College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
Diabetes Res Clin Pract. 2020 Mar;161:108043. doi: 10.1016/j.diabres.2020.108043. Epub 2020 Jan 30.
To evaluate the effect of positive and negative message framing in diabetes education on attitudes, perceived control, and behavioral intentions toward diabetes self-care, and to identify potential moderating effects of health literacy on message framing.
A total of 52 patients with type 2 diabetes that visited an ambulatory endocrinology wing at a university hospital in Korea were randomized into positive or negative message framing groups. Each group watched a 10-minute video that was either positively or negatively framed, accentuating desirable outcomes from good diabetes self-care in the former and undesirable outcomes from inadequate diabetes self-care in the latter. Two-way ANCOVA controlling for HbA1C was conducted to evaluate outcomes.
Patients who watched the negatively framed message showed significantly more favorable attitudes and perceived control toward diabetes self-care than those who viewed the positively framed message. Message framing had significant indirect effects on behavioral intentions for diabetes self-care that were mediated by attitudes and perceived control. Conversely, no significant interaction effects were observed between health literacy level and message framing of these same markers.
The use of negative message framing in diabetes education is a promising strategy for shaping favorable attitudes, beliefs, and intentions toward diabetes self-care behavior.
评估糖尿病教育中积极和消极信息框架对糖尿病自我护理态度、感知控制和行为意向的影响，并确定健康素养对信息框架的潜在调节作用。
韩国一所大学附属医院的门诊内分泌科共随机分配 52 例 2 型糖尿病患者进入积极或消极信息框架组。每组观看时长为 10 分钟的视频，内容分别为积极或消极信息框架，前者强调良好的糖尿病自我护理可带来理想的结果，后者则强调糖尿病自我护理不足可能带来的不良后果。采用双向协方差分析（ANCOVA）控制糖化血红蛋白（HbA1C），以评估结果。
观看消极信息框架视频的患者对糖尿病自我护理的态度和感知控制明显优于观看积极信息框架视频的患者。信息框架对糖尿病自我护理行为意向有显著的间接影响，这种影响是通过态度和感知控制来介导的。相反，健康素养水平和信息框架对这些标记物的交互作用均不显著。
在糖尿病教育中使用消极信息框架是一种很有前途的策略，可以帮助形成对糖尿病自我护理行为的有利态度、信念和意向。
