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健康信念在影响患者慢性糖尿病并发症筛查中的作用:基于健康信念模型的路径分析。

The role of health beliefs in affecting patients' chronic diabetic complication screening: a path analysis based on the health belief model.

机构信息

West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China.

Department of Cardiothoracic Surgery, Yichang Central People, Hospital, Yichang, China.

出版信息

J Clin Nurs. 2021 Oct;30(19-20):2948-2959. doi: 10.1111/jocn.15802. Epub 2021 May 5.

Abstract

AIMS AND OBJECTIVES

To explore the role of health beliefs in affecting patients' chronic diabetic complication (CDC) screening.

BACKGROUND

Patients' adherence to the guideline-recommended CDC screening was far from optimal. While many demographic and clinical characteristics were documented to influence patients' adherence, psychological profiles, such as health beliefs, were not well studied before. It is crucial to understand how health beliefs affect patients' CDC screening behaviour and thus to provide implications for future intervention programmes.

DESIGN

A cross-sectional study was conducted.

METHODS

785 type 2 diabetes were enrolled from the community health centre in Wuhou District, Chengdu, China. Structured questionnaires were used to collect data regarding the demographic and clinical information, knowledge about CDC, health belief model constructs and CDC screening behaviour. Mediation analysis was performed to explore the mechanisms of health belief model constructs on CDC screening behaviour. The study methods were compliant with the STROBE checklist.

RESULTS

Knowledge had a significant indirect effect on CDC screening behaviour through perceived susceptibility, perceived benefits, perceived barriers and self-efficiency. Cues to action exerted both significant direct and indirect effects on CDC screening behaviour. The indirect effects of cues to action were exerted through perceived susceptibility, perceived barriers and self-efficiency.

CONCLUSION

Health beliefs played vital roles in mediating the effects of knowledge and cues to action on patients' CDC screening behaviour. Health beliefs should be assessed and modified through creative educational methods. Strategies aimed at increasing cues to action are also expected to facilitate patients' CDC screening behaviour.

RELEVANCE TO CLINICAL PRACTICES

The study contributes to the exploration of how health beliefs affect patients' CDC screening behaviour. The results could be used to inspire future community-based intervention programmes.

摘要

目的和目标

探讨健康信念在影响患者慢性糖尿病并发症(CDC)筛查中的作用。

背景

患者对指南推荐的 CDC 筛查的依从性远不理想。虽然已经记录了许多人口统计学和临床特征会影响患者的依从性,但之前对心理特征(如健康信念)的研究并不充分。了解健康信念如何影响患者的 CDC 筛查行为至关重要,从而为未来的干预计划提供启示。

设计

进行了一项横断面研究。

方法

从中国成都市武侯区社区卫生中心招募了 785 名 2 型糖尿病患者。使用结构化问卷收集有关人口统计学和临床信息、CDC 知识、健康信念模型结构和 CDC 筛查行为的数据。进行中介分析以探讨健康信念模型结构对 CDC 筛查行为的作用机制。该研究方法符合 STROBE 清单。

结果

知识通过感知易感性、感知益处、感知障碍和自我效能对 CDC 筛查行为有显著的间接影响。提示因素对 CDC 筛查行为有显著的直接和间接影响。提示因素的间接影响是通过感知易感性、感知障碍和自我效能来发挥作用的。

结论

健康信念在调节知识和提示因素对患者 CDC 筛查行为的影响方面发挥了重要作用。应通过创造性的教育方法评估和改变健康信念。预计增加提示因素的策略也将促进患者的 CDC 筛查行为。

临床相关性

本研究有助于探索健康信念如何影响患者的 CDC 筛查行为。研究结果可用于启发未来基于社区的干预计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cbe/8453575/6192b20f5bfa/JOCN-30-2948-g001.jpg

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