# The mediating role of psychological resilience in the relationship between health literacy and health promotion behaviors among older adult patients undergoing PCI in China

## TL;DR

This study shows that psychological resilience helps link health knowledge to better health behaviors in older patients recovering from heart procedures in China.

## Contribution

The study identifies psychological resilience as a mediator between health literacy and health promotion behaviors in older PCI patients.

## Key findings

- Health literacy and health promotion behaviors are strongly correlated in older PCI patients.
- Psychological resilience partially mediates the relationship between health literacy and health promotion behaviors.
- Improving health literacy and resilience could enhance health behaviors in this patient group.

## Abstract

This study investigates whether psychological resilience mediates the relationship between health literacy and health promotion behaviors among older adult patients after PCI. The findings provide theoretical support for targeted interventions aimed at improving health promotion behaviors in this group.

This cross-sectional study employed convenience sampling to survey 299 older adult patients who underwent PCI in the cardiovascular department of a Grade A tertiary hospital in Sichuan Province, China, from March to July 2024. Data collection employed questionnaires to gather general information, as well as the health promotion lifestyle scale, the health literacy scale, and the psychological resilience scale. Data analysis was conducted using SPSS 26.0 software for descriptive analysis, univariate analysis, correlation analysis, and multivariate stratified regression analysis. Mediating effect analysis was conducted using Model 4 in the Process v4.1 plugin.

The mean health promotion behavior score among older adult PCI patients was (82.13 ± 11.78). Correlation analysis revealed positive correlations between health literacy and health promotion behaviors (r = 0.840, p < 0.01), between health literacy and psychological resilience (r = 0.844, p < 0.01), and between psychological resilience and health promotion behaviors (r = 0.811, p < 0.01). Mediation analysis revealed that psychological resilience mediated the relationship between health literacy and health promotion behaviors, with an effect size of 0.260. This mediation accounted for 34.0% of the total effect (BootSE = 0.043，95%CI = [0.175, 0.343]).

Health promotion behaviors among older adult patients after PCI were at a moderate level, and psychological resilience mediated the relationship between health literacy and health promotion behaviors. This suggests that healthcare providers should prioritize enhancing health literacy and psychological resilience among older adult PCI patients to improve their health promotion behaviors.