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 China

Correspondence: Yaru Xiao, Email tjxyrjy@tjh.tjmu.edu.cn

Purpose: 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