College of Nursing, Suseong University, Daegu, Korea.
College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea.
Contemp Nurse. 2023 Apr;59(2):99-113. doi: 10.1080/10376178.2023.2226252. Epub 2023 Jun 19.
Self-determination theory (SDT) states that the self-care behaviors of patients with chronic illnesses are affected by an autonomy-supportive healthcare climate, satisfaction of autonomy, competence, and relatedness. Autonomy-supportive healthcare climate means to provide interpersonal conditions that support the person's volition, initiative, and integrity.
The aim of this study was to explore the structural relationships of an autonomy-supportive healthcare climate, as well as the perception of illness consequences, autonomy, competence, and relatedness with self-care behaviors among adult outpatients with hypertension.
A cross-sectional survey was conducted in 2020 across three hospitals outpatient clinics in South Korea.
A questionnaire package containing instruments measuring the perception of autonomy-supportive healthcare climate, autonomy, competence, relatedness, perception of illness consequence, self-care behaviors, sociodemographic data, and disease-related characteristics among the patients. The hypothetical model was derived from the SDT. Data were analyzed to test the hypothetical model and propose the final model.
Complete survey data was provided by 228 participants. Overall, the findings supported the hypothesized model (Goodness-of-Fit Index = 0.90 and Comparative Fit Index = 0.99). An autonomy-supportive healthcare climate and autonomy, competence, and relatedness directly influenced the self-care behaviors of adult hypertensive patients. However, the perception of illness consequences did not have a significant direct effect on self-care behavior.
Improving the autonomy-supportive healthcare climate, as well as positive perception of illness consequences, autonomy, competence, and relatedness among patients positively affects self-care behavior. Thus, an authentic partnership between healthcare providers and hypertensive patients is required to enhance trust, cooperation, and adaptation, consequently improving self-care behaviors among patients.
Autonomy-supportive healthcare climate was both directly and indirectly associated with self-care behavior that mediates autonomy, competence, and relatedness among young and middle-aged hypertensive patients.
自我决定理论（SDT）指出，慢性病患者的自我护理行为受到支持自主性的医疗保健氛围、自主、能力和相关感的满意度的影响。支持自主性的医疗保健氛围意味着提供支持个人意志、主动性和完整性的人际条件。
本研究旨在探讨支持自主性的医疗保健氛围的结构关系，以及对疾病后果、自主性、能力和相关感的感知与高血压成年门诊患者自我护理行为之间的关系。
2020 年在韩国的三家医院门诊诊所进行了横断面调查。
问卷包包括测量对支持自主性的医疗保健氛围、自主性、能力、相关感、对疾病后果的感知、自我护理行为、社会人口统计学数据和与疾病相关的特征的仪器。假设模型源自 SDT。分析数据以测试假设模型并提出最终模型。
共有 228 名参与者提供了完整的调查数据。总体而言，研究结果支持假设模型（拟合优度指数=0.90，比较拟合指数=0.99）。支持自主性的医疗保健氛围以及自主性、能力和相关感直接影响成年高血压患者的自我护理行为。然而，对疾病后果的感知对自我护理行为没有显著的直接影响。
改善支持自主性的医疗保健氛围以及患者对疾病后果的积极感知、自主性、能力和相关感会积极影响自我护理行为。因此，需要在医疗保健提供者和高血压患者之间建立真正的伙伴关系，以增强信任、合作和适应性，从而改善患者的自我护理行为。
自主性支持性医疗保健环境与自我护理行为直接相关，自我护理行为则通过自主性、能力和相关性间接影响年轻和中年高血压患者。
