[1]刘玮楚,王攀,罗业涛,等.基于健康信念模式的冠心病患者自我管理行为模型构建及实证研究[J].第三军医大学学报,2020,42(09):953-958.
 LIU Weichu,WANG Pan,LUO Yetao,et al.Self-management behaviors of patients with coronary atherosclerotic heart disease based on health belief model: model building and empirical study [J].J Third Mil Med Univ,2020,42(09):953-958.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第09期
页码:
953-958
栏目:
公共卫生与预防医学
出版日期:
2020-05-15

文章信息/Info

Title:
Self-management behaviors of patients with coronary atherosclerotic heart disease based on health belief model: model building and empirical study 
作者:
刘玮楚王攀罗业涛王俊赵庆华
重庆医科大学附属第一医院:妇科,护理部;中国人民大学健康科学研究所;重庆医科大学附属儿童医院,儿科研究所
Author(s):
LIU Weichu WANG Pan LUO Yetao WANG Jun ZHAO Qinghua
Department of Gynecology, 4Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016; 2Institute of Health Science Research, Renmin University of China, Beijing, 100872; 3Institute of Pediatrics, Children’s Hospital of  Chongqing Medical University, Chongqing, 400014, China
 
关键词:
健康信念模式冠心病自我管理影响因素分析结构方程模型
Keywords:
health belief model coronary atherosclerotic heart disease self-management root cause analysis structural equation model
分类号:
R192; R492; R541.4
文献标志码:
A
摘要:

目的基于健康信念模式构建冠心病患者自我管理行为模型并进行实证研究。方法采用横断面调查的方法,使用一般情况调查表、社会支持评定量表、冠心病健康素养调查问卷、慢性病自我效能量表和冠心病自我管理量表,于2017年11月至2018年4月对重庆市3家三级甲等医院的280例住院冠心病患者进行问卷调查,并基于结构方程模型分析验证冠心病患者自我管理行为理论模型中各因素间的作用机制。结果回收有效问卷276份(98.57%),冠心病患者自我管理行为总分为(81.49±13.83)分;相关性分析显示:社会支持、健康素养、自我效能得分与自我管理得分均呈正相关(r=0.229、0.499、0.341,P<0.001);结构方程模型显示:冠心病患者自我管理行为模型拟合较好,影响自我管理行为的因素按作用大小排序为:健康素养(0.533)、自我效能(0.431)、社会支持(0.398)、合并症数目(0.257)、文化程度(0.165)、年龄(-0.115)、个人月平均收入(0.079),提示社会支持对自我管理行为仅有间接正向效应(β=0.398),健康素养对自我管理行为有直接(β=0.452,P<0.001)和间接正向效应(β=0.081),自我效能对自我管理行为有直接正向效应(β=0.431,P<0.001)。结论冠心病患者自我管理行为处于中等偏下水平,基于健康信念模式的冠心病患者自我管理行为模型具有较好的解释和预测作用。

Abstract:

ObjectiveTo establish a model of self-management behaviors for patients with coronary atherosclerotic heart disease based on the theory of health belief model and conduct an empirical study to verify the validity and performance of the model.  MethodsWe conducted a cross-sectional questionnaire survey among 280 patients with coronary heart disease from 3 general hospitals in Chongqing during the period from November, 2017 to April, 2018. The general condition questionnaire, social support rating scale, coronary heart disease health literacy questionnaire, chronic disease self-efficacy scale and coronary heart disease self-management scale were used in the survey. The factors in the theoretical model that potentially affected self-management behaviors of the patients were analyzed based on the structural equation model. ResultsBased on 276 valid questionnaires retrieved (98.57%), the total mean score of self-management behaviors of the patients with coronary heart disease was 81.49±13.83. Correlation analysis revealed that the scores for social support, health literacy and self-efficacy were positively correlated with the scores for self-management (r=0.229, 0.499, and 0.341, respectively; P<0.001). The structural equation model demonstrated that the model of self-management behaviors was well fitted in patients with coronary heart disease. The factors affecting self-management behaviors included health literacy (0.533), self-efficacy (0.431), social support (0.398), number of complications (0.257), education level (0.165), age (-0.115), and average monthly personal income (0.079). The model also showed that social support had only an indirect positive effect (β=0.398), health literacy had both direct (β=0.452, P<0.001) and indirect positive effects (β=0.081), and self-efficacy had a direct positive effect on self-management behaviors (β=0.431, P<0.001). ConclusionThe patients with coronary heart disease have moderate to low levels of self-management behaviors. The self-management behavior model constructed based on the health belief model has good interpretative and predictive effects in patients with coronary heart disease.

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更新日期/Last Update: 2020-05-06