Perceived Stress, Resilience, Perceived Social Support and Self‐Management Behaviour in Young‐ and Middle‐Aged Patients With Multiple Chronic Conditions: A Structural Equation Modelling

AIM: To explore the structural relationships among perceived stress (PS), perceived social support (PSS), resilience and self-management behaviours in young- and middle-aged patients with multiple chronic conditions (MCC). BACKGROUND: Self-management behaviours are essential for young- and middle-aged patients with MCC. However, research specifically focusing on these behaviours in this demographic remains limited. Moreover, the structural relationships among PS, PSS, resilience and self-management behaviours have not yet been analysed within a single hypothesised model. METHODS: A total of 302 young- and middle-aged patients with MCC were recruited from March to June 2023 at a general hospital in Dalian, Liaoning Province. Data on self-management behaviours, resilience, PS and PSS were collected using the Self-Health Management Assessment Scale for Chronic Disease Patients, Connor-Davidson Resilience Scale, Chinese Perceived Stress Scale and Multidimensional Scale of Perceived Social Support. Structural equation modelling was employed to test the study's hypotheses. This cross-sectional study was reported in accordance with STROBE guidelines. RESULTS: The findings revealed that PS was negatively associated with resilience, PSS and self-management behaviours. PS demonstrated an indirect relationship with self-management behaviours through resilience and PSS. Resilience was found to positively influence both self-management behaviours and PSS. PSS was positively correlated with self-management behaviours. CONCLUSIONS: This study confirmed the structural relationships among the four variables under investigation. Resilience and PSS were identified as mediators between PS and self-management behaviours. RELEVANCE TO CLINICAL PRACTICE: The findings offer practical guidance for improving self-management behaviours in young- and middle-aged patients with MCC. Interventions should aim to reduce PS and strengthen both resilience and PSS. Nursing approaches should incorporate individualised psychological care, organised disease management and family engagement in treatment. These strategies may support psychological stability, reinforce resilience and support systems and sustain commitment to self-management behaviours. PATIENT OR PUBLIC CONTRIBUTION: Patients contributed by participating in the study and completing the questionnaire.