<![CDATA[Dietary adherence is an essential component of hypertension control but is influenced by social and psychological factors. Family support may assist patients through emotional, informational, instrumental, and appraisal support, whereas self-efficacy reflects patients’ confidence in maintaining recommended dietary behaviors. This study aimed to analyze the mediating role of self-efficacy in the relationship between family support and dietary adherence among patients with hypertension. A quantitative analytical observational study with a cross-sectional design was conducted among 210 patients with hypertension. Data were collected using validated and reliable questionnaires measuring family support, self-efficacy, and dietary adherence. Pearson correlation and mediation regression with 5,000 bootstrap samples were applied while controlling for demographic and clinical characteristics. Family support was positively associated with self-efficacy and dietary adherence. Self-efficacy showed the strongest positive association with dietary adherence. Mediation analysis indicated a significant indirect effect of family support on dietary adherence through self-efficacy, demonstrating partial mediation. The indirect effect was 0.16, with a 95% confidence interval from 0.10 to 0.23, while the model explained 41.8% of the variance in dietary adherence after covariates were included. Self-efficacy is an important psychological mechanism linking family support to dietary adherence. Hypertension interventions should involve family members while strengthening patients’ confidence through education, goal setting, problem solving, behavioral monitoring, and reinforcement of progress. This integrated approach may promote more independent, consistent, and sustainable dietary adherence over time.]]>
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