIS
TY - JOUR
TI - Associations of social support and disease-specific quality of life with self-management among patients with chronic hepatitis B: a multicenter cross-sectional study.
AU - Wen-Ting Yi
AU - Ling-Ling Li
AU - Mao-Ting Huang
AU - Hui-Ling Yan
AU - Jia-Jun Liu
AU - Yi-Jing Chen
AU - Xiao-Yan Huang
AU - Jing-Zhi Yang
AU - Ke-Hao Zhao
AU - Ying Zeng
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1962656
UR - https://europepmc.org/article/MED/42908953
AB - 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.
SN - 2296-2565
ER -