Pan Lihua, Zhang Xia, Wang Sizhe, Zhao Nan, Zhao Ran, Ding Bogui, Li Ying, Miao Wenxue, Fan Hong
101 Longmian Road, School of Nursing, Nanjing Medical University, Nanjing, PR China.
101 Longmian Road, School of Public Health, Nanjing Medical University, Nanjing, PR China.
Int J Clin Health Psychol. 2023 Jan-Apr;23(1):100332. doi: 10.1016/j.ijchp.2022.100332. Epub 2022 Sep 9.
Diabetes self-management (DSM) is essential for patients to achieve better health outcomes. However, previous studies have demonstrated that the performance of DSM is not optimal. This study was designed to identify the significant determinants of self-management behavior in type 2 diabetes(T2DM) patients to improve DSM.
A convenient sampling method was employed in this study. Data were collected from a community health center from January to February 2021 in Nanjing city, China. A total of 431 patients completed the self-administered questionnaires. A structural equation model based on the theory of planned behavior(TPB) was adopted for analysis.
TPB model presents excellent goodness of fit of data. Attitude (β=0.161, < 0.01), subjective norms (SN) (β=0.239, < 0.001), and perceived behavior control (PBC) (β=0.197, < 0.001) were strong predictors of intention. Intention (β=0.230, < 0.001) and PBC (β=0.259, < 0.001) had a direct effect on self-management behavior. The impact of attitude and SN on behavior was significantly mediated via behavioral intention.
The application of TPB to self-management behavior in T2DM patients can significantly enhance our understanding of theory-based self-management behavior. This predictive model could potentially be a valuable tool and provide a feasible approach for formulating more targeted and population-specific DSM interventions in future research.
糖尿病自我管理（DSM）对于患者实现更好的健康结局至关重要。然而，先前的研究表明，DSM的执行情况并不理想。本研究旨在确定2型糖尿病（T2DM）患者自我管理行为的重要决定因素，以改善DSM。
本研究采用便利抽样法。于2021年1月至2月在中国南京市的一个社区卫生中心收集数据。共有431名患者完成了自填式问卷。采用基于计划行为理论（TPB）的结构方程模型进行分析。
TPB模型对数据具有良好的拟合度。态度（β=0.161，<0.01）、主观规范（SN）（β=0.239，<0.001）和感知行为控制（PBC）（β=0.197，<0.001）是行为意向的强有力预测因素。行为意向（β=0.230，<0.001）和PBC（β=0.259，<0.001）对自我管理行为有直接影响。态度和SN对行为的影响通过行为意向显著中介。
将TPB应用于T2DM患者的自我管理行为可以显著增强我们对基于理论的自我管理行为的理解。这种预测模型可能是一种有价值的工具，并为未来研究制定更具针对性和针对特定人群的DSM干预措施提供可行的方法。
