How does patient-centred communication reduce chronic disease risk in adults? exploring the sequential mediation of personal electronic health records and health literacy Authors Jinran Li Department of Plastic and Cosmetic Surgery, Army Medical Center, Daping Hospital, Army Medical University, Chongqing, China Yingxia Zhu Department of Communication, University of Macao, Taipa, Macao Liuchang Tan Department of Plastic and Cosmetic Surgery, Army Medical Center, Daping Hospital, Army Medical University, Chongqing, China DOI: https://doi.org/10.47391/JPMA.30041 Keywords: Patient-centred communication, Electronic health record use, Health literacy, Chronic disease Abstract Objective: To investigate the mediating roles of personal electronic health record usage and health literacy in the relationship between patient-centred communication and chronic diseases. Method: The study was conducted at Chongqing, China from September 2024 to December 2024, and used secondary data from the Health Information National Trends Survey related to adults aged 18 and above. Guided by the conceptual framework from patient-centred communication pathway models, the sequential mediating roles of behavioural and cognitive factors in the relationship between PCC and chronic disease were examined. Data was analysed using SPSS 27. Results: A negative association was found between the individual's patient-centred communication scale and chronic diseases (p<0.001). Furthermore, patient-centred communication was negatively associated with chronic diseases through the serial mediation of personal electronic health record usage and health literacy (bp=-0.001, 95% confidence interval: -0.002--0.0004). Conclusion: Both personal electronic health record usage and health literacy sequentially mediated the relationship between patient-centred communication and chronic disease, highlighting the importance of these factors in enhancing health outcomes. Key Words: Patient-centred communication, Electronic health record use, Health literacy, Chronic disease. Downloads Full Text Article Published 2026-04-20 How to Cite Li, J., Yingxia Zhu, & Tan, L. (2026). How does patient-centred communication reduce chronic disease risk in adults? exploring the sequential mediation of personal electronic health records and health literacy. Journal of the Pakistan Medical Association, 76(05), 721–727. https://doi.org/10.47391/JPMA.30041 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 76 No. 05 (2026): MAY Section RESEARCH ARTICLE License Copyright (c) 2026 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.