Kim Moon Ja, Lee Eun Nam
Department of Nursing, Dong-Eui Institute of Technology, Busan, Korea.
Department of Nursing, Dong-A University, Busan, Korea.
J Korean Acad Nurs. 2022 Apr;52(2):157-172. doi: 10.4040/jkan.21238.
This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation.
This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data.
The fitness of the hypothetical model met the recommended level (χ²/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level.
The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.
本研究旨在构建并检验一个基于自我决定理论的假设模型,以解释强直性脊柱炎患者运动水平的预测因素和因果路径。构建了一个概念框架,假设医疗保健提供者的自主支持将满足患者的三种基本心理需求,这将增加他们运动的自主动机,从而导致运动的开始和持续。
这项横断面研究纳入了221名在两家三级医院风湿科就诊的强直性脊柱炎患者。使用《医疗保健氛围问卷 - 定期锻炼》《基本心理需求满意度量表》《运动行为调节问卷 - 2》以及运动水平来收集数据。
假设模型的适配度达到了推荐水平(χ²/df≤3,SRMR≤0.08,RMSEA≤0.08,GFI≥0.90,AGFI≥0.85,NFI≥0.90,TLI≥0.90,CFI≥0.90)。模型效应分析表明,医疗保健提供者的自主支持对患者的自主性、能力感、归属感、自主动机和运动水平有积极影响。能力感和归属感分别对自主动机和运动水平有积极影响。自主动机对运动水平有积极影响。
强直性脊柱炎患者运动水平的预测因素是自主动机、医疗保健提供者的自主支持、能力感和归属感。考虑到这些因素,我们建议制定一个有效的计划来提高这些患者的运动水平。