Chronic Illness Resource Utilization as a Mediator Between Perceived Control and Health Empowerment in Patients With Coronary Heart Disease

BACKGROUND: Coronary heart disease (CHD) remains a major global health challenge that requires patients to sustain self-management efforts beyond acute clinical treatment. Within empowerment-oriented approaches to chronic disease care, perceived control and chronic illness resource utilization have been increasingly recognized as important psychosocial constructs that may influence patients' engagement in long-term health management. However, how these constructs interact-and the extent to which they contribute to health empowerment among individuals with CHD-has not been clearly established. OBJECTIVE: This study examined the levels of perceived control, chronic illness resource utilization, and health empowerment among patients with CHD, and further explored how perceived control influences health empowerment both directly and indirectly through chronic illness resource utilization. METHODS: From August 2022 to February 2023, 324 coronary heart disease patients were recruited from 2 tertiary hospitals in Chengdu, China. Data were collected using validated questionnaires: the revised Control Attitudes Scale, Chronic Illness Resource Survey, and Patient Perception Empowerment Scale. Pearson correlations and structural equation modeling were applied. RESULTS: Perceived control and health empowerment were moderately high, while resource utilization was moderately low. Both perceived control and resource utilization were positively associated with health empowerment. Resource utilization partially mediated the relationship between perceived control and empowerment. CONCLUSIONS: Perceived control and chronic disease resource utilization are key positive predictors of health empowerment. Enhancing patients' control beliefs and promoting access to health resources may jointly support empowerment and better self-management outcomes.