Relationships between oral health-related self-efficacy, oral health literacy, social support, and illness perception among patients with periodontitis: a moderated mediation model

TL;DR

This study explores how self-efficacy, social support, and illness perception relate to oral health literacy in periodontitis patients.

Contribution

It introduces a moderated mediation model to explain these relationships and identifies self-efficacy and social support as key factors.

Findings

Oral health-related self-efficacy directly improves oral health literacy.

Social support partially mediates the relationship between self-efficacy and oral health literacy.

Illness perception does not significantly moderate these relationships.

Abstract

To assess oral-health literacy and test a conceptual model of the relationships among oral health-related self-efficacy, social support, illness perception, and oral-health literacy in patients with periodontitis.

This cross-sectional study recruited 230 eligible adult periodontitis patients by convenience sampling at the Department of Periodontology, Fourth Military Medical University (Xi’an) from March to July 2024. Participants completed validated Chinese versions of the short-form Health Literacy Dental Scale, the Self-efficacy Scale for Self-care, the Social Support Rating Scale, and the Brief Illness Perception Questionnaire. Data analysis included descriptive statistics, nonparametric tests, correlation analysis, and Hayes’s PROCESS macro (Model 4 and Model 7) to test for social support’s mediation and illness perception’s moderation.

The study included 230 participants (121 males, 52.6%; 109 females, 47.4%), with a mean age of 39.27 ± 11.85 years. The health literacy score for periodontitis patients was 42.00 (34.00, 52.00). The direct effect of oral health-related self-efficacy on oral-health literacy was significant (β = 0.2367, 95% CI [confidence interval] = [0.1176~0.3558]), and social support played a partial mediating role between oral health-related self-efficacy and oral-health literacy (β = 0.0526, 95% CI = [0.0153~0.0980]). Illness perception did not significantly moderate the relationship between oral health-related self-efficacy and social support (β = -0.0061, 95% CI = [-0.0133, 0.0010]).

This study assessed oral-health literacy at a moderate level in periodontitis patients. The tested model was partially supported: self-efficacy directly improved oral-health literacy, and social support partially mediated this relationship. Illness perception did not moderate the pathway. Therefore, self-efficacy and social support are primary targets for improving oral-health literacy.

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