The mediating role of self-care self-efficacy in the relationship between health behavior and psychological wellbeing among community-dwelling older adults with hypertension

Background Hypertension in older adults is a growing public health issue, often associated with decreased quality of life and increased healthcare demands. Health behaviors, self-efficacy in managing chronic illness, and psychological wellbeing are critical factors in effective hypertension control. Objective To examine the mediating role of self-care self-efficacy in the relationship between health behaviors and psychological wellbeing among community-dwelling older adults with hypertension. Methods A cross-sectional design was used, including 250 older adults attending outpatient geriatric clinics. Data were collected using a demographic questionnaire, the Arabic Geriatrics Health Behavior Questionnaire, the Arabic Self-Care Self-Efficacy Scale (SCSES), and the Psychological Wellbeing Scale. Results Geriatric health behavior correlated positively with self-care self-efficacy and psychological wellbeing. Self-care self-efficacy was strongly associated with wellbeing. Self-care self-efficacy demonstrated a statistically significant partial mediating role between health behaviors and psychological wellbeing; the indirect effect ( β = 0.399, p < 0.001) exceeded the direct effect ( β = 0.140, p = 0.034). Education level showed a positive correlation with wellbeing, while age and longer hypertension duration were negatively correlated. The model explained 28.7% of the variance in self-care self-efficacy and 23.9% in wellbeing. Conclusions and recommendations Self-care self-efficacy plays a partial mediating role between health behaviors and psychological wellbeing in older adults with hypertension. Interventions should enhance self-care self-efficacy and health education while tailoring support to those with lower literacy or longer disease duration. Promoting confidence in self-management may improve wellbeing, treatment adherence, and support healthier aging.