Presseau Justin, Johnston Marie, Francis Jill J, Hrisos Susan, Stamp Elaine, Steen Nick, Hawthorne Gillian, Grimshaw Jeremy M, Elovainio Marko, Hunter Margaret, Eccles Martin P
Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK,
J Behav Med. 2014 Aug;37(4):607-20. doi: 10.1007/s10865-013-9513-x. Epub 2013 May 14.
Behavioral theory is often tested on one behavior in isolation from other behaviors and theories. We aimed to test the predictive validity of constructs from motivation and action theories of behavior across six diabetes-related clinician behaviors, within the same sample of primary care clinicians. Physicians and nurses (n = 427 from 99 practices in the United Kingdom) completed questionnaires at baseline and 12 months.
six self-reported clinician behaviors related to advising, prescribing and examining measured at 12 months; secondary outcomes: baseline intention and patient-scenario-based simulated behavior. Across six behaviors, each theory accounted for a medium amount of variance for 12-month behavior (median R adj (2) = 0.15), large and medium amount of variance for two intention measures (median R adj (2) = 0.66; 0.34), and small amount of variance for simulated behavior (median R adj (2) = 0.05). Intention/proximal goals, self-efficacy, and habit predicted all behaviors. Constructs from social cognitive theory (self-efficacy), learning theory (habit) and action and coping planning consistently predicted multiple clinician behaviors and should be targeted by quality improvement interventions.
行为理论通常是针对一种行为进行测试，与其他行为和理论相隔离。我们旨在检验行为动机理论和行动理论中的构念在同一组初级保健临床医生样本中对六种糖尿病相关临床医生行为的预测效度。医生和护士（来自英国99家医疗机构的427人）在基线期和12个月时完成问卷调查。
12个月时自我报告的六种与建议、开处方和检查相关的临床医生行为；次要结局：基线期意向和基于患者情景的模拟行为。在六种行为中，每种理论对12个月时的行为解释了中等程度的方差（调整后R²中位数 = 0.15），对两种意向测量解释了较大和中等程度的方差（调整后R²中位数 = 0.66；0.34），对模拟行为解释了较小程度的方差（调整后R²中位数 = 0.05）。意向/近端目标、自我效能感和习惯预测了所有行为。社会认知理论（自我效能感）、学习理论（习惯）以及行动和应对计划中的构念一致地预测了多种临床医生行为，质量改进干预措施应针对这些构念。
