健康素养、自我效能感和结果期望对伊朗2型糖尿病患者自我护理行为依从性的影响
Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes.
作者信息
Reisi Mahnoush, Mostafavi Firoozeh, Javadzade Homamodin, Mahaki Behzad, Tavassoli Elahe, Sharifirad Gholamreza
机构信息
Department of Health Education and Health Promotion, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran.
出版信息
Oman Med J. 2016 Jan;31(1):52-9. doi: 10.5001/omj.2016.10.
OBJECTIVES
Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran.
METHODS
We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire.
RESULTS
Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively.
CONCLUSIONS
This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient's HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance.
目的
健康素养（HL）较高的糖尿病患者可能对自己执行自我护理行为的能力更有信心，并且可能坚信与糖尿病相关的行为会带来特定结果。我们的研究旨在记录伊朗2型糖尿病（T2DM）患者的健康素养、自我效能感、结果期望与糖尿病自我护理之间的关系。
方法
我们对187例T2DM患者进行了一项横断面观察性研究。参与者完成了功能性沟通与批判性健康素养量表、糖尿病自我护理活动总结、糖尿病管理自我效能量表、结果期望问卷和一份人口统计学问卷。
结果
接受糖尿病教育的参与者（t = 5.79，p<0.001）和已婚参与者（F = 3.04，p<0.050）具有更好的糖尿病自我护理行为。自我护理行为与沟通性健康素养（r = 0.455，p<0.010）、批判性健康素养（r = 0.297，p<0.010）、自我效能感（r = 0.512，p<0.010）和结果期望（r = 0.387，p<0.010）之间存在显著正相关。糖尿病教育和婚姻状况占糖尿病自我护理方差的16.9%。自我效能感、结果期望、沟通性和批判性健康素养分别解释了方差的28.0%、1.5%、3.7%和1.4%。
结论
本研究表明，在糖尿病患者教育项目中应考虑自我效能感、结果期望、沟通性和批判性健康素养的潜在影响。我们发现自我效能感是糖尿病自我护理的最重要预测因素。因此，在设计患者教育干预措施时运用自我效能感理论可以增强糖尿病自我护理。医疗保健提供者评估患者的健康素养水平以定制特定健康素养领域的健康相关信息至关重要。这将使患者充分了解并促进赋权，而不仅仅是简单的依从。
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